When treating skin of color, there’s a lot to consider. Aesthetic treatments come in all shapes and sizes, and some of them just aren’t safe for all skin tones, particularly those with a lot of melanin. Because of that fact, there’s a lot of misinformation and fear surrounding all kinds of treatments that are suitable for any skin color.
We spoke with experts to learn what makes some treatments ‘color-blind’ and what’s actually safe for all skin tones.
What Makes a Treatment ‘Color-Blind?’
Color-blind treatments are the ones that dermatologists are able to perform on any skin tone, without an increased risk of hyperpigmentation or similar adverse side effects. Moreover, these treatments are considered so safe that skin tone is rarely a consideration or factor in their administration.
“There are a tremendous, tremendous amount of treatments that are suitable for all skin tones,” explains Delray Beach, FL dermatologist Janet Allenby, MD. “Fillers are easy. Neurotoxins are easy. Most things with a needle aren’t going to leave discoloration—that is a very rare reaction.”
There are a lot of myths and misinformation surrounding treating skin of color, including a fear that injectable treatments can cause hyperpigmentation at the injection site. We covered this myth in detail here.
According to Monroe, LA dermatologist Janine Hopkins, MD, treatments that are safe for all skin tones have to be largely heatless, or able to use heat very selectively. “The heat of the laser can cause burns or blisters that damage the melanocytes resulting in loss of pigment, or the opposite, darkening of the skin,” Dr. Hopkins explains. “I often perform ‘cold laser resurfacing’ on my patients with darker skin types to minimize heating their skin while still resurfacing the epidermis for a nice even result.”
Treatments that don’t use heat at all are excellent options for darker skin tones and tend to be recommended first for their safety and favorable outcomes. Gentle acid peels, facials, and microneedling are all examples of aesthetic treatments that are generally safe for any skin tone.
Dark Skin Tones and Treating Scarring and Hyperpigmentation
Washington, DC dermatologist Tina Alster, MD explains that even skin issues like acne scarring and melasma that are commonly treated with lasers in fair skinned patients have favorable, safe treatment options for skin of color. “Depending on what we’re dealing with, there are a lot of options for patients with darker skin tones,” Dr. Alster explains. “You always want to start with safe options like light chemical peels, microneedling or even fillers for certain scars.”
In this way, a dermatologist can work up to more intense options. “Lasers are really my last resort for people with melasma and atrophic scarring, only because the heat can lead to more pigmentation if you aren’t experienced with darker skin tones,” Dr. Alster says.
There has also been a lot of growth in laser technology that enables them to be safe for all skin tones.
“There are certain lasers such as the Fotona laser and AeroLase laser that have setting safe for all skin types including skin of color because the wavelengths of light avoid pigment in the upper layer of the skin,” Dr. Hopkins explains. “And they can also be adjusted to avoid heating the skin, which can burn or damage the pigment cells.”
If you’re unsure about the results of a popular or recent device on your skin tone, it’s always a good idea to do some investigating. Check out before and after photos, and don’t be afraid to ask questions of your provider.
“You know, there are so many devices out there, and they’re not all created equal,” Dr. Allenby says. “They all use marketing language, so you need to research and ask questions.”
But the most important thing to keep in mind is that your practitioner should be experienced working on your skin type and tone. “Seek treatment from board-certified dermatologists who are well trained in treating skin of color and offer treatments safe for all skin types,” Dr. Hopkins advises.
Why Are Some Treatments Not Safe for All Skin Tones?
Aventura, FL dermatologist Bertha Baum, MD explains that some technologies, like laser hair removal, worked by targeting melanin, making them unsafe for darker skin. “Laser hair removal technology was not considered as safe or effective for individuals with darker skin tones,” Dr. Baum explains. “Traditional laser hair removal systems relied on targeting the pigment (melanin) in the hair follicle.”
Additionally, darker skin tones are more prone to developing hyperpigmentation since the skin is already creating melanin. That puts some treatments like deep chemical peels off the table because of their likelihood of causing new dark spots to occur.
According to Louisville, KY plastic surgeon Chet Mays, MD, scales were developed to standardize what treatments and energy levels are appropriate for a given skin tone. “The scale helps us to determine the effectiveness of lasers on the different skin types,” Dr. Mays explains. “The strength of the laser used is determined based on the skin’s reaction to the light, similarly to how different skin types react to the sun. It’s one of the first steps in determining the proper treatment and energy used to help you reach your skin-care goal.”
There are also aesthetic treatments that can be used safely on dark skin but need to be used with caution by a trained professional familiar with treating your skin type.
Glenn Dale, MD dermatologist Valerie D. Callender, MD explains that even laser hair removal can be performed safely on dark skin these days. “Laser hair removal in patients with darker skin can be used, however, it must be performed with caution and by a provider who is experienced with treating these patients,” Dr. Callender says. “Special considerations with laser settings that include longer wavelengths (1064nm), longer pulse durations and skin cooling is warranted and many of the newer lasers have these capabilities.”
