What is the best laser resurfacing treatment for african american skintones?

I have icepick acne scarring on my cheeks and jawline. I would like to undergo laser skin resurfacing but I have heard that it is a risky procedure for darker skintones because of possible post-inflammatory hyperpigmentation or burns. Is there a CO2 resurfacing laser or other laser which is safe on dark skin? what results can I expect?

Doctor Answers 5

Laser Resurfacing For Acne Scarring

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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. 

Philadelphia Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Acne scar laser treatments in darker skin types

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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.

Karen Stolman, MD
Sandy Dermatologic Surgeon

Acne Scar Treatment on African American Skin Tone

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I 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.

It is 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:

Nissan Pilest, MD
Irvine Dermatologic Surgeon
4.6 out of 5 stars 23 reviews

Post inflammatory hyperpigmentation in dark skin types

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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.

Richard O. Gregory, MD
Orlando Plastic Surgeon
4.6 out of 5 stars 13 reviews

Resurfacing darker skinned patients

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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. 

Jason R. Lupton, MD
San Diego Dermatologic Surgeon

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.