lasers in persons of color
What is the problem?
It is remarkable that persons of color represent over 50% of the population yet, are omitted from laser rejuvenation programs. There are several reasons for avoiding laser therapy in persons of color. Most from a myth that all lasers in darker skin tones will cause burns, scars, and pigment changes.
However, there are many lasers such as the YAG that are safer and effective for all skin types. Moreover, this YAG can be used for all the popular laser procedures.
- Laser Hair Removal
- Laser Veins
- Laser Tattoo Removal
- Skin Rejuvenation
- Spots
Where do the concerns for lasers come from ?
The start of laser treatments for cosmetic concerns began in the middle 1990s. One of the first lasers was for laser hair removal. Unfortunately, as these treatments became popular many untrained or poorly trained individuals started offering sessions. Therefore, persons who are laser sensitive, such as those darker skinned, were injured. It was common to see an African American person have pigment loss or scar formation after a simple laser procedure.
Therefore, in no time, rumors circulated that laser treatments in dark-skinned persons are a no-no. However, this is not true, and in the right hands, lasers can be safe and very effective in all skin types.
the fitzpatrick score
Dr. Fitzpatrick, a dermatologist created a list of skin features that determined ones skin type. The score calculated factors like response to sun, sunburn risk, freckles and genetics to create a score. Thus, darker skin tones have a score of V or VI. Therfore, requiring an adjustment in laser settings.
What lasers are safe ?
The safest laser for darker skin tones is the YAG laser. This laser has a low to moderate affinity to melanin and therefore has a lower risk of complications. The YAG is used for many treatments and is effective.
Why are darker skin types at risk of complications
While it may seem intuitive that a darker skin-toned individual with a thicker dermis, greater collagen, and more melanocytes would be more resistant to lasers, the exact opposite is true. Darker skin tones are more sensitive to lasers with pigment issues, scar formation, and burns.
How the laser interacts with pigments is the basis of laser risk. A laser that has a solid attraction for pigments will damage the skin. Therefore, it’s essential to use only lasers with low to moderate attraction to pigments in any patient of color.
Moreover, some lasers, such as the Co2 laser The laser vaporizes the water and, thus, the skin above that water. While not targeting a pigment, the burst of vaporizing heat can cause a darkening of the skin. This darkening is Hyperpigmentation and can be permanent. Microneedeling and dermal filler injections can also cause dots of Hyperpigmentation.
While the Alexandrite laser with a string attraction to pigments will lead to a loss of skin color which also can be perminent.