I do not suggest laser resurfacing for acne scarring, in darker skin tones. I feel the risk of post inflammatory hyperpigmentation is too great. A safer, but more minimally invasive option for your skin tone is the Vi Peel. This peel can be used in multiple sessions to improve skin quality.
I treat all skin types in my practice for acne scars. I agree that laser resurfacing should be considered with caution in Fitzpatrick skin types 3 or darker. With fairer African American skin tones similar to a light skinned Indian, Hispanic or Asian I do fractional Erbium or Fraxel Repair 1325 micron (fractionated CO2). For medium or darker, I would not recommend Erbium or CO2 and instead just fractionated 1540nm or fractionated RF (such as the eMatrix. In addition, if uncertain, whichever treatment you choose, unless the physician is confident and has treated many patients previously with your exact skin type (and has pictures to prove it), try a test spot treatment on the side of your face or behind your ear.
like to use eMatrix for acne scars on darker skin types. The eMatrix system uses Sublative RF- fractioned bi-polar radio
frequency technology to effectively place heat energy into the dermis to
stimulate collagen production.
The reason I choose the eMatrix
is because the RF technology is safe and effective for all skin types. It’s
important to know that treating acne scars is very difficult and takes time to
see the improvement.
Multiple sessions are required
generally 1 month apart. Results are dependent on the severity of the acne
scars, but when treating scars improvement is usually seen 4-6 months post
procedure as it takes healthy collagen about 6 months to fully form.
best to consult with a Board Certified Dermatologist to see if this treatment
is best for you and how many sessions you will need.
For more information on eMatrix click link below:
You are correct in assuming you would risk PIH with any laser treatment to the skin. The 1550 or even 2932 nm fractional laser would have the least (not zero) likelihood of causing pigmentation changes. There are other things that can be done to minimize the possibility such as pretreatment with pigment blocking drug, and things that can be done to treat any pigment abnormalities if it occurs. The decision may come down to whether it would be better to have acne scars or pigmentation abnormality. I suggest that you go to a laser surgeon who is accustomed to treating darker skin types.
I do not use traditional resurfacing lasers on very dark skinned patients as the risk of significant (and possibly permanent) hyper pigmentation is too high. I have used a radio frequency device (eMatrix), however, in these patients with very good results. The main advantage with this type of system is there is virtually no risk of pigment alteration. The disadvantage of this system is the need for multiple treatments to improve scarring and/or pigmentation. Good luck.