Our therapists on Dermastore® Support get asked many different questions but the one question that comes up time and time again and about which there seems to be a lot of confusion, is skin treatments in patients with darker skin types.
I will try and clarify the matter.
These can be very useful for anti-ageing, sun freckles (solar lentignes) and the superficial pigmentation such as epidermal melasma. There are many different types and strengths of chemical peels and the results are very operator-dependent i.e. a lot depends on upon the skill and training of the person performing the peel. This may be a Dermatologist, General Practitioner or Skin Therapist.
However, in patients with darker skin types, the procedure needs to be done with extreme caution otherwise you can end up with a poor result. With this skin type, I generally recommend milder peels, best performed in the winter months with the meticulous use of a high factor, broad spectrum sunscreen post-peel.
A deeper, more aggressive peel can cause irritation to the skin and if the post-treatment care is not correct then you can end up with severe post-inflammatory hyperpigmentation (PIH) – extensive brown marks on the face, leaving the patient very unhappy and worse off than before the peel. Again, this is operator-dependent and you need to do your research and make sure that the person doing this deeper peel is experienced and understands the pathology of pigmentation.
Medical Micro-Needling (DermaPen)
This treatment is useful for anti-ageing, post-acne scarring and may produce slight improvement in melasma. The procedure is actually colour-blind, in other words, all skin types can be treated. However, in patients with a darker skin type there is again a risk of post-inflammatory hyperpigmentation if the correct post-operative instructions are not given i.e. the patient should avoid the sun, wear a broad-brimmed hat with UV protection and be meticulous about the use of a high factor, broad spectrum sunscreen.
Intense Pulsed Light Laser (IPL)
This is a laser-like device that uses a mixture of wavelengths of light to treat sun freckles and dilated capillaries (telangiectasia which are small red broken veins) on the face. It works extremely well in patients with a fairer skin but I personally never use the IPL for darker skin types as the risk of PIH are too high.
There are many different types of laser but the one laser that is colour-blind is the fractional laser. There are different types of fractional laser depending upon which wavelength is used. The laser beams penetrate into the dermis, stimulating collagen and is therefore useful for skin rejuvenation, post-acne scarring and it may also help for melasma. It is very important that this laser treatment be performed by an experienced operator and post-treatment care and instructions, including meticulous use of a high factor, broad spectrum sunscreen and sun avoidance (if possible) be followed. Always wear a broad-brimmed hat with UV protection if you are outdoors.