There are two common myths about using lasers to treat darker skin tones, which were dispelled many years ago, but are still commonly referenced by patients and some inexperienced cosmetic dermatologists. The first is that darker skin cannot be treated with laser because it’s not safe – not true – with the second being that skin colour is the only consideration in these cases – also not true.
Skin colour is just one element that a cosmetic dermatologist must assess before providing laser treatments, with ethnic mix, sun exposure and health history other key elements to successful laser treatments on any skin. People raised in different areas will all respond differently to treatments due to lifetime sun exposure and genetic heritage, in the same way that skin of a diabetic will respond differently to the laser.
The reasons for side-effects being more common in those with dark skin is that practitioners have a lack of training, not because darker skin tones cannot be treated effectively with laser.
Skin’s own culture
Skin has the same amount of melanocytes across the genetic board. Melanin is found inside structures called melanosomes, with the size, how they are packed in, and where they are dispersed in the skin layers being important factors in how the laser affects the skin. This is where we’re from comes into it: ethnicity and sun exposure will both, differently, dictate how melanin is dispersed in the skin.
Lighter-skinned people have smaller melanosomes, packed together in membranes in the basal layer of the epidermis. Darker-skinned people have larger and more numerous melanosomes that are dispersed throughout the layers of the epidermis, not just the basal layer. Sun exposure over a lifetime may change melanin arrangements.
Melanocytes are receptive to cold and heat-induced injury, so the closer to the surface they are, the more opportunities to cause these cells damage. Melanin in the epidermis competes for laser waves, which is the factor mostly responsible for pigmentation changes and scarring in darker-skinned patients. More conservative treatments are therefore indicated.
It matters who your parents and their parents were: we are often a diverse mix of genetic groups, and this element is still not fully understood when it comes to how our skin is structured. Your skin type, underneath, could be a mixture of relatives you never knew existed. White is not white, brown is not brown, and black is not black.
Many cosmetic dermatologists may avoid use of certain technologies on darker skin tones, for example vascular lasers, IPL or resurfacing lasers. Safety is a priority, so treating the individual is critical.
Laser hair removal on dark skin
Laser hair removal in people with tight curly hair has proved a useful treatment for pseudofolliculitis barbae (PFB), also known as hair bumps. There are three FDA-approved wavelengths for laser hair removal on darker skin tones: 805-nm, 1060-nm and 1064-nm. The safest is believed to be the 1064-nm, however each practitioner will have their own preference.
Treating pigmentation on darker skin tones
Pigmented lesions are another popular cosmetic treatment, also known as complexion blending. Dark spots on the skin can appear for a variety of reasons in any skin tone, but are more obvious the lighter the skin. Multiple treatments are usually required.
We are expert cosmetic dermatologists and you can trust us with your skin, no matter the tone.