The small holes left behind after pimples heal are indentations where your skin lost collagen during the inflammatory process. Whether yours look like tiny deep pits or wider shallow dips, closing them requires rebuilding that lost collagen, and the approach depends on how deep the damage goes. Fresh wounds from a recently popped pimple can still heal flat with proper care, while older, settled scars need more active intervention.
Why Pimples Leave Holes
When your skin fights off an inflamed pimple, it breaks down and rebuilds collagen in the damaged area. If that process goes wrong, the new tissue sits below the surface instead of filling in flush. The result is a depressed, or atrophic, scar. The longer and more severe the inflammation, the more collagen gets destroyed, and the deeper the hole.
These indentations fall into three types. Ice pick scars are narrow, V-shaped pits no wider than 2 mm that can extend deep into the skin. Boxcar scars are wider (1.5 to 4 mm), round or oval with sharp vertical edges, shaped like a U or square. Rolling scars have sloped edges that create a wavy, uneven texture. Ice pick scars are the hardest to close because of their depth and narrow shape. Boxcar and rolling scars respond better to surface-level treatments because there’s more skin at the base to work with.
If the “hole” you’re seeing is actually an enlarged pore rather than a scar, the approach is different. Enlarged pores haven’t lost collagen. They just stretch open from excess oil production or loss of skin elasticity. A 4% niacinamide product can visibly reduce pore size and skin unevenness within about 8 weeks, with continued improvement in elasticity by 12 weeks.
If the Pimple Just Popped: Prevent the Hole
You have a window right after a pimple opens or is extracted to minimize scarring. The single most important step is keeping the wound moist. A moist healing environment activates collagen synthesis, speeds up the migration of new skin cells across the wound, and directly reduces scarring compared to letting the area dry out and scab over.
After gently cleaning the spot, apply a thin layer of petroleum jelly or a hydrocolloid patch (the small, clear “pimple patches” sold at most drugstores). These create an occlusive barrier that locks in moisture without trapping harmful bacteria. Despite old concerns that covering wounds would breed infection, research has consistently shown moist wound care is safe and produces better outcomes. The key is applying this environment as soon as possible after injury, since early continuous moisture reduces tissue loss significantly.
Leave the area alone. Don’t pick at the edges or peel off forming skin. Mechanical manipulation of healing tissue creates a different, harder-to-treat type of damage.
Topical Treatments for Shallow Holes
For indentations that have already healed but are relatively shallow, topical retinoids are the strongest evidence-backed option you can use at home. Retinoids (tretinoin by prescription, adapalene over the counter) work by stimulating your skin to produce new collagen while slowing the breakdown of existing collagen. Over time, that new collagen can partially fill in depressed areas. Clinical studies confirm that retinoids reverse epidermal thinning and increase collagen synthesis in the skin.
Results are gradual. Your skin’s remodeling phase actively produces new collagen for about 4 to 5 weeks after any stimulus, then spends up to a year replacing the initial soft collagen with stronger, more permanent tissue. This means you won’t see meaningful improvement from retinoids for at least 2 to 3 months, and the full effect can take closer to a year of consistent use. Start with a low concentration a few nights per week to let your skin adjust, then increase frequency.
Pairing a retinoid with a product containing niacinamide can help on multiple fronts. Niacinamide improves skin elasticity, reduces uneven texture, and is gentle enough to use alongside retinoids without added irritation.
Professional Treatments for Deeper Scars
When topical products aren’t enough, in-office procedures can trigger much more aggressive collagen rebuilding. The right choice depends on the type and depth of your scars.
Microneedling
A device studded with fine needles creates hundreds of controlled micro-injuries in the scarred skin, prompting your body to flood the area with new collagen as it heals. Microneedling works well for rolling and shallow boxcar scars. Sessions typically cost upward of $500 each, and most people need multiple treatments spaced several weeks apart. Results build gradually as collagen matures over the following months.
Fractional CO2 Laser
Laser resurfacing delivers more dramatic results than microneedling, particularly for moderate to severe scarring. Fractional CO2 lasers have been shown to produce around 50% improvement in scar appearance, and randomized studies have found them statistically superior to microneedling for texture, pigmentation, and contour. Sessions run between $800 and $1,500 each, with multiple sessions typically needed. Recovery involves redness and peeling for a week or more.
TCA CROSS for Ice Pick Scars
Deep, narrow ice pick scars don’t respond well to broad surface treatments. A technique called CROSS (chemical reconstruction of skin scars) uses a high concentration of trichloroacetic acid applied precisely inside each individual scar with a fine wooden applicator. The acid triggers intense, localized inflammation that forces the body to produce collagen from the bottom of the pit upward, gradually raising the depressed area. In one study, 8 out of 10 patients saw greater than 70% improvement after four sessions spaced two weeks apart, and the remaining two patients saw 50 to 70% improvement. This is a professional procedure, not something to attempt at home.
Punch Excision and Grafting
For the deepest scars that don’t respond to other methods, a dermatologist can physically cut out the scar using a small round tool matched to its size, then either stitch the tiny wound closed or fill it with a skin graft taken from behind the ear. This essentially replaces the scarred tissue with normal skin. Bruising lasts one to two weeks, and the wound site requires daily cleaning and bandage changes. Punch excision is sometimes combined with laser resurfacing afterward to blend the treated area with surrounding skin.
Dermal Fillers
If you want immediate visible improvement while pursuing longer-term collagen treatments, hyaluronic acid fillers can be injected beneath individual scars to physically push the depressed skin up to the surrounding surface level. Multiple studies show consistent improvement in acne scar appearance with minimal side effects. The tradeoff is that results are temporary, lasting up to 18 months before the filler is absorbed and the indentation gradually returns.
How Long Closing a Scar Actually Takes
No matter which method you choose, your skin’s biology sets the pace. After any collagen-stimulating treatment, active collagen production continues for 4 to 5 weeks. Then the initial collagen is gradually replaced with stronger, more organized tissue over the following year. Wound tensile strength reaches only about 3% of normal after one week, 20% after three weeks, and peaks at roughly 80% of normal skin strength by three months. It never fully returns to 100%.
This means even the best treatments produce incremental results over months, not days. Most people see noticeable improvement by 3 months and continued gains through 6 to 12 months. Deeper scars typically require multiple treatment sessions spread across this timeline.
Preventing New Holes From Forming
The link between inflammation duration and scar formation is well established. Atrophic scars develop as a continuous process, evolving from inflamed papules through post-inflammatory tissue changes that destroy the skin’s structure. The longer a pimple stays inflamed, the more likely it is to leave a permanent indentation.
Treating active acne early and consistently is the most effective prevention strategy. A combination of adapalene (a topical retinoid) with benzoyl peroxide has been shown in a controlled clinical study to reduce the formation of new atrophic scars over six months. This applies to all acne severity levels, not just severe cases. Even mild acne that lingers untreated can produce scarring, particularly if there’s a family history of acne scars.
The one thing topical prevention can’t fix is picking. Squeezing, scratching, or digging at pimples creates mechanical damage that heals through a separate, more scar-prone process. If you’re prone to picking, hydrocolloid patches serve double duty: they protect the pimple from your fingers while keeping the healing environment moist if it does open.