November 05, 2023
2 minutes reading
Basic foods:
- Post-inflammatory hyperpigmentation is a concern when treating skin of color with lasers.
- The use of high-energy, low-density parameters and appropriate counseling can reduce these risks.
CHICAGO — With proper counseling and parameters, aggressive acne scar treatments can be used in patients of color, according to a speaker at the annual meeting of the American Society for Dermatologic Surgery.
“It’s very important for us to remember the differences in skin composition that exist in our skin of patients of color.” DiAnne SMALL. Davis, MD, FAAD, a board-certified dermatologist practicing in Dallas, said during her presentation. “You want to make sure you’re assessing the overall quality of their skin, the degree of oiliness they have, and also remember the wide spectrum of absorption that melanin has.”
The use of lasers to treat acne scars can lead to dyspigmentation or post-inflammatory hyperpigmentation (PIH), which practitioners should be especially careful of in patients with skin of color.
However, using the right tools and fully counseling a patient about the risks and aftercare can help reduce the risks of these effects.
“You want to make sure you have that full transparency with your patients, assessing how much this is affecting their quality of life, so you can really guide your treatment options to what you think would be best suited,” Davis said.
This consultation includes taking a detailed genetic and scarring history, checking for acne, and strict adherence to SPF use before care.
During treatment, the most important issue is density, especially if you are using fractionated lasers.
Multiple studies have shown that higher energy and lower density settings reduce the risk of PIH in skin of color patients. However, there may still be some throughout the healing process that the patient should be aware of.
“A lower amount of density or a reduced amount of density will work better in minimizing the risk of PIH,” Davis said.
In addition, using larger spot sizes, avoiding massive heating, and using pre- and post-cooling techniques will also help reduce hyperpigmentation.
After treatment, complete sun avoidance is essential and topical corticosteroids may be used.
“You can treat your patients of color,” Davis said.
“If they’re coming to you looking for options, you can do a lot of these aggressive procedures. … You just have to be very careful,” Davis continued. “You want to be careful about adequate parameters, you want to be very careful about the counseling that you can do … and also make sure that they follow your protocol after the procedure.”
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Davis DS. Practical pearls and tips for dealing with acne scars on skin of color. Presented at: American Society for Dermatologic Surgery Annual Meeting; November 1-5, 2023. Chicago.
Disclosures: Davis reports being a speaker, consultant, researcher, and/or advisory board member for Allergan Aesthetics, Fotona, Galderma, Johnson & Johnson, Merz, Quanta, and Unilever.
