What is the best laser treatment for black/brown skin? (Photo)

Question

Hello all! I’m a 54 year old female working toward building collagen. I had Botox for the first time 5/10/24, I’ve had 2 sessions of Radiesse , and I’ve just completed 3 sessions of Microneedling w/PRP. I just started using a medical grade skin care line Revision I use the following Vitamin C 30%, DEJ night , Retinol 0.5, under eye vitamin C for my dark circles and the Gentle Foam facial wash. I do strength training 4x week & the sauna. Thx in advance Tammy

Anna Chacon, MD, FAAD · Answer

When considering laser treatments for black or brown skin, it's crucial to choose options that minimize the risk of hyperpigmentation, burns, and other potential side effects. The following laser treatments are generally considered safe and effective for darker skin tones:

1. Nd:YAG Laser (1064 nm)
- Description: This laser has a longer wavelength, which allows it to penetrate deeper into the skin while minimizing the risk of damaging the epidermis.
- Benefits: Effective for skin tightening, collagen stimulation, and treating vascular lesions.
- Suitability: Safe for all skin types, including darker skin tones.

2. PicoSure Laser
- Description: This picosecond laser delivers ultra-short pulses of energy to target pigment without causing significant heat damage.
- Benefits: Useful for pigment correction, skin rejuvenation, and collagen stimulation.
- Suitability: Generally safe for darker skin tones due to its precise targeting and minimal thermal effect.

3. Fractional CO2 Laser (with caution)
- Description: Fractional CO2 lasers create micro-injuries in the skin to stimulate collagen production while leaving surrounding skin intact.
- Benefits: Effective for skin resurfacing, improving texture, and stimulating collagen.
- Suitability: Can be used on darker skin tones with careful settings and in the hands of an experienced practitioner to reduce the risk of hyperpigmentation.

4. Erbium:YAG Laser
- Description: This laser is known for its precision and ability to ablate the skin with minimal thermal damage.
- Benefits: Effective for fine lines, wrinkles, and collagen stimulation.
- Suitability: Can be safer for darker skin tones compared to other ablative lasers, but should still be performed by an experienced practitioner.

Additional Considerations:
- Pre-Treatment: Ensure your skin is well-prepared and free from any active inflammation or infections.
- Post-Treatment Care: Follow a strict post-treatment regimen to protect your skin from sun exposure and potential hyperpigmentation.
- Practitioner Experience: Choose a board-certified dermatologist or plastic surgeon with extensive experience in treating darker skin tones.

Current Skin Care Regimen:
Your current skincare regimen, including the use of Vitamin C, Retinol, and medical-grade products, is excellent for supporting skin health and collagen production. Continue using these products as recommended by your healthcare provider.

Combining Treatments:
Since you've already had Botox, Radiesse, and microneedling with PRP, integrating laser treatments should be done strategically. Allow adequate time between different treatments to let your skin heal and to assess the results of each modality.

The Nd:YAG laser is often the preferred choice for darker skin tones due to its safety profile and effectiveness in stimulating collagen. However, consultation with a qualified dermatologist or cosmetic surgeon is essential to determine the best treatment plan tailored to your specific skin type and aesthetic goals. They can provide a personalized assessment and recommend the most appropriate laser treatment for you.

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis. We see atrophic and hypertrophic scars, as well as scars that have hypo and hyperpigmentation. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to discuss the best treatment options for your type of skin. .

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Anil R. Shah, MD · Answer

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin in Winnetka and Chicago. This is a great question. Based on your concerns, if you are seeking treatment for collagen production, I highly recommend Sculptra injections. This treatment is used to restore facial volume lost due to aging or weight loss by stimulating collagen production. Unlike hyaluronic acid fillers that provide immediate results, Sculptra works gradually over several months to produce natural-looking results that can last up to two years. It's commonly used to treat deep facial wrinkles, folds, and hollow areas, offering a subtle and long-lasting improvement in facial contour and appearance. I hope this helps and best of luck!

Guilherme Szerman, MD · Answer

The CO2 Laser can be done on black skin, but it must be done by a very experienced professional and the skin tends to be prepared at least three months before the session. Collagen bio-stimulators are generally safer on black skin to promote facial rejuvenation and firmness.

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