Are Active FX Laser Treatments Safe for Use with Dark Skin or Ethnic Skin?

For patients with darker skin, laser resurfacing can be very tricky and so the key is to seek out a Board Certified Plastic Surgeon or Dermatologist to perform your treatment.  Experience is essential here so do not let price be the determining factor in who you ultimately choose.  Dark skin can often respond in very unpredictable ways to laser or chemical peels and fractional lasers do not completely prevent this.  

As such, make sure that the practitioner who is performing your peel has adequate experience with the laser before moving forward.

I hope this helps!

Active FX is safe to use on darker skin patients (Fitzpatrick type 4-5). However, there is some increased risk of pigmentation problems (ie hyperpigmentation or hypopigmentation) that can be permanent. It is best to get a test spot first in an inconspicuous area to see if you have an adverse reaction. If the spot heals well, then Active FX performed by an experienced surgeon should get you nice results.

Thanks to the evolution made in Fractional CO2 Laser technology, ethnic skin with acne scarring is no longer excluded from laser resurfacing. All Fractional CO2 Lasers performed comparably (e.g. DeepFx, Mixto, Fraxel Repair). However, to maximize clinical benefit and minimize potential complication such as post-inflammatory pigmentation (PIH), the procedure should be done by an experienced board-certified dermatologist or plastic surgeon, preferably having performed greater than 50 cases of your skin type. The risk of PIH for ethnic skin is anywhere from 20-40%, typically does not manifest until 2-3 weeks after procedure, and can last several weeks. PIH can be minimized but it is critical that appropriate pre-treatment and post-treatment steps be taken involving combination of topical bleaching and retinoid creams as well as strict daily sun protection.

Asian and hispanic skin can do fairly well with Active FX or Total FX, but may require pretreatment to prevent hyperpigmentation. You must weigh the risk versus benefit, and your doctor can help you with that. Make sure you consult with a doctor who is very experienced with the laser, and also has a support staff including estheticians who can help you with before and after skin care.  

Darker skin types do have more problems after CO2 lasers such as Active Fx.  We expect that there will be some increase in pigment as a reaction to the laser.  This is called post inflammatory hyperpigmentation (PIH)and is temporary although it can last many months, even a year!  CO2 can be safely performed with pretreatment and post treatment with lightening agents, however there is still a high risk of PIH.