Tethered Acne Scar

A photo of facial acne.

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What are acne scars?

Acne scars are permanent textural changes and indentations that occur on the skin as a result of severe acne. The term “scarring” is not used for the temporary red and brown marks left early after acne has occurred as these marks will almost always improve without treatment.

Scarring as a result of acne can cause significant psychological distress. However, not all acne scars are true scars. Pseudo-scars are non-permanent reddish macules that are the final stage of inflamed acne lesions. These disappear in about six months.

In acne, the scarring is caused by an inflammatory response to the sebum, dead cells and bacteria present in the comedone. Dermal fibrosis occurs as a result. Some patients scar more easily than others.

Treatment options


When assessing scars, it is important to check whether they are tethered. This can be done by stretching the skin; if the scar flattens, it is not tethered. Tethering implies a fibrotic connection into the lower dermis, which requires additional treatment. A range of treatments are available for acne scarring and often, several techniques are required.



Some scar areas may be anchored to deeper structures. A number of methods can be used to treat rolling scars and tethered scars including subcision, fractional laser resurfacing, radiofrequency and dermal fillers. The basis behind scar revision is to free up bound scars and fill up depressions with collagen. This form of acne scarring will usually require several treatments for the best possible outcome.

“At the end of the day, the real take-home is prevention: don’t pick at pimples, don’t leave aggressive acne untreated and see your doctor if you’re getting acne that’s leaving marks on your skin.”


Book your appointment today with Tangchitnob MD!

Dr. Edward Tangchitnob

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