Restylane and people of color

Ethnic skin presents a unique paradox. Its melanin content provides protection from the sun, but the same skin can react to the slightest of injuries. The safety of Restylane in patients with increased susceptibility to keloid formation, hypertrophic scarring, hypersensitivity, and hyperpigmentation has not been studied. A retrospective review was used to determine whether Fitzpatrick skin types IV to VI are associated with an increased incidence of adverse outcomes related to Restylane use.

Sixty consecutive patients were injected with Restylane by a single surgeon (J.W.F.). Forty patients were categorized as Fitzpatrick skin types I to III and 20 as types IV to VI. Patient charts were reviewed for transient and permanent adverse outcomes related to Restylane injections, such as hypersensitivity, scar formation, altered pigmentation, and contour irregularities. All patients were evaluated at 2 to 4 weeks and 6 to 9 months.

The authors observed that 97.50 percent of the Fitzpatrick type I to III patients had no transient adverse outcomes related to Restylane injections. One patient experienced a 36-hour episode of exaggerated angioedema of the lips after injection, which resolved spontaneously. Another patient had an inclusion cyst that required incision and drainage and a 7-day course of antibiotics. None of the type I to III patients had permanent adverse outcomes related to Restylane. There were no transient or permanent adverse outcomes among the type IV to VI subjects.

This study demonstrates that with proper and meticulous injection techniques, patients with Fitzpatrick skin types IV to VI can experience the same benefits of Restylane therapy as their lighter-complected counterparts.