Laser Treatments

What People With Skin of Color Should Know Before Getting Laser Treatments

Stocksy United / Bonnin Studio

Not so long ago, there weren’t many in-office treatments available to people with medium to deep skin tones. While it was due in part to skin of color often being overlooked in the beauty industry — after all, 40- and 50-shade-wide foundation ranges only recently became the new standard — another factor was the technology.

 

Light and laser treatments were once particularly risky for two reasons. They weren’t sophisticated enough to tell the difference between melanin (skin’s natural pigment) and their actual targets (hair follicles, for instance). They also could lead to hyperpigmentation issues, which already disproportionately affect people of color. “Back when the research first started coming out, we didn't know as much as we do know about [the devices] now,” says Forum Patel, MD, a board-certified dermatologist at Union Square Laser Dermatology℠ in New York City. 

However, technology has evolved significantly, and these once-contested procedures are no longer off-limits to those with skin of color. In the right hands and with the proper consideration, you can get any laser treatment you want — safely. Keep reading for the breakdown of four of the most popular light and laser treatments, including what to know before you book and how to ensure they work for your skin.

 

Laser Hair Removal

 

The Concern: Like a case of mistaken identity, laser hair removal devices couldn’t easily differentiate between the (ideally dark) hair follicle and melanin pigment in skin. That explains why for years, the ideal candidate was someone with light skin and dark hair. This combo creates the most contrast. When devices confuse the two, the melanin absorbs the energy intended for the hair follicle. Thus, “people with darker skin types are at higher risk of getting either a burn, a dark spot, or a light spot, because it's targeting that melanin,” Dr. Patel explains.

 

What to Consider: There are two types of laser hair removal devices: the Alexandrite, which operates at a shorter wavelength, and the Nd:YAG, which has a longer wavelength. “The longer the wavelength is, the deeper the energy is trying to penetrate,” Dr. Patel says. And because the Nd:YAG sends energy deeper into skin, it essentially bypasses the melanin, thus reducing the risk of burns. 

However, Alexandrite machines are incredibly common — so much so that if you have deeper skin, you’ll want to ensure that your provider offers Nd:Yag for your more sensitive complexion. For the same reason, you should probably skip deals on laser hair removal from discount sites. Finally, if you’re the type to get significantly tanner in the summer — to the point where you have to use a slightly darker shade of foundation — it’s best to hold off on laser hair removal until that tan wears off, just in case.

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Intense Pulsed Light (IPL)

 

The Concern: IPL, also known as the photofacial, is notorious for creating burns in those with medium to dark skin tones, because it can be set to any wavelength between 500 and 1,200 nanometers, which is a huge range. But that’s part of the reason dermatologists love it. “It can handle multiple things: hair removal, photo damage, and even facial redness,” Dr. Patel says. She notes, however, that the Alexandrite and Nd:YAG are much better hair removal options. In order to treat sun damage, which is more superficial in the skin, the wavelength has to be shorter. “And again, shorter wavelengths are more dangerous in darker skin types,” she says.

 

What to Consider: In the hands of a licensed provider, who would know to keep the settings at a longer wavelength, someone with skin of color could still safely get a photofacial treatment. That said, IPL isn’t quite as effective at a longer wavelength, so there’s a drawback. “The plus side is that darker skin types don't usually get sun spots,” Dr. Patel says. The natural melanin offers some protection against the photo damage that IPL treats, so it’s typically not as severe as in those with lighter skin tones. (That’s still not an excuse to skip sunscreen — find a few of our favorite SPFs for deeper complexions here.)

 

Fractionated Non-Ablative Laser

 

The Concern: Fortunately, melanin confusion is not the issue with fractionated lasers. Instead, the risk of this treatment is causing hyperpigmentation. Those with darker skin types, such as Asians, African Americans, South Asians, and Latinxs, tend to be prone to this skin concern. “[With] any sort of injury to the skin, there's a bigger propensity to develop dark spots,” Dr. Patel says. Fractionated lasers boost collagen and resurface skin by causing controlled, microscopic injuries to the skin, and the subsequent healing of these tiny wounds can lead to hypopigmented or hyperpigmented scars. 

 

What to Consider: You can still get a fractionated non-ablative laser treatment if you have darker skin. The density — that is, the percentage of the surface area being treated — just needs to be dialed down. “You can't be as aggressive with those settings as with somebody who has a lighter skin tone,” Dr. Patel says. She gives her patients a topical medication with hydroquinone to use before and after the treatment, which can help minimize post-procedural hyperpigmentation. 

[Editor’s note: As always, talk to your doctor before starting or stopping any medication.]

Dr. Patel also stresses the importance of sunscreen post-treatment. “The bigger risk factor than the laser itself is sun exposure,” she says. “If anyone gets a fractionated laser and goes out in the sun, their chance of getting pigmentation at the areas of lasering is super high.” Otherwise, consider it fair game. You should also think about saving the treatment for a time of year when you plan on less sun exposure overall, such as winter or fall.

 

Fractionated Ablative Laser

 

The Concern: Ablative laser is the far more intense sister of fractionated non-ablative lasers, and resurfaces your complexion to stimulate new, fresh skin to heal in its place. This type of laser comes with similar risks of hyper- and, in some cases, hypopigmentation. “Fractionated ablative lasers use CO2 to ablate the skin at specified depths, so you're creating deeper, more aggressive wounds,” says Dr. Patel. “They take longer to heal and are also more prone to post-treatment scarring if not done properly.”

 

What to Consider: Dr. Patel treats different skin types equally when using fractionated non-ablative and ablative lasers: she uses a topical hydroquinone treatment before and after, as well as advises on the use of ample sunscreen. The major difference is that she adjusts the density so that the wounds are smaller and spaced farther apart, leaving more normal skin in between the areas of injury. “I'm trying to make sure that there's enough normal surrounding skin for those normal skin cells to then crossover into those wounds,” she explains. That facilitates better healing with the right amount of pigment, thus reducing the odds of darker or lighter pigmentation.

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