Fraxel Lasers and TCA Peels (Facial) for Middle Easterners/Indians?

I'm of Middle Eastern/Indian descent and have light brown skin, and would like to get fraxel treatment or TCA peels to deal with wrinkles under my eyes. But I've heard that these procedures are riskier for people who aren't caucasian, and may discolor (perhaps permanently?) the skin of people with brown skin tone. What is the risk level for these procedures for people who are not white?

Doctor Answers 5

Fraxel Restore for all skin colors

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Fraxel is so safe that it is used in all skin colors and skin types. Traditional laser treatments target melanin and or have a higher risk of scarring. Since the laser light in Fraxel targets water and is fractionated it can be used in Asian, Latino and Middle-Eastern skin types


New York Dermatologic Surgeon
4.3 out of 5 stars 17 reviews

Fraxel is a safer choice for wrinkle removal in dark skin

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Fraxel restore and Fraxel repair laser treatments can be excellent procedures to smooth wrinkles, texture and scars in dark skinned individuals. Although there is some risk for hyperpigmentation, it is a much lower risk than with other procedures such as TCA peels. We have found it to be a very safe treatment in our office with a low incidence of increased pigmentation. When this has occurred it was usually in Asian skin, not Middle-Eastern and it was usually temporary. I have not seen loss of color (depigmentation) from Fraxel. I would avoid any peels other than light glycolic peels if you have dark skin.

Lorrie Klein, MD
Laguna Niguel Dermatologic Surgeon
4.9 out of 5 stars 216 reviews

TCA not the treatment in Indian skin for Wrinkles

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In my experience it would be a major risk and therefore a mistake to use TCA in a high percentage to treat under eye wrinkles in someone with Indian skin color. While Fraxel has a higher risk in this population than in Caucasians ( light skinned individuals) it has been safely used on thousands without longterm side effects when not used overaggressively. The severity of the eyelid wrinkles as well as the number of Fraxel treatments you would be willing to pursue would determine if Fraxel , filler such as Restylene, or eyelid surgery would be utilized. A consultation with a laser expert in your area would probably be most helpful to you in making the correct choice.

Fraxel Lasers and TCA Peels (Facial) for Middle Easterners/Indians?

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  This is a truly excellent question.  Certainly there are increased risks for these procedures in people of color.  however, these risks can usually be managed with vigorous pre and post treatment skin regimens, and any increased pigmentation is almost always reversible (not permanent).  Personally, I think the most important question to ask yourself is whether either of these procedures would be effective for the under eye wrinkles which are your greatest concern.  It is difficult to say without seeing photos but personally I would favor Botox/Dysport or surgery for wrinkles and age related changes in this area.  Resurfacing procedures will only be effective for the finest of wrinkles and great caution must be used with these treatments when they are applied to the periocular area (around the eyes).

Lawrence Kass, MD
Saint Petersburg Oculoplastic Surgeon
4.9 out of 5 stars 138 reviews

Farxel and TCA

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neither would get rid of wrinkles.

TCA has to be very deep to affect the wrinkles, and that would be dangerous in your color,

Proceed very carefully.

Samir Shureih, MD
Baltimore Plastic Surgeon

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.