Ablative Laser on Black Skin?

Over the yrs, my nose has become disfigured d/t rhinophyma. I'm 35 y/o African am male. Tried accutane for several months to no effect. Also used saw pawmetto and beta sitasterol which did stop it either. I understand there are risks of hypo/hyperpigmentation. I think that might be preferable to a hugely enlarged & disfigured nose. I do have hx keloids chest area from c. Pox. Is there a physician w/ advice or willing to help?

Doctor Answers 4

Ablative lasers for darker skin

Ablative lasers on darker skin can sometimes be problematic. I would suggest lower settings and prepping your skin with Melarase creams before and after the laser. You should be advised of all potential problems. 

DR. Karamanoukian 
Los Angeles

Los Angeles Plastic Surgeon
4.8 out of 5 stars 94 reviews

Ablative Laser for Ethnic Skin

Thank you for your question. Rhinophyma is a difficult condition to treat in ethnic skin. You may want to consult a board certified plastic surgeon to see if there could be surgical options to smoothen out the cosmetic disfigurement. Lasers may cause adverse events such as further scarring.  I hope this helps.

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

Laser for Rhinophyma

I am sorry you have this problem. My thoughts -

  • I would consult a Board Certified Plastic Surgeon and have a detailed discussion  and examination because - 
  • Chest "Keloids" are often not real keloids and if so, you may heal fine,
  • Pre-treatment with hydroquinone reduces the risk of color changes,
  • Reducing the rhinophyma with a blade, not a laser, may cause less injury,
  • Color changes may be preferable to rhinophyma.

Best wishes!

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

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Laser Contraindicated

 I do not have good news. Laser ablation of Rhinophyma in an Afro-American patient with a history of keloids is likely to be a disaster. There is a very high risk of unfavorable outcomes of permanent hypopigmentation and possible keloid formation. Best,


Gary R Culbertson, MD, FACS

Gary R. Culbertson, MD
Columbia Plastic Surgeon
4.9 out of 5 stars 9 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.