Written for Scars1 by Michelle Alford
Laser surgery has been historically more difficult and potentially dangerous for dark skinned patients. Patients with dark skin were more likely to receive laser burns or have side effects such as hypopigmentation. However, new technology has significantly increased the safety of laser surgery on dark skin.
Until recently, laser surgeons would assess a patient’s level of skin melanin based on hair, eye color, skin tone, and their response to ultraviolent light—i.e. if they burned easily, or tanned and never burned. Unfortunately, these assessments could be subjective—a patient ‘s skin tone might be darker than usual because of time spent in the sun, or two patients who burn at the same rate could give different answers based on differing perceptions of how quickly they burned.
According to Dr. Jeremy Green, an assistant professor of Dermatology and Cutaneous Surgery at the University of Miami Department of Dermatology, incorrect assessment of skin tone can lead to injuries. “Most of the laser-induced burns and scars we see in our clinic are due to a clinician incorrectly assessing a person’s skin,” explains Dr. Green. “For example, for a patient with a lot of pigment in their skin, lasers for hair removal targeting pigment in the hair itself can also be absorbed by pigment in the skin, causing the patient to get burned.”
Emerging technology takes the guesswork out of ascertaining a patient’s skin tone. New devices such as Skintel allow doctors to measure the amount of melanin or pigment present in a patient’s skin. This gives them a melanin index and provides them with an objective scale.
If used appropriately, both fractionated and non fractionated lasers are safe for all skin types; however, it’s still essential for patients with dark skin to choose a doctor who has experience treating their skin tone. Dr. Green explains, “The more pigment there is in a person’s skin, the more carefully it must be treated. In order to reduce the risk of any post procedure pigment change, it’s important to decrease the density of the laser. This means that the laser treatment will be lower strength and the patient will probably require more treatments, but they can still get fabulous results.”
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Photo: Cedward Brice