Kamal Ghorui
NEW DELHI: If you’ve spent money on creams, peels or lasers and your acne scars still refuse to fade, the issue may not be the treatment — it may be how deep the scars actually go.A new study by doctors at Delhi’s ABVIMS and Ram Manohar Lohia Hospital shows that acne scars are far more than a surface problem. They can run nearly 2 millimetres deep into the skin — deeper than many treatments are designed to reach.That is why results are often uneven. The research looked at different types of scars under the microscope. The narrow, pin-like ice-pick scars turned out to be the deepest. Broader boxcar and wavy rolling scars were slightly less deep, but still extended well below the upper layers of skin.Explaining the findings, one of the authors, Dr Kabir Sardana from RML’s dermatology department said, “We did a pilot study to assess how deep acne scars are as part of a thesis. We found that some scars are deep like ice picks and may not respond to lasers.”This depth mismatch is crucial. Many commonly used treatments work only on the top layers. If they don’t reach the base of the scar, the dent remains — even if the surface looks temporarily smoother.Dr Sardana added that the findings have practical implications: “One needs to know and tell patients that some scars may not completely go with even lasers. Also, laser dose can be tweaked to achieve a depth that reaches deep scars.”The study also shows that scarred skin is not just “damaged” — it is structurally altered. Collagen becomes disorganised, elastic fibres shrink, and normal structures like hair follicles and oil glands are largely lost. There are even signs of ongoing inflammation, suggesting scars are not fully inactive. The skin doesn’t return to how it was before. It heals by forming new tissue in a different way, which is why scars or uneven marks can appear, said doctors.The findings are particularly relevant for Indians and others with darker skin, where acne scarring is common and treatment carries a higher risk of pigmentation.Dr Abhinav Bansal from RML said that there is no one-size-fits-all fix. Each scar type needs a different approach, and treatment must go as deep as the scar itself.So if your acne scars aren’t improving, it may not be about trying harder — it may be about treating smarter.
