There isn’t a one-size-fits-all method when it comes to treating skin concerns. The truth of the matter is, noninvasive procedures, such as laser hair removal, have traditionally favored light complexions while being problematic for dark ones. “Skin of color can be tricky to treat, because a lot of cosmetic treatments can cause inflammation, which can damage the pigment cells and lead to increased or decreased pigmentation,” explains Dr. Peterson Pierre, a board-certified dermatologist in Thousand Oaks, California. “It’s very important for you to know how much experience your dermatologist has in treating your skin type, because certain procedures that are fine for Caucasians are not indicated for dark skin tones.”
Before scheduling a treatment, do your research to find out whether it can work with your skin, and more important, how much risk is involved. You can start by knowing where your skin falls on the Fitzpatrick scale—a system developed in 1975 by dermatologist Dr. Thomas Fitzpatrick, to classify a person’s skin type according to the pigment in their skin. The scale measures how a person’s skin will react to sun exposure as well as the risk for developing skin cancer and other conditions. According to Dr. Alix J. Charles, a board-certified dermatologist in Hinsdale, Illinois, “A person who burns easily in the sun and can never develop a tan would be a Fitzpatrick Type I, while a person on the opposite side of the spectrum, who never burns and always tans deeply, would be a Fitzpatrick Type VI.” A visual example of a Fitzpatrick Type I, he says, would be somebody with very fair skin, freckles, blue eyes, and red hair who can’t tan but burns very easily. A Fitzpatrick Type VI might be someone who is African with deeply pigmented skin, who can go out in the sun without getting a sunburn. (It should be noted that even if you’re higher on the scale, you should still always wear sun protection.)
According to Dr. Pierre, the number-one treatment that patients with dark skin tones should be extremely cautious of is lasers. “The issue with lasers and some other technologies when treating different skin colors, and the reason behind adverse outcomes on dark complexions, is the amount of energy absorbed by the skin,” he says. “Dark skin types absorb more energy and are thus prone to developing hyperpigmentation, irregular pigmentation, and hypopigmentation. Light skin, on the other hand, doesn’t absorb energy and responds directly to the treatment.”
Ultimately, it depends on how experienced your provider is with the equipment and with treating patients with dark skin tones. While a discounted laser service at a spa may be hard to resist, it’s not worth the possibility of causing damage to your skin. See a board-certified dermatologist instead—and know which treatments to avoid and which to seek out.
Related: 7 Common Assumptions About Black Skin and Cosmetic Treatments That Are Totally Wrong
Hair removal
Instead of the alexandrite laser, try the Nd:YAG
If you’re looking to remove unwanted body hair, you don’t have to give up lasers entirely. The alexandrite laser may be better suited for light to medium skin, but thankfully, it’s not the only option. Dr. Charles’ preferred laser for Fitzpatrick Types IV–VI is the Nd:YAG because it penetrates the hair follicle more deeply, bypassing the melanin. The Neo Laser is an especially popular option for dark skin. As a reminder, he notes that the bottom line is whether the person using the device knows what they’re doing. “If so, they can use these devices safely.”
Acne scars
Instead of a CO2 laser, try the Fraxel Dual 1550
Acne scars are treated with fractionated carbon dioxide lasers by going right through the epidermis, which is not good news for those with more melanin. This is because it could destroy the epidermis and damage pigment-producing cells, leading to hyperpigmentation or hypopigmentation, which is loss of pigment. A non-ablative laser, like Fraxel 1550, will skip the epidermal layer, where melanin resides. “It won’t even see that layer and, instead, will affect just the dermis—which is the next layer below, where the collagen and support structures exist and where scarring and deep wrinkles can also reside,” says Dr. Charles. “That’s advantageous to somebody with a dark complexion.”
Age spots and wrinkles
Instead of intense pulsed light (IPL), try a pico laser
“I never use IPL on dark skin because the risk of a burn and subsequent dyspigmentation is too high,” says Dr. Pierre. “It’s best to use a combination of creams, chemical peels, and certain lasers.” This may include pico lasers, like the Picosure, which can decrease hyperpigmentation while also increasing collagen. These lasers are known to target fine lines and age spots while producing less heat and faster than other lasers, making it safer for dark skin tones.
Improving texture
Instead of dermabrasion, try microdermabrasion or microneedling
Typically, dermabrasion is used to improve different skin-texture issues left over from scarring or wrinkles. However, it can be risky for deep skin tones and can cause even more scarring or discoloration. Instead, opt for microdermabrasion, which is a gentler version but is still effective at treating scars and texture issues. Dr. Charles also says that microneedling is another effective treatment that can be done on all skin types.
Wrinkles and fine lines
Instead of a deep peel that uses phenol, try a medium-depth peel that uses Jessner’s solution
Light-complexioned patients can opt for chemical peels that use phenol or trifluoroacetic acid (TCA) in higher concentrations, but those with dark skin should avoid deep peels and instead try a Jessner peel, which includes salicylic acid, lactic acid, resorcinol, and sometimes trichloroacetic acid (TCA). “Those are safer to use because, again, they are not going to penetrate as deeply and [don’t] go through the epidermal layer,” explains Dr. Charles. “People with dark complexions have, in a way, more melanin, or differently packaged melanin, within the superficial layers of the skin, so you just need to be careful with that skin layer and do treatments that either bypass that layer or are very gentle to it. That’s really what it boils down to.”
Related: The Differences Between the Most Common In-Office Chemical Peels
