From laser skin treatments to laser hair removal, tone matters — skin tone, that is. Laser therapy procedures are not one size fits all and the wrong treatment can cause lasting damage. So, how can you tell which laser treatments are right for darker skin tones? Here, we caught up with top dermatologists and an aesthetic nurse to find out why skin tone affects the outcome of certain laser procedures and the best skin refining and hair removal laser options for those with darker complexions.
The Relationship Between Lasers & Skin Tone
Not all laser and light therapies are safe for all skin tones. Generally speaking, those who fall above type IV on the Fitzpatrick Skin Phototype scale (the go-to measure of skin type for dermatologists) need to be careful when choosing a treatment. For the uninitiated, the Fitzpatrick scale was developed in 1975 by Harvard dermatologist Thomas B. Fitzpatrick, MD, to classify a person’s tendency to burn (erythema) versus tan (induce pigmentation) — providing an estimation of the amount of melanin present in skin cells. The original scale had four types and was later broadened to six.
The best way to determine your Fitzpatrick skin type is to visit your dermatologist, but below are the general classifications for each:
- Type I: Pale skin; light blue or green eyes; red or blonde hair; always burns, never tans
- Type II: Fair skin; blue or green eyes; blonde hair; burns easily, tans poorly
- Type III: Light brown to olive skin; hazel or light brown eyes; dark blonde or light brown hair; burns mildly, tans gradually
- Type IV: Olive to brown skin; dark brown eyes; dark brown hair; burns minimally, tans easily
- Type V: Dark brown skin; dark brown to black eyes; dark brown to black hair; tans easily, rarely burns
- Type VI: Dark brown or black skin; dark brown to black eyes; black hair; never burns, tans easily
Aesthetic lasers target water, red hemoglobin, or brown melanin in the skin. Skin types IV to VI have a higher concentration of melanin, which means there is a greater risk of damage if the laser is used incorrectly. “Patients with darker skin tones and who are tan are more susceptible to complications, which is why it’s essential to see a board certified laser expert and someone with many different tools in their kit,” says Paul Jarrod Frank, MD, a board certified dermatologist in New York City. The damage caused by improper laser treatments is often permanent and ranges from burns and scars to hypo- and hyperpigmentation.
But that’s not to say there aren’t cosmetic laser therapies that can safely be employed on a wide range of skin tones. When performed by a well-trained professional, there is an array of skin refining and hair removal treatment options. To ensure you’re visiting a provider with the right level of experience, Dr. Frank recommends asking the following questions:
- Do you have more than one technology in your office to treat the various skin types?
- Do you have experience with treating people with my skin type?
“Those are the two most important questions you can ask,” he says. And don’t be shy about asking to see before and after photos of patients who look like you — it can help you get a sense of how much experience the provider has.
The Best Laser Treatments for Darker Skin
Now that you have a better understanding of the relationship between skin tone and lasers, it’s time to learn more about which treatments are safe and effective. When it comes to refining skin tone and texture, non-ablative (read: non-wounding), picosecond, and Q-switched lasers are the way to go for darker complexions and there have been some notable technological advances in the last decade. “The skin stays intact, so patients can use makeup during recovery and they can be used on darker skin types,” Dr. Frank says.
- Clear + Brilliant®
- Fraxel® Dual
- Lutronic Ultra™
- Pico Genesis™
Generally speaking, Dr. Frank says longer wavelength technologies tend to be safest for darker skin tones. Tara Garrick, nurse and aesthetic laser specialist at Neinstein Plastic Surgery in NYC, likes the Lutronic Ultra™ because the non-ablative, thulium laser works deeper in the skin without damaging the surface layer. “It’s a customizable, comfortable laser with minimal downtime,” Garrick says. It can for address fine lines and wrinkles, melasma, hyperpigmentation, acne and body scars, large pores, actinic keratosis, even stretch marks in all skin tones, she notes.
Laser Treatments to Avoid
Those with darker skin tones should avoid traditional resurfacing lasers, like ablative Fraxel® and carbon dioxide (CO2) devices, because there is a risk of permanent hyperpigmentation, says Dendy Engelman, MD, a board certified dermatologist in NYC.
Other light therapies that are best to steer clear of? Intense pulsed light (IPL) and broadband light (BBL). “We need to be extremely cautious, as IPL and BBL are really not safe for dark skin tones,” Dr. Frank says. He often sees complications in patients inappropriately treated with IPL devices by inexperienced practitioners. “You need to have laser-specific technology that works well on darker skin tones,” he explains, adding that those typically include the longer wavelength therapies mentioned above.
Laser Hair Removal for Darker Skin Tones
For many years, laser hair removal technology wasn't sophisticated enough to work for dark skin. “Traditionally, lasers work by beaming intense light at the follicle, which causes permanent damage so the hair no longer grows there,” Dr. Engelman explains. “The key was the contrast between the follicle and the skin.” That means people with fair skin and a dark hair follicle enjoyed the best results, while people with dark skin and dark hair or light skin and light hair didn’t have many options.
In the case of patients with darker complexions, Dr. Engleman says the devices weren't able to distinguish between the skin pigment and the pigment of dark hair follicles. As a result, there was a risk of damaging the skin and causing hypopigmentation (light spots), blisters, or even scarring. Fortunately, the technology has come a long way. “I'm excited about the Nd:YAG laser, which safely penetrates deeper into the dermis, totally bypassing the pigment of the skin,” she shares, adding that the Q-switched device is the safest option for laser hair removal for darker skin tones.
The Deka Motus AX is another Q-switched laser that can effectively remove light and dark hair from all skin tones. “The one-of-a-kind wavelength used by the Motus AX allows for the treatment of fine and light hair, whereas most lasers are only effective for dark hair,” Dr. Frank explains. “Additionally, it is also effective for darker skin tones, which are not able to be treated with some other lasers.” Another benefit? It’s painless and requires half the number of sessions compared to standard treatments. “This laser is unique because it treats and heats the area very slowly, instead of the classic stamping technique of hair removal,” he says. “It also features a cooling system for increased comfort.”
While patients with darker skin tones should take special care in finding a provider, laser treatments (of all kinds) carry risks for everyone. “They are just instruments that rely on the performer,” Dr. Frank cautions. Generally speaking, you need to be careful using lasers on people with a history of eczema and psoriasis or any type of skin disease, he says. Taking the time to research and consult with several providers will help ensure you get the best treatment for your needs.
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