Can African Americans Get Laser Resurfacing For Dark Under Eyes?

I'm an African American, and I have bad dark under eyes which makes my appearance look bad. I've seen online that laser resurfacing may not work for dark skin. Can someone explain it in depth?

Doctor Answers 7

Laser Resurfacing for African Americans

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Thank you for your question. Laser skin resurfacing has several benefits: improved texture, elasticity, decreased wrinkles and improved appearance. However, there is always a chance for irregular pigmentary changes following the procedure. In your case as an African American... the darker the skin, the higher the risks. It would be wise to consult with a laser surgeon who is familiar with multiple laser devices and has a track record of treating African Americans. Please ask for "before" & "after" photos of dark-skinned patients. That way, you can discuss your expectations and desired treatment results. It is also important that the physician has experience handling laser complications.

If you decide not to risk laser treatment, there are "bleaching creams" on the market as well as retinoid products that are less aggressive and may be more effective & safe for you.

Good luck! I hope you find this helpful.

Laser Resurfacing for African Americans?

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Your question really has two parts: Is laser resurfacing safe for patients with brown or black skin? The answer to that is you must choose a very experienced laser surgeon who knows how to handle dark skin. The basic problem with dark skin is that if it is peeled there may be a stage of healing during which there is too much brown pigment produced. This happens because of the inflammatory reaction that occurs with wound healing. Melanin acts as an anti-oxidant and is produced in abundance to quell the inflammation. This is called post-inflammatory hyperpigmentation and resolves over a period of 2-6 months usually, but does require treatment. So aside from that reaction, the skin responds the same. There are methods to reduce the risk of this happening, but it cannot be reduced to zero. The darker the skin, the higher the risk.

The second part of the question is can dark brown circles under the eyes be removed in any way? These dark circles are usually a family characteristic and present during youth, but very persistent and darker as aging occurs. They do not respond to hydroquinone or other bleaching creams. If a biopsy is done pigment will be seen in the dermis, which is not where it is supposed to be. Because of the depth of the pigment it gives almost a bluish color to the skin. It can be removed with a pigment laser, but to have access to the pigment it is generally necessary to peel away the epidermis and then use the pigment laser. This process does work but invariably causes PIH, which then requires 3-4 months to get rid of. Not an easy process but it does work. Just choose your Doctor carefully.

Richard Fitzpatrick, MD (in memoriam)
San Diego Dermatologic Surgeon

Lasers for African-American skin

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Yes, African-Americans and people with darker skin tones can get laser treatments but you must go to a VERY experienced laser physician for treatment. In the wrong hands, it could backfire and damage your skin. An expert dermatologist or laser physician will be able to recommend the most appropriate treatment. 

Kimberly Butterwick, MD
San Diego Dermatologic Surgeon
4.9 out of 5 stars 20 reviews

Laser is not typically safe in African Americans.

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Hello Corey54293,

Thanks for your question.  For patients of color, laser needs to be approached with caution.  There are a few types of technologies that can be used, such as Nd-Yag, that won't significantly increase the risks from laser.  Typical risks of laser in people of color are pigment change, scarring, and ineffective treatments.  Dark circles under the eyes are typically due to several things: thin skin showing deep blood vessels, weak blood vessels leaking iron pigment, and excess fat bulging causing a shadow effect.  An evaluation by an expert in cosmetic eye surgery, or blepharoplasty, could help you determine your issues.  Some people need special eye creams.  Some people need special bleaching creams.  Some people need surgery.

Do your homework and find out what you really need.

Good luck,

Dr. Shah

Manish H. Shah, MD, FACS
Denver Plastic Surgeon
4.8 out of 5 stars 69 reviews

Laser Skin Resurfacing and Discoloration

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Laser skin resurfacing is ideal if you want to look younger without surgery. The best candidates do not have folds of excess skin or dark skin. Laser skin resurfacing will restore elasticity and plumpness to your skin, but it does not remove excess skin. It can cause discoloration in dark skin.

Laser resurfacing more unpredictable the darker your skin is

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It depends on how dark your skin really is.  The bottom line is that the more pigment you have to begin with, the more unpredictable and possibly more variable your resultant color could be.  Could be lighter, darker, or with a combination in the same area.  The safer way to go is usually hydroquinone topicals especially with another tyrosinase enzyme inhibitor such as kojic acid.  I've had good success with this in many darker ethnic groups over the years, but you really need to give it a month to work.

Myles Goldflies, MD
Seattle Plastic Surgeon

African American Skin and Dark Circles under eyes

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African american patients will often carry more pigment under the eyes appearing as dark circles.  Lasers are not very effective in treating this since they may darken or remove too much pigment from the area.  Treatment usually starts with some hydroquinone based lightening creams and sun protection.  It can also be from a hollow there as concave areas may appear darker on african american skin.  In that case a filler underneath may help the issue.

Louis M. DeJoseph, MD
Atlanta Facial Plastic Surgeon
4.9 out of 5 stars 32 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.