Best Laser Treatment for Scars on Dark Ethnic Skin?

Very concerned about the little information on the internet about laser treatment on dark-skin individuals. As an individual who has brown skin, I am currently using Obagi products to tone and treat the skin prior to laser. As I have a slightly raised burn scar on my forehead (from the age of one - now 42 years old), can you please advise me of what your thoughts are with regards to treating this type of scar on dark skin.

Doctor Answers 4

Very tough problem

The reason for little information is that dark skin individuals are very difficult to treat with lasers. There are some lasers which can be safely used on darker skinned individuals. What you describe though may not be best treated with a laser but may be best treated with other modalities such as dermabrasion or serial excisions of the scar to make it less noticeable. I would suggest visiting with a plastic surgeon or facial plastic surgeon to determine your best course of action. Best of luck.

Dallas Facial Plastic Surgeon
3.9 out of 5 stars 14 reviews

Someone who specializes in ethnic skin...

The reason there is so little information is the risk factors are very high for treating dark skin with the wrong setting and or laser. There can be loss of pigment or too much pigment forming after the treatment.

The best thing to do is go to someone who specializes in ethnic skin and is familiar with treating skin types IV –VI (Asian, Hispanic to African and all in between). Failure to properly pre-treat the skin and use of the correct device can have long-lasting consequences.

Sonia Badreshia-Bansal, MD
Bay Area Dermatologist
3.9 out of 5 stars 12 reviews

Non-ablative 1540 fractional Erbium laser best for scar removal in dark skin

Erbium lasers produce less thermal injury than CO2 lasers. Thermal injury (burn) causes hyperpigmentation in the short term and hypopigmentation (loss of pigment) in the long term in patients with dark skin. Most experts in laser resurfacing agree that CO2 lasers should not be used on dark skin because of the risk of hyperpigmentation and hypopigmentation. Scars require the production of new deep collagen in the skin to plump scars. Non-ablative fractional 1540 Erbium laser resurfacing is more effective at deep collagen production than ablative lasers. in my opinion Non-ablative 1540 fractional Erbium laser resurfacing is best for treating scars in dark skinned and light skinned patients. On dark skin patients lower power settings and multiple 3-4 treatments are used.

I would consider excising and then revising it with resurfacing

If it is raised you could consider laser resurfacing but with dark skinned individuals the risk of complications is little more. I would excise your scar and close it possibly in a geometric fashion to break up a noticeable line and then consider resurfacing in less aggressive means. You can consider fractional resurfacing to decrease the complications. This can be done and with the surgeon he will hold your hand through the whole process and do his/ her best to make sure that you are happy.

Philip Young, MD
Bellevue Facial Plastic Surgeon
4.2 out of 5 stars 84 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.