Which Laser Wavelengths are safe for dark skin?

Question

I am Middle Eastern and was recently told by an Esthetician that the Yag 1064 is the only wavelength safe for darker skin tones. I am considering several laser treatments including the Halo, Infiniti, Vivace and Genesis. My primary areas of concerns are skin texture, large pores and fine lines under the eye area and between the brows. Genesis seems to be the only laser with a 1064 wavelength, however it seems to be used primary for redness and hyperpigmentation.

Laura Riehm, MD · Answer

Thanks for your question.  It is posted in different ways every time:  "What's the best for my ...?"  You do have to pick a place that uses good equipment, but it is more important to find an office that knows what they are doing.  You can have a great device and use it with improper settings or technique leading to a bad outcome.  Look for a medical office in your area that has SEVERAL treatment options and good reviews.  Rely on your local physician to give you the best options for what is available in your area.  We would have several laser treatment options here that would be safe for your skin type, but none of ours are 1064 nm.  Best of luck.

Amiya Prasad, MD · Answer

Thank you for your question. You describe your discussion with an aesthetician who said because of your Middle Eastern background the 1064 YAG laser is the only wavelength safe for your skin type and for darker skin. Your primary concerns are to improve the pores, the fine lines under the eyes, and the lines in between the eyebrows. You’ve listed several names of different brands, and you found one particular brand mainly helps pigmentation and redness.
I can understand why this can be overwhelming based on that one particular idea presented to you by the aesthetician, and I can share how I discuss these issues with my patients. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island for over 20 years. In our practice, we offer everything from non-surgical procedures such as Hydrafacial, multiple different lasers, and advanced surgical procedures such as lower eyelid blepharoplasty, eyelid surgery, facelifting surgery, etc.
It is important for any practitioner to select the right wavelength, or right laser procedure for the right patient. It is understandable why you’re overwhelmed looking at the information often provided by manufacturers about things that are good for light or dark skin. I can tell you from decades of using lasers and different devices that many lasers can be used for dark skin, which  has to do with the relative absorption of particular wavelengths to melanin. Your aesthetician is somewhat appropriately counseling you in that 1064 YAG is safer for darker skin types because of that wavelength selectivity. However, the differences between lasers are too many to describe, and there are certain technologies that have been used at different wavelengths that can also be used on darker skin. 
It is less about the laser than it is about the doctor who is selecting the laser. You don't need to limit yourself when it comes to these treatments through laser alone. For example, if you want to improve the appearance of pores or dilated pores, you can use a combination approach. We have used for pores a 1064 YAG Q Switch laser to help reduce pores. We can also use a technique of using Botox®, a neuromodulator injection or the delivery through a microneedling device, to improve the appearance of pores which is well documented. I believe in synergistic approaches, so I often combine two different modalities together. 
For fine lines under the eyes, there is a method using an Erbium laser, but minimally ablative. One of our lasers, we use in a way to stimulate collagen and improve the skin quality without getting the classic ablation (removal of skin) with that same wavelength. So wavelength is one part of the equation, the other parts are the longevity of that pulse, and the energy delivered. These are technical issues, and not necessarily important for you to fully understand, but when you think of these variables, you realize there are a lot of ways to adjust these variables to maximize safety. 
With any darker skin type, the biggest concern is getting a reaction which results in too much pigment, or losing pigment, so most of the time, these treatments have to be adjusted. 
In addition, when it comes to fine lines under the eyes, we have a lot of success using platelet-rich plasma (PRP). We can also combine that with a neuromodulator and improve the fine lines. For the lines in the brows, Botox® or any other neuromodulator is likely to be a value, as well as injectable fillers perhaps  in the hyaluronic acid family. 
You might be getting a little of a bias in your advice because if it’s an aesthetician advising you, they may be legally limited to only use a laser. If you were to go to a physician, you might find more options which can be more appropriately customized for your issues. The goal is to get the best treatment, so you really shouldn’t be limited. You may want to consider combining different modalities. There are also ways to help improve pores with Hydrafacial or microdermabrasion. 
You are in the right path in asking about lasers, but laser is only as good as the practitioner who uses it, and how they customize that treatment. It is true that lasers more recently developed over the past several years have a lot of safety measures where you can enter the person’s skin type ,their problem, and get a range of parameters. An experienced physician will also have the experience from doing previous treatments, and the understanding of the skin to help customize, and I think there is a value there. I think it’s worthwhile pursuing that approach. 
Meet with a qualified, experienced physician who offers all these different types of treatments, and a get a sense of their experience, and what their bias is. Understand that anything for skin is often a treatment strategy which requires multiple treatments, as well as some maintenance treatments, and that’s very important to understand going in so you don't have disproportionate expectations after one treatment. I think that you are on the right path. I think it’s overwhelming, and that’s why having an experienced professional guide you will probably take you to the next step moving forward. I hope that was helpful, I wish you the best of luck, and thank you for your question.

Which Laser Wavelengths are safe for dark skin?

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Which Laser Wavelengths are safe for dark skin?

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Our mission is to create a world where every investment in modern beauty is Worth It.