Skin rigid and pitted after Sciton Profractional laser 7 months ago - how can I fix this? (Photos)

Question

I had a Sciton Profractional laser at a depth of 40 micron ablation, 22% density, 7 months ago. It swelled up for months, has been sensitive to heat, and dry air, and now is rigid and pitted. Now when I put on makeup, I have to fill in holes! A dermatologist said maybe dermatitis. I tried elidel for months. I don’t think it did anything. It had been red for months, it fluctuates now. My skin barrier is ruined. She only cleaned my skin with a quick swipe of an alcohol swab , and I had a CC cream on! She didn’t give me post op printout, just verbal instructions. I’ve tried 2 separate week rounds of doxycycline, one week of bactrim, and most recently ENT recommended Kenalog injections. I’m so scared to do anything else to the area, because no one can give me an exact cause to all of this.

Anna Chacon, MD, FAAD · Answer

Thank you for sharing your experience — it sounds both physically and emotionally distressing, and I’m sorry you’re going through this.

Based on your history, it appears you are experiencing post-inflammatory dermal remodeling, which can sometimes occur after ablative procedures like Sciton Profractional laser, especially when healing is prolonged or complicated by suboptimal aftercare or skin prep.

Your description of rigid, pitted skin, redness, and sensitivity to heat and dryness—along with fluctuating inflammation—suggests a combination of the following:

Compromised skin barrier from the procedure and possibly from prolonged inflammation or inappropriate product use post-treatment.

Dermal fibrosis or collagen irregularity, leading to pitting or a “waxy”/stiff texture.

Possible chronic irritant or allergic dermatitis, especially if skin care products or treatments continued during the healing phase.

Recommended Management Approach:
Barrier Repair:

Use gentle, fragrance-free emollients like petrolatum-based products (e.g., CeraVe Healing Ointment, Vanicream) to help restore moisture.

Avoid actives (like retinoids, acids, or vitamin C) temporarily.

Anti-Inflammatory Support:

Topical calcineurin inhibitors like Elidel (pimecrolimus) are useful, but efficacy can be slow—consider short-term topical steroids (only with guidance), if inflammation persists.

Avoid Kenalog injections unless fibrosis is confirmed, as this could worsen atrophy if used incorrectly.

Texture and Scar Refinement:

Once stable, non-ablative laser options (such as low-fluence Clear + Brilliant or Fraxel Restore) and microneedling with PRP can stimulate collagen remodeling.

Silicone gel or sheets may help soften surface irregularities if used regularly.

Photoprotection:

Absolutely daily SPF 50+ with physical blockers (zinc/titanium) is essential to prevent pigmentary worsening and to support healing.

Professional Evaluation:

A biopsy may be warranted if the skin continues to thicken, remains inflamed, or if other underlying dermatoses (like granulomatous inflammation or cutaneous lupus) are suspected.

It’s understandable to feel hesitant after such an experience, but with a tailored and conservative approach, your skin can still improve. Healing after aggressive resurfacing takes time and should always be supported with a gentle, non-irritating regimen.

Skin rigid and pitted after Sciton Profractional laser 7 months ago - how can I fix this? (Photos)

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Skin rigid and pitted after Sciton Profractional laser 7 months ago - how can I fix this? (Photos)

Answers (1)

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Recommended reading

Everything you need to know about Laser Resurfacing

Our mission is to create a world where every investment in modern beauty is Worth It.