Dermatology and Non-Surgical Cosmetic Treatments for Brown & Black Skin: What’s Safe and What Isn’t

At Berks Plastic Surgery, we want all of our patients to make informed choices about what’s safe and what’s not. We recognize that patients with darker skin tones come into our office with different concerns than those with light skin, and our dermatology team and skincare team understand that cosmetic and dermatology treatments affect individuals differently.

Are non-surgical cosmetic treatments safe for darker skin?

Many non-surgical cosmetic services are equally safe and effective for patients with darker complexions. BOTOX® and dermal fillers like Juvederm® are among the most popular non-surgical treatments, and they have been proven to be safe for all skin types.

However, take precautions when it comes to cosmetic skin treatments that rely on laser skin resurfacing or use other forms of “controlled injury” as a method for skin renewal. They can have negative side effects for people with melanin-rich skin.

Any provider you choose should be aware of the unique risks to patients with darker skin. One of them is post-inflammatory hyperpigmentation (PIH), a condition that can occur after even minor skin injuries such as bug bites or an acne breakout. Your cosmetic treatment provider should be forthcoming and guide you towards options that have been tested and proven safe. Discuss the incidence rate of pigmentation issues for any treatment you’re considering. Since some patients are more prone to pigmentation problems than others, it’s also important to share your skin history—be sure to tell your doctor or PA if you’re prone to discoloration, PIH, or any other skin issues.

No matter which treatment you’re considering, don’t be shy about asking to see before-and-after photos of other BIPOC patients, especially those with skin tones similar to yours. Seeing the results first-hand will tell you more about the procedure’s effects on (and the provider’s experience with) your skin type.

Are laser treatments safe for people with dark skin?

Many laser treatments are safe—but some laser technologies are not safe to use on skin with deeper pigmentation. Be aware that not all lasers are created equally; they vary in light intensity and how the pattern of light targets the skin, including the underlying layers. Step number one is to choose a provider with proven experience treating patients with your skin tone. Ask the practice what type of laser equipment they use to make sure it’s the most up-to-date.

The go-to choice of laser for dark skin is a long-pulse Nd:YAG laser with a 1064nm wavelength. This is because it uses a longer energy wavelength that travels deeper beneath the surface, reducing any potential interaction with pigment in the skin.

Lasers to avoid include Fraxel and C02 lasers. Because they remove the top layer of the epidermis, resurfacing lasers like Fraxel® and CO2® can cause permanent hyperpigmentation when used on dark complexions and should be avoided. Vbeam lasers can sometimes be used with modified settings; however, the darker your skin is, the riskier this can be.

Misuse of laser technology on any skin tone can injure or burn the skin; that’s why your provider should have specialized training in laser treatments, know how to treat your skin type, and work under physician supervision.

Is RF technology safe for dark skin?

For the most part—yes! Radiofrequency (RF)—technology is generally a safe choice for dark skin tones. Unlike lasers, RF doesn’t use light waves or target pigmentation. Instead, RF treatments use radio waves to prompt collagen renewal.

Here at Berks Plastic Surgery, we love the Venus Viva—it’s safe for all skin types and can treat a wide range of skin concerns including acne scars, surgical scars, stretch marks, large pores, fine lines & wrinkles, hyperpigmentation, skin laxity, and skin texture problems. It delivers the kind of improvements you’d expect with a skin laser but without the associated risks or downtime.

Other RF treatments safe for people of color include ThermiSmooth for smoothing wrinkles and treating skin laxity of the face and neck, and ThermiVa for feminine rejuvenation and reducing urinary incontinence.

There is one caveat when it comes to RF treatments and dark skin: some RF devices also make use of laser technology for a synergistic effect. While this is fine for light skin, it could be harmful to some patients. For example, FotoFacial should NOT be used on patients with darker skin tones.

Is Intense Pulse Light (IPL) treatment safe for dark skin?

Patients with dark skin should avoid IPL treatment. Instead of the highly focused, single wavelength lasers use, IPL uses a broad spectrum of light wavelengths delivered in brief pulses—but that doesn’t make it safe for dark skin. Because darker skin absorbs more heat, IPL can cause permanent pigmentary changes and scarring.

Are chemical peels safe for darker skin?

It depends on the depth and type of peel. Chemical peels work by removing the top layer of skin, which, as we’ve mentioned above, can be problematic. Light chemical peels (such as glycolic acid peels), which only remove dead skin cells at the surface, are generally safe and effective on darker skin. However, deeper peels should be avoided as they can cause dark (hyperpigmented) patches, light (hypopigmented) patches, or scarring. When it comes to chemical peels, be sure your provider has plenty of experience safely treating your skin type. To be extra cautious, ask your provider to first do a small test in an inconspicuous area.

We are happy to offer VI Peel, a chemical peel that is safe for dark skin tones.

What should I know about dermatology for people with dark skin?

When it comes to dermatology for people with dark skin, we recognize there is a unique set of concerns to think about. Our on-staff Dermatology Physician Assistant, Stacey J. Spehalski, PA-C, MPH, understands that more highly pigmented skin often responds differently to dermatology treatments than light skin and that certain skin conditions appear very differently on darker shades of skin.

What causes post-inflammatory hyperpigmentation?

When it comes to dermatology, a primary concern for patients of color is post-inflammatory hyperpigmentation or PIH. Whenever something triggers skin to make extra melanin, patients with medium to dark-colored skin can get dark spots and patches. Many seemingly minor things can trigger these dark spots, including:

• Healing after a wound caused by a cut, burn or even an insect bite
• A reaction to certain medications, including topical creams
• When a skin or hair care product irritates the skin
• Hormonal changes, such as during pregnancy or menopause
• When a pimple or patch of psoriasis clears

How can I treat post-inflammatory hyperpigmentation?

For effective long-term treatment of PIH, the underlying skin problem that led to the discoloration needs to be treated first. Hyperpigmentation can be sun-induced, caused by various types of inflammation or by any sort of damage to the skin. There are a variety of topical treatments to consider, including hydroquinone, azelaic acid, cysteamine cream, vitamin C cream, tretinoin cream, corticosteroid creams, and glycolic acid peels.

What is the best acne treatment for dark skin?

Several acne treatments work well on all skin tones; combining a retinoid with prescription-strength benzoyl peroxide is one effective topical option (we particularly like the topical gel Epiduo Forte®). Accutane® is also safe for people of color; however, if you take Accutane, it’s imperative to wear a non-comedogenic sunscreen as it increases sun sensitivity for all people, regardless of skin tone.

As far as treating acne scarring, newer RF technology is a great option. Venus Viva is very helpful for treating acne scarring in darker-skinned patients.

What is the best psoriasis treatment for dark skin?

When it comes to plaque psoriasis treatment, we’ve seen excellent results with the injectable medications Humira® or Enbrel®. Plaque psoriasis is caused by the immune system over-producing a protein called TNF, which causes skin cells to grow too quickly and multiply abnormally. That’s why systemic treatments that control TNF, like Humira and Enbrel, are more successful than topical ones.

More helpful resources

Of course, there are many more dermatological skin conditions than we’ve covered here. For information on common skin conditions for people of color, we suggest taking a look at the helpful online guide put together by Boston’s reputable Beth Israel Deaconess Medical Center. You can also review the information on WebMD about conditions unique to the skin of BIPOC. For anyone with skin rich in melanin pigments, working with a BIPOC dermatologist or dermatology provider is ideal if there is a licensed one in your area. If not, be sure the provider you choose has experience treating your skin type.

Convenient, experienced treatment in Berks County

No matter what kind of complexion you have, we’re here to help patients in Berks County, Wyomissing, and surrounding areas. As a boutique provider of cosmetic and dermatology treatments, you can expect a higher level of care at our dermatology office than you would get at others—from our elegant décor to after-hours appointment options, we’re confident you’ll appreciate every detail.

Our Dermatology Physician Assistant Stacey J. Spehalski, PA-C, MPH, is ready to discuss your concerns and go over all of your safe treatment options in detail. She offers a full range of adult and pediatric dermatology services, including full-body skin exams, skin cancer screening and excision, cryotherapy, and the management and treatment of skin conditions. We are currently welcoming new patients, so please give us a call at (610) 320-0200 or request a free in-person or virtual consultation.