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Edison, NJ Dermatology

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In-Office Treatment Swaps Better Suited for Dark Skin

January 7, 2021 //  by Dr. Robert Paull, MD//  Leave a Comment

There are lots of methods available to treat skin concerns today. But the truth of the matter is that many in-office treatments, particularly laser treatments, can be problematic for dark skin tones. That’s because they can cause inflammation, which can damage melanin and lead to increased or decreased pigmentation.

Before scheduling a treatment, ask your dermatologist how much experience they have treating your skin type. In 1975, a dermatologist named Dr. Thomas Fitzpatrick developed a system for classifying a person’s skin type according to the pigment in their skin. Basically, the Fitzpatrick scale, as it’s called, measures how a person’s skin will react to sun exposure, as well as their risk for developing skin cancer and other skin conditions.

A Fitzpatrick Type I, for example, would be someone with very fair skin who burns very easily. By contrast, a Fitzpatrick Type VI might be someone of African descent who has deeply pigmented skin that doesn’t get sunburn.

Knowing your skin type will also help you research your treatment. Your dermatologist should be able to answer any questions you may have, but it always helps to do some reading on your own to better appreciate how much risk is involved.

If you have a dark skin tone, as a general rule, be wary of lasers. Dark skin tends to absorb more energy during laser treatments and similar technologies, which makes it prone to developing hyperpigmentation, hypopigmentation, and irregular pigmentation.

But in most cases, a simple swap can deliver the same results as the conventional treatment—and spare your skin from any adverse effects. Here are some common examples.

In-Office Treatment Swaps Better Suited for Dark Skin

Age spots and fine lines

Intense pulsed light (IPL), the popular treatment for age spots and fine lines, can burn dark skin. Instead, your dermatologist is likely to recommend a pico laser, like the Picosure, in combination with creams and chemical peels. A pico laser will reduce hyperpigmentation while also boosting collagen. It produces less heat and works faster than other lasers, which makes it safer for dark skin tones.

Fine lines and wrinkles

If you have dark skin, avoid deep peels. A better option is a Jessner peel, which includes salicylic acid, lactic acid, resorcinol, and, sometimes, trichloroacetic acid. They’re safer—but still effective—because they don’t penetrate as deeply.

Acne scars

Typically, acne scars are treated with fractionated carbon dioxide lasers that go right through the epidermis. But for someone with a dark skin tone, they could destroy the epidermis along with pigment-producing cells, leading to hyperpigmentation or a loss of pigment. A non-ablative laser, such as the Fraxel Dual 1550, can bypass the epidermis, where melanin resides, and affect only the next layer below, where scarring and deep wrinkles reside.

Hair removal

The alexandrite laser is usually the go-to for removing unwanted body hair, but it’s best suited for light to medium skin tones. For dark skin (Fitzpatrick Types IV though VI), the Nd:YAG is a better option because it penetrates the hair follicle more deeply, again, bypassing the melanin.

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