Is Pulsed Dye Laser Treatment Safe for Dark Complexions?

Question

I have medium brown skin (carribean descent) with rosacea and acne vulgaris. Age 49. Most redness and swelling on nose around nostril area. Swollen red painful bumps. Acne vulgaris clusters of them on cheek and around space over top of mouth area, a few small pimples on forehead. What would work best. Vipeel, or pulsed dye laser. I have been told no IPL due to my dark complexion. Thanks.

Edward J. Gross, MD · Answer

You may need a topical antibiotic, Solodyn orally, or a low-potency steroid to reduce redness. The Pulse Dye laser can be used safely on Fitz 3-4, but at lower settings. A Test spot is always a good idea before committing to treating darker skinned patients. Dr. G.

John L. Burns Jr., MD · Answer

Your Fitzpatrick Skin Type is critical for proper laser safety.  Fitzpatrick Skin Types are rated from 1 to 6 and indicate how your skin responds to sun exposure.  Fitzpatrick Skin Type 1 is very white skin, usually freckled, with red or very blond hair, and always burns (never tans) with sun exposure.  Type 2 will usually burn and rarely tan.  Type 3 can burn but also tans easily.  Type 4 is closer to Hispanic or Pacific Rim nationalities and can burn but usually tans.  Type 5 is light black skin and Type 6 is darker black skin, usually of African descent.

	Fitzpatrick skin types 4 and 5 are very sensitive to the Pulsed Dye Laser wavelength of 585nm or 595nm because the higher concentration of melanin in the skin will absorb much of the laser light which can burn the skin.  This is also why you should not have a suntan when undergoing either a pulsed dye laser or IPL/photofacial/broad-band light source treatments.  Tan skin will also compete with the oxyhemoglobin molecule in blood born lesions such as Rosacea or port wine stains. 

	Pulsed dye laser treatments should be used with caution in Fitzpatrick skin types 4 or 5 to avoid blistering, burning, or scarring.  The fluence (power) should be set much lower and a skin cooler used to protect the epidermis.  I suggest either the Zimmer Air Cooler or a cryogen cooler. 

	For acne vulgaris, medical or topical creams might be a better option than a vascular laser.

Jason R. Lupton, MD · Answer

I routinely use the pulsed dye laser in darker skin types. It is true that you have to be more cautious with your energy settings in dark skin but it is possible to treat and treat safely.  The pulsed dye laser is one of the safest lasers on the market if used properly.  I would suggest that you only go to an experienced laser operator for your treatments.  Rosacea  and red "bumps" often respond quite well to pulsed dye laser treatment, even in darker skin types.  Good luck.

Yoash R. Enzer, MD, FACS - Account Suspended · Answer

Any laser is more risky for skin color changes with darker skin, especially if there has been a recent sun exposure history.  That being said, the Candela Vbeam pulsed dye laser has been used safely and effectively in patients with darker skin.  I do warn the patient it will be less effective for any given treatment session, and thus more sessions are necessary.  This is due to the fact that the power is turned down to protect the skin, and the dark pigment competes more with the blood vessels for the laser energy.  Because you are at higher risk for complications, I would advise that you have your treatment performed by an experienced laser physician (M.D./D.O.), and not a nurse or other ancillary staff.

	Good Luck,

	Yoash R. Enzer, MD

Is Pulsed Dye Laser Treatment Safe for Dark Complexions?

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Answer: Pulsed dye laser in darker skinned patients

Answer: Pulsed dye laser in darker skinned patients

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Is Pulsed Dye Laser Treatment Safe for Dark Complexions?

Answers (4)

Answer: Pulsed dye laser in darker skinned patients

Answer: Pulsed dye laser in darker skinned patients

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Everything you need to know about Pulsed Dye Laser

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