As cosmetic procedures become more and more popular in the United States, dermatologists and plastic surgeons urge dark-skinned patients to proceed with caution before undergoing any treatments since their skin is more prone to risk.
While dark skin is believed to be tougher because it contains extra melanin—which provides sun protection and slows down signs of aging—it actually makes the skin more vulnerable and sensitive.
“If the skin is darker it is prone to scarring and hyper-pigmentation, so we have to be more careful with skin of color,” says Terri Dunn, a dermatologist in Berkeley, Calif. Even laser hair removal and acne treatments should be handled differently in patients with dark skin, she adds.
Most cosmetic procedures are made for and tested on lighter skin patients, and not until recently, as the nation's ethnic population has exceeded 40 percent, have the treatments become more scientifically geared toward dark skin.
“In the past couple of years, devices, cosmetics and topical medications are being tested on people of different colors because we realize that the skin reacts differently,” Philadelphia dermatologist Susan Taylor says. “Even the FDA is requiring companies to make sure their clinical trials include individuals from different backgrounds.”
Some common adverse reactions to popular cosmetic treatments such as microdermabrasion, chemical peels, laser procedures, and dermal fillers in dark skin may include hyper or hypopigmentation—dark or light spots resulting from trauma to the skin—lumps/bumps, and acne-like pockmarks.
To avoid such side effects, specialists should prep the skin and administer lower-strength solutions when performing chemical peels on darker-skinned patients. In addition, treatments should be left on for a shorter period of time and longer intervals are recommended between treatments.
With microdermabrasion procedures, specialists should use linear strokes at a lower setting to reduce the risks of side effects. “There are lasers that transmit a long pulse and are better-suited for pigmented skin,” Taylor says.
“Physicians should test spots to check for side effects over a period of 24 to 72 hours. Also, either the dermatologist should do the procedure or someone who is trained by him. You don't want to go to a medi-spa where there isn't a physician,” she adds.
Popular dermal fillers and collagen injections and even tattoos and piercings may result in raised scar tissue or keloids in patients with dark skin. Keloids must be surgically removed and can grow back. Laser hair removal can burn, blister, and scab dark skin if the laser power is too high. Dark skinned patients are advised to be especially cautious before getting these treatments.
Specialists advise researching the procedure and the dermatologist. Taylor suggests asking the physician if their equipment is FDA-approved for ethnic skin, and what percent of the physician's clientele has dark skin.
“You need someone who knows different types of skin and has the latest products and equipment,” says Michele Byers, a dark-skinned patient who suffered skin problems after her microdermabrasion procedure.