Cosmetic Dermatology Diagnosing and Treating Skin of Color

Skin, in all its many shades and colors, is created equal. Our differences are what make us interesting. They are what make us beautiful. But when it comes to cosmetic dermatology treatments and diagnosis of different skin tones, one size does not fit all. There are key differences when it comes to treating and diagnosing skin of all shades, and it is important to use a doctor who has mastered the science of the spectrum.

Most Common Types of Skin Treatments

The skin color may be different, but the needs are all the same. No matter the color of your skin, there are a few common types of treatments that are prevalent across the spectrum. These include:

• Skin pigmentation
• Mole removal
• Laser hair removal
• Tattoo removal
  

What to consider when treating skin of color

Depending on the color of your skin, the way a cosmetic dermatologist approaches your treatment may be different. This is because most laser skin treatments rely heavily on the laser being able to detect differentiating pigment. Skin pigment is called melanin, and it is produced by cells called melanocytes. These live in the deepest part of the epidermis, right before the second layer of skin, the dermis.

Fair skinned people can be treated with a higher energy laser because it’s easy for the laser to pinpoint where pigment is darker, whether man-made, a hair follicle, or tattoo ink. The darker a person’s skin, the more difficult it is for the laser to determine the difference between skin pigment and any other structure that is supposed to be removed. For people with darker skin, using the wrong type of laser can result in over-stimulating the skin pigment, or removing the skin pigment altogether.

Skin treatment options for skin of color

To protect all the different shades of skin out there, there are a variety of methods that Dr. Khorasani uses to treat skin of color. But the most important thing to remember is that one laser does not fit all. Adjusting the wavelength depending on skin tone makes a huge impact in the ability to seek out the unwanted pigment. The darker the skin color, the more chances of hyper- or hypo- pigmentation with the use of a laser, so the more conservative the settings have to be.

The first option Dr. Khorasani recommends is to use Clear & Brilliant, which is a very low energy laser. Higher energy lasers can be used for fairer skin, like an ablative fractional laser, which you can read about here. For someone with dark skin, a non-ablative and lower energy laser is optimal, like Clear & Brilliant. This is a great treatment option for someone with superficial dark spots, like surface-level sunspots.

For something that goes deeper, another option is to use a laser with a longer wavelength. The epidermis is where a lot of the pigment lives, so a laser with a longer wavelength is needed to bypass that layer of skin, to avoid disrupting your natural pigment. The varying shades of skin tone across the spectrum dictates the wavelength and energy levels of the laser, so finding a doctor who understands those distinctions is imperative.

Similarly, with hair removal and tattoo removal in skin of color, the main goal is to target pigment deep in the skin. The longer the wavelength, the better ability for the laser to bypass the epidermis and cause less harm to the natural pigment.

Keep Cool

Melanocytes are activated by heat. If they are activated too much, they will produce additional pigment, which can cause hyperpigmentation in skin of color. For something like sunspots, Clear & Brilliant is a great option because it doesn't penetrate deep enough to activate the melanocytes. But for something deeper like a mole or laser hair removal, a mechanism to cool the epidermis would help protect the skin's pigment.

Of course, it's important to not cool the melanocytes too much because this can kill them and result in hypo-pigmentation. It's a delicate dance and a fine line, but one that is important to stick to, in order to protect your gorgeous skin color and keep your complexion clear.

Pre-treatment and planning ahead

Another way to avoid hyperpigmentation is to pre-treat skin of color with a bleaching agent. The best types of bleaching agents are ones compounded in higher doses by a pharmacist, so it's best to consult with a physician like Dr. Khorasani, rather than purchasing an over-the-counter option.

Finally, it’s absolutely paramount that one avoids any kind of sun exposure before a laser treatment. A tan may absorb the laser energy, resulting in epidermal heating and stimulation of the melanocytes. This may result in hyperpigmentation and even blistering of the skin.  

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Why Dr. Khorasani?

It’s crucial to find a doctor who knows how to care for and protect skin across the spectrum. Dr. Khorasani is a foremost expert in treating and diagnosing skin of color, with a decade of experience treating every shade of skin. Not only is he a triple board-certified dermatologist and surgeon, but he also has spent the majority of his career in an academic environment, teaching future surgeons how to get it right. He also happens to be a person of color himself, and has been his own guinea pig when testing his methods to see what will and will not work on skin of color.

Request A Consultation

Dr. Khorasani and his highly-specialized team look forward to working with you to transform your medical or aesthetic goals into reality. To expedite a request for a consultation, message us securely or visit our contact page for more information.

Related Video: Dr. Khorasani discussing melanoma and skin cancer DETECTION ON SKIN OF COLOR at NBC News