Not all skin reacts the same to different environmental conditions or to different cosmetic or surgical treatments. The pigment of skin can be an indicator for success (or failure) by your cosmetic, aesthetic, reconstructive or therapeutic efforts. This is something that all aesthetic physicians, aestheticians, cosmetic surgeons, oculoplastic surgeons, and everyone else in the field should be paying close attention to. SCALE 2019 Music City is here to help educate you on how to successfully navigate what could be a sensitive area of practice.
Why Pigment Matters
While the world should be color blind for many different things, when it comes to treatments that interact with the skin color and tone both matter an awful lot. It impacts not only the way the sun affects the skin, leaving residual damage, but also the way different cosmetics and other products provide coverage and the noticeability of scarring.
As noted by Dermascope:
The color that is seen in the stratum corneum is produced within the epidermis in a cell called the melanocyte. The melanocytes sole function is to produce melanin. Everyone has approximately the same number of melanocyte cells, but genetics cause the melanocytes of various individuals to produce different amounts of melanin. The more melanin produced, the darker the skin will be. However, it is not only melanin that gives skin its color. Carotene produces a yellow to orange pigment that influences the color of the skin as well; carotene can give the skin a yellowish hue. Thomas Fitzpatrick, a Harvard dermatologist, developed the Fitzpatrick Numerical Classification, which categorizes skin color as type I through type VI…. When those who have less melanin in their natural skin tone expose their skin to high levels of ultraviolet rays, by spending lots of time in the sun or regularly using tanning beds, more melanin is produced and the skin gets darker…
Many common skin products containing glycolic acid can worsen the problems of darker skin. Alpha hydroxy acid products with concentrations higher than 15 percent may also have detrimental effects on skin of color. However, milder alpha hydroxy acid products, like mandelic acid, are safe for use on all skin tones. Mandelic acid, which is extracted from bitter almonds, gently exfoliates the skin to remove damage and reveal clearer, healthier skin… With proper care, the common problems of darker skin can be managed, minimized, or even eliminated. Skin care professionals can take a proactive approach to preventing problems like acne scarring and sun damage by educating their clients on proper skin care procedures early, before damage begins to occur.
Thus, the color and tone of your clients’ skin can impact the effectiveness of your treatment.
Skin Pigment And Treatment
There is another implication for everyone in our industry when it comes to the question of pigment (color and tone). This has to do with getting our clients’ skin to match itself after treatments. If you are very lucky and very skilled, the scars that your clients/patients have following any procedure are miniscule at best. There are various techniques that exist to resurface the skin and give someone their even and smooth color and tone back, but in order to do this you have to know how the various types of skin will react.
Unfortunately, despite massive advances in laser technology, physicians are seeing more side effects than ever before on patients of skin of color. They are being treated by practitioners who have limited experience with lasers or skin of color. (Source).
Lasers used on skin that is darker can more easily trigger hyperpigmentation or dark spots. This is because darker skin, or skin of color, has higher sensitivity. Lasers cause inflammation and redness for everyone, but dark skin is subject to more irritation than light skin. Thus, practitioners should be more cautious and conservative when applying laser treatments to non-caucasian clients. Similar parameters exist for the use of lasers in hair removal.
For hair removal, there are only two wavelengths that are FDA-approved for skin of color ― the diode and Nd YAG. Diode lasers have evolved to treat skin of color more safely, whether from using suction, longer wavelengths (diodes now go up to 1060 nm), larger cooling plates that are often coupled with laser scanning or in-motion diodes which heat the dermis gradually through faster motion to offer greater protection of the epidermis. “Regardless of the advances in the diode wavelength, the Nd YAG is by far the safest wavelength. The diode lasers are definitely improving but they certainly do not touch the Nd YAG lasers as being the gold standard in treating patients with skin of color, particularly Skin Type VI patients. (Source).
Talking To Your Client About their Skin Color
Handled professionally and appropriately, conversations with your clients about their personal skin tone prior to any procedure will lead to the best outcome. It is key that they have the information they need to understand how the factors that make them unique play into the uniqueness of their treatment. Your clients will appreciate the customized care you are offering to help them look their absolute best.