Medically reviewed by Dr Sin Yong · Last reviewed · 3 min read
For the other shapes and how each is treated, see acne scar types.
Published 13 October 2026 · Reviewed by Dr Sin Yong
Rolling scar is the term for a broad, shallow acne scar with sloping edges that gives the skin a wave-like, undulating surface rather than a sharp pit. Rolling scars are usually wider than 4 to 5 mm and are tethered from beneath by fibrous bands pulling the skin down to deeper tissue. That band, not the surface, is what has to be addressed, which is why a rolling scar is a subcision problem before it is a laser problem.
Key facts
Shape
Broad, wave-like undulation with soft, sloping edges
Cause of the dip
Fibrous bands tethering the skin to deeper tissue
Usually approached by
Subcision to divide the bands, then volume support or resurfacing once the skin is free
Stretch test
A scar that stays pinned while the skin around it stretches is being held down from below
Where rolling scars matter on this site
A rolling scar in cross-section is a shallow wave with a fibrous band running from its floor down to the deeper tissue. That band is why the term appears wherever this site explains plateaus: the scars that improved were the surface ones, and the ones that stayed were being held down.
A rolling scar is a band before it is a surface; I will not resurface a dimple that is still being held down.— Dr Sin Yong
Rolling scars treatment: the dedicated page, with subcision as the foundation step and surface work afterwards.
Subcision: how the band is divided beneath the scar, and what is done to stop it re-forming.
Subcision with filler: the pairing used when a volume deficit sits beneath a released scar.
4D Scar Reconstruction: the programme in which tethers are released first, support follows, and texture is treated last.
Secret RF: the RF microneedling platform added for shallow rolling scars and overall skin quality once the skin is free.
The order is not negotiable in Dr Sin Yong's practice: release, then support where needed, then surface. The subcision vs laser comparison explains why reversing it wastes the laser.
Not to be confused with
Rolling scars are the most misread of the atrophic shapes because, from a distance, they look like uneven skin rather than scarring.
Boxcar scars. Defined edges and a flat floor. A boxcar is a resurfacing problem first; a rolling scar is a subcision problem first.
Ice-pick scars. Narrow and deep rather than broad and shallow, and treated at the floor with acid rather than from beneath.
Tethered scars. Almost every rolling scar is tethered, but the term is wider: a boxcar can be tethered too. Tethering is the mechanism; rolling is the shape.
Volume loss. A hollow cheek can make rolling scars look worse and can be mistaken for them. Dr Sin Yong maps fat against scar with ultrasound, because the hollow is treated with support and the scar with release.
Uneven texture. Coarse texture and enlarged pores flatten on stretching; a rolling scar does not.
A photograph flattens the wave, so the diagnosis is made in the room with the skin stretched and the face in motion.
What decides whether a rolling scar matters for you
The questions that decide the plan are about the band, the skin above it and what sits beneath.
Does the scar stay pinned? The stretch test and animation show whether a tether is present. If the dimple flattens fully on stretching, it may be a surface problem after all.
Is there a deficit beneath? If the floor stays low once released, support with filler or a biostimulator is planned; if not, the surface is treated directly.
How much of the face is involved? A few isolated waves are released individually; a broad field is treated in stages so that the skin is not over-handled.
Skin type and bruising. Subcision bruises, and in Fitzpatrick III to V skin any inflammation can darken, so the post-inflammatory hyperpigmentation risk is managed from the start.
Is the acne quiet? Active acne means new tethers can form, so control comes first.
Rolling scars are the atrophic acne scar type most likely to plateau under lasers and radiofrequency, because both act on the dermis from above while the tether sits beneath it. In Dr Sin Yong's sequence the tether is released first by subcision, a fine needle or blunt cannula passed beneath the scar to divide the bands, and only then is the surface treated. For shallow rolling scars and overall skin quality, Secret RF microneedling is added; deeper or mixed scarring moves to the S3 Resurfacing Lift. The classification and the full plan are on the acne scar treatment guide. Resurfacing a still-tethered rolling scar polishes a dimple that is being held down.
Usually because the tether beneath them was never released. Lasers and radiofrequency act on the dermis from above, while the fibrous band that pulls a rolling scar down sits beneath it. Resurfacing a still-tethered scar polishes a dimple that is being held in place. Subcision divides the band first; once the skin is free, the surface treatment has something to work with.
The number of releases depends on how many scars are tethered and how the skin responds, so it is planned scar by scar and reviewed rather than set in advance. Dr Sin Yong releases the bands beneath the scars he has identified by stretch and animation, assesses whether support is needed beneath any floor that stays low, and only then schedules surface treatment.
A rolling scar has soft, sloping edges and a wave-like outline; a boxcar scar has a flat floor and defined, steep walls. Rolling scars are nearly always tethered from beneath, boxcar scars only sometimes.
It is used for shallow rolling scars and texture, and it remodels the dermis well. It does not lift a tethered scar on its own; the tether is released by subcision first, then the surface is treated.
References
Kumar N, et al. Effectiveness of radiofrequency microneedling in the treatment of dermatological conditions: a systematic review. Aesthetic Plast Surg. 2026. doi:10.1007/s00266-026-05834-y (PMID 42047762). source
Syder NC, Chen A, Elbuluk N. Radiofrequency and radiofrequency microneedling in skin of color: a review of usage, safety, and efficacy. Dermatol Surg. 2023;49:489. doi:10.1097/DSS.0000000000003733 (PMID 36826381). source
Subcutaneous incisionless (subcision) surgery for the correction of depressed scars and wrinkles. Dermatologic Surgery (PubMed), 1995. pubmed.ncbi.nlm.nih.gov
Acne scars: pathogenesis, classification and treatment. Dermatology Research and Practice (PMC), 2010. pmc.ncbi.nlm.nih.gov
Acne Scarring: A Classification System and Review of Treatment Options. Journal of the American Academy of Dermatology (PubMed), 2001. pubmed.ncbi.nlm.nih.gov
Evidence-Based Management of Cutaneous Scarring in Dermatology Part 2: Atrophic Acne Scarring. Archives of Dermatological Research (PubMed), 2023. pubmed.ncbi.nlm.nih.gov
