Laser treatment of dark skin: a review and update

Of the estimated 11.7 million cosmetic surgical and nonsurgical procedures performed in the United States (U.S.) in 2007, 22% were performed on racial and ethnic minorities. Laser and light treatments rank in the top five most requested procedures in annual surveys of cosmetic and dermatologic surgeons. Recent U.S. population statistics reveal dramatically shifting demographics that would anticipate a likely increase in this percentage. U.S. Census Bureau data projects that by 2050, people of color are expected to become the majority, comprising 54% of the U.S. population, with Latinos accounting for 30%, African Americans 15%, and Asians 9.2%. The rising popularity of cutaneous laser surgery as an accepted therapy for various skin pathologies, coupled with the diverse face of the patient population, has led to increased demand for laser treatment of darker skin tones. Although difficult, effective laser therapy in patients with darker skin phototypes can be achieved. When determining a treatment protocol for an individual patient, the proper laser energy and wavelength are important in ensuring a substantial margin of safety while still achieving satisfactory results.