New Delhi: If you’ve spent money on creams, peels or laser treatments and your acne scars still refuse to fade, the issue may not be the treatment but how deep the scars actually are.A new study conducted by doctors at Delhi’s ABVIMS and Ram Manohar Lohia Hospital suggests that acne scars are not just a superficial problem. They can penetrate nearly 2 millimeters into the skin – deeper than many treatments are designed for.That’s why results are often mixed. The study looked at different types of scars under a microscope. Narrow, needle-shaped ice pick scars are the deepest. Wider boxcar and undulating rolling scars are slightly less deep but still extend below the upper layers of skin.Explaining the findings, study co-author Dr. Kabir Sardana of RML’s Department of Dermatology said: “As part of the paper, we conducted a pilot study to assess the depth of acne scars. We found that some scars are as deep as an ice pick and may not respond to laser.”This deep mismatch is crucial. Many common treatments only work on the top layer. If they don’t reach the base of the scar, the dents will remain—even if the surface appears temporarily smoother.Dr. Sadana added that these findings have practical implications: “People need to be aware and educate patients that some scars may not disappear completely even with laser. Additionally, the laser dose can be adjusted to achieve the depth required to reach deep scars.”Research also shows that scarred skin isn’t just “damaged”—its structure is also altered. Collagen becomes disordered, elastic fibers shrink, and normal structures such as hair follicles and oil glands are lost. There are even signs of ongoing inflammation, indicating that the scar has not completely lost its activity. The skin has not returned to its previous appearance. Doctors say it heals by forming new tissue in different ways, which is why scarring or uneven marks appear.The findings are particularly important for Indians and other people with darker skin tones, where acne scarring is common and the risk of developing hyperpigmentation after treatment is higher.Dr Abhinav Bansal of RML said there is no one-size-fits-all solution. Each scar type requires a different approach, and treatment must go deep into the scar itself.So if your acne scars aren’t improving, it’s probably not because you’re trying harder, but because you need to treat them smarter.
