What Do You Recommend For Laser Resurfacing for People of Color?

hello, I acne scars (crater/boxcar) on my temples and a few on my cheeks but have brown skin (latino) very prone to hyper-pigmentation and wanted to know what laser would be best for me.

Doctor Answers 9

Laser Resurfacing for Acne Scarring

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I would recommend an ablative laser, particularly the Sciton Erbium:Yag laser, which is used in the operating room under anesthesia as it treats the deepest layers of skin, and can achieve extraordinary results in appropriate patients. This laser can be used in darker skinned patients and produces outstanding results for acne scarring, fine or deeper skin wrinkles, enlarged pores, and irregular skin pigmentation. A thorough consultation with a board certified plastic surgeon is necessary to decide what laser skin resurfacing treatment plan is most suited to address your needs. Best of luck! 

Laser Resurfacing for Ethnic Skin

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Thank you for your question. If you are a person with ethnic skin, laser resurfacing options are very limited.  Your risks are very high for adverse outcomes with resurfacing.  For lighter skin tones, it is safer but would still proceed with caution.  You have to be willing to take the risks and expect to have some darkening at least for a few months, even with pretreatment. A good laser for ethnic skin is the Ematrix laser, which will require a series of sessions, especially to treat the challenging acne scarring, and can be done safely in all skin types. Be certain to be under the supervision of a board certified dermatologist or plastic surgeon with expertise in laser surgery and ethnic skin for the most effective and safe treatments. I hope this helps.

Color-Blind Lasers Are Available

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For skin of color, any of the RF fractional devices work well – RF is color-blind so that would be a good choice.  Also, the newer fractional CO2 lasers also seem to work well on skin of color, just so the person doing the procedure is skilled in taking care of skin of color patients.

Michael Gold, MD
Nashville Dermatologic Surgeon
3.9 out of 5 stars 17 reviews

Hyperpigmentation is a key issue

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When treating patients of color, hyperpigmentation is a frequent concern.  The practitioner needs to be experienced, expert, and careful.  The laser needs to be specifically able to handle darker skin. Other options such as Obagi skin care or peels should be explored as well.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 56 reviews

Resurfacing with laser for acne scars and hyperpigmentation

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If someone were to consider Fraxel Restore resurfacing on your skin, pretreatment skin lightening with topical therapy would be potentially useful to diminish the risk of post inflammatory hyperpigmenation. The creams are discontinued at the time of the procedure and the doctor will tell you when to resume them after the resurfacing.  Test spots are useful. I often do this behind the ear, and then one month later if there is no hyperpigmentation I will do a second test on the temple or sideburn area, somewhere not  so visible in case the test area hyperpigments.  If hyperpigmentation occurs and doesn't fade, then the treatment is not done. Unfortunately, it doesn't mean that if the two tests are clear that the treatment won't cause hyperpigmentation...it could still occur. There are methods to treat this hyperpigmentation and sun protection is crucial.

The E2 is a new technology from Syneron and may help acne scars with less risk of hyperpigmentation but I do not have any experience with this device.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Profractional XC by Sciton for Acne Scars in Poeple of Color.

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I have treated multile Latinos for acne scariing using profractional XC module on the Sciton Joule Erbium Laser. This is a tunable technology the allows your surgeon to drill down with small columns and vaporize this stubborn scar tissue. A more even skin will follow and add Broad Band Light (BBL)to the finished profactional treatment will aid in eliminating the risk of hyperpigmentation.

Charles Virden, MD
Reno Plastic Surgeon
5.0 out of 5 stars 70 reviews

The Fraxel Laser

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Working with a properly trained physician, preferably a board-certified dermatologist or board-certified facial plastic surgeon, I have seen beautiful results with the Fraxel SR 1500 on all color types. Of course, it depends on what we are treating. Acne scars may respond to subcision (floating), followed by Fraxel SR 1500 treatment. There are medications that your dermatologist or plastic surgeon can give you to apply immediately after your treatments to turn off the enzyme and the inflammation that can lead to hyperpigmentation. Consult an expert. More experience=Better outcomes.

Christine Glavey, MD (retired)
Alpharetta Dermatologic Surgeon

Laser resurfacing for people of color

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I think the risks outweigh the benefits so I will not do it. However there are excellent and much safer alternatives, such as the Obagi system and Blue Peel, that can be repeated and eventually will yield result comparable to laser resurfacing if you stick with it.

Andrew Pichler, MD
Sacramento Facial Plastic Surgeon

Laser resurfacing in people of color

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The short answer is I DO NOT recommend laser resurfacing in people of color.  The risk of hyper- pigmentation or scarring is simply too high.

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.