10 Aesthetic Treatments to Never use on Facial Skin of Color

Skin of Color Facial Treatment
Facial aesthetic treatments on skin of color can often cause long-lasting or even permanent damage. One must be especially careful of laser treatments and chemical peels.

I have mentioned Dr. Vanita Rattan several times on this blog in the past. She is among the world’s most renowned skincare specialists for people with skin of color (i.e., for those with melanin-rich skin).

Recently, Dr. Rattan wrote a highly interesting post on Linkedin regarding 10 professional-grade aesthetic treatments that she would never use on her face (or on the face of anyone with skin of color). This list comes from 15 years of her work as a doctor and renowned cosmetics formulator. I summarize these 10 treatments below. Note that most of these should also be avoided in other areas of the body besides the face if you are of a darker skin complexion.

10 Professional Treatments to Avoid on Skin of Color

  1. High-strength Trichloroacetic Acid (TCA) 30% or higher chemical peels. On people with darker skin, trichloroacetic acid at such a high percentages is way too aggressive. It can lead to deep dermal inflammation and even cause burn injuries that lead to hyperpigmentation.
  2. 1064nm Q-switched lasers. Such lasers when used at high-energy settings can lead to permanent white spots in a “confetti-like” pattern of hypopigmentation if the laser can not distinguish between the target area and your natural skin tone. Note that 1064nm Q-switched Nd:YAG lasers are primarily designed for removing dark tattoo inks and pigmentation via nanosecond pulses. In contrast, standard Nd:YAG lasers (that are recommended for skin of color) typically operate in long-pulsed modes for hair removal or vascular treatments. While both types of lasers use the same 1064nm crystal, the Q-switched laser specializes in shattering pigment without excessive heat. In contrast, the long-pulsed Nd:YAG provides sustained, deep heating.
  3. High-percentage Glycolic Acid peels. The procedure is increasingly viewed as a high-risk approach for people with darker skin tones It has earned the moniker “surgical knife” error. Dr. Rattan never uses high-strength glycolic acid on the face since it is a tiny molecule that penetrates too fast, in turn creating hot spots of skin irritation. She prefers Mandelic acid or Lactic acid for a uniform and controlled exfoliation process.
  4. Aggressive Microneedling (without tyrosinase inhibitors). Any kind of needling creates trauma, which in turn leads to increased melanin production in people of color. Dr. Rattan never needles her patients’ faces without first prepping the skin with tyrosinase inhibitors. This process leads to melanocytes going to “sleep” temporarily.
  5. Intense Pulsed Light (IPL) for hair removal. The “scattergun” light from IPL is not recommended for people with darker skin, especially when it comes to the face. The epidermis absorbs too much energy, often leading to first or second-degree burns.
  6. Deep Dermabrasion. The process of mechanically ripping off layers of the epidermis “triggers a massive inflammatory response”. In skin of color, this in turn can cause scarring and hyperpigmentation.
  7. High-Concentration Hydroquinone. At lower concentration levels, hydroquinone is usually safe. However, when using 4% or higher doses of topical hydroquinone continuously for over 3 months, skin of color can develop ochronosis.
  8. Alkaline “Brightening” Masks. Professional masks with a high pH (above 8) are too alkaline for the skin and can destroy the acid mantle. It has been noted in studies that black skin can have lower ceramide levels, making it more vulnerable to damage from high pH masks.
  9. CO2 Ablative Resurfacing. Those with darker skin tones should avoid traditional resurfacing lasers such as the ablative Fraxel and other carbon dioxide (CO2) devices. There is too much of a risk of permanent hyperpigmentation with such devices.
  10. Generic “One-Size-Fits-All” Facials. People with darker skin have a more compact stratum corneum and more reactive melanocyte cells. The a generic facial is always a gamble. Make sure to go to a doctor, clinic, or spa that is highly experienced at giving specialized facial treatments to darker skinned individuals.

The Epilaser 980: Safe IPL At-Home Hair Removal for Darker Skin

Epilaser 980 for Dark Skin Tones
Epilaser 980 for Dark Skin Tones.

Epilaser 980: Safe Laser Hair Removal for for Dark Skin Tones

When it comes to at-home laser hair removal devices, virtually all Intense Pulsed Light (IPL) devices on the market are meant for people with lighter skin tones. This has now changed with the release of Epilaser 980, the new kid on the block. It is effective on darker complexioned people with skin type five or six on the Fitzpatrick scale,

The Epilaser’s patented Smart Precise Optical Targeting (SPOT) technology is designed to treat melanin-rich skin and hair colors with precision and safety foremost in mind. It will not discolor your skin since it only targets the hair follicles. The FDA-cleared Epilaser 980 device operates at a 980-nanometer wavelength.

Epilaser only targets the follicle, leaving the skin untouched. The device is cordless and rechargeable, and doesn’t require the user to wear any safety glasses or goggles during treatment. Unlike traditional IPL laser hair devices that run out of flashes, Epilaser 980 works for life.

The retail price of Epilaser 980 is currently $995. Online customer reviews seem to be favorable, although the device is not yet available for sale on Amazon.

How Does the Epilaser 980 work?

The Epilaser 980 IPL device comes with four smart camera-guided 24j/cm2 diode lasers. They help distinguish hair from skin, freckles and moles. Once the hair follicles are identified, all four of the diode lasers are activated. These lasers dynamically adjust wavelength, pulse duration, intensity, direction and focus based on the density and coarseness of the hair detected.

The patented SPOT™ technology makes use of an advanced deterministic algorithm to differentiate hair follicles from melanin and pigment. When you place the device across your skin, it immediately generates a high-contrast optical map of the treatment area in real time.

The Epilaser 980 is safe for use in all body areas, including on the face. However, avoid using it on or around your eyes or nose. Each treatment burst takes just a few seconds and is entirely pain-free. Epilaser’s manual states that:

  • After a month of regular use (two to three times per week), you will see a significant reduction in hair regrowth. Moreover, as your hair follicle density lessens over time, Εpilaser treatment sessions will also become quicker.
  • After three months (12 weeks), most users report a permanent decrease in hair regrowth. The treated body area will feel smoother and looking clearer.
  • Beyond three months, you will just need rare touch-up sessions to keep things clear.

You can expect to see a minimum of 70% permanent hair reduction within 90 days of beginning treatment. Note that this same manufacturer also makes Epilaser 808 for at-home laser hair removal in people with light to medium skin tones.

Dark Circles in People of Color

Undereye dark circles (periorbital hyperpigmentation) are a common cosmetic concern in both men and women. Moreover, they are especially prevalent in people of color such as Indians and Africans.

Dark Circles in People of Color
Dark circles around the eye are a common cosmetic concern in people of color. Indians and Africans are especially prone to periorbital hyperpigmentation (undereye circles).

While anyone can develop dark circles, individuals with darker skin tones are more prone to this problem, largely due to genetic factors. The problem can be further exacerbated by lack of quality sleep, a bad diet, dehydration, too much screen time and more.

Types of Dark Circles in People of Color

There are two main types of dark circles in people with brown or black skin tones:

  • Pigmentary Dark Circles: These appear as brown or black discolorations and are primarily caused by hyperpigmentation. Meaning the overproduction of melanin in the skin around the eyes.
  • Structural (Hollow) Dark Circles: These are caused by the loss of fatty tissue under the eyes, creating a shadow or groove that can accentuate darkness.

Why are People of Color more Susceptible to Periorbital Hyperpigmentation?

Darker skin contains more active melanocyte cells, which are responsible for melanin production. This makes people of color more susceptible to hyperpigmentation, including around the eyes. Additionally, the contrast between the under-eye area and the rest of the face can make dark circles more noticeable in individuals with deeper skin tones.

Key Causes of Dark Circles

While genetics are the primary cause of dark circles in people of color, other factors can also lead to more prominent undereye skin darkening. Among the main reasons include:

  • Genetic: Many people of color inherit a predisposition to increased melanin production around the eyes. In addition, inherited anatomical features that promote shadowing under the eyes can also lead to prominent dark circles.
  • Post-inflammatory Hyperpigmentation: The thin, sensitive skin around the eyes can easily react to inflammation from conditions such as eczema, allergies, or even frequent rubbing. Such irritation or injury can leave lingering dark marks around the eyes.
  • Hormonal Changes: Hormonal fluctuations can stimulate melanin production, worsening dark circles.
  • Sun Exposure: Despite the natural photoprotection offered by darker skin, excessive sun exposure can still trigger hyperpigmentation. This is especially true in the delicate thin under-eye area.
  • Aging: As people age, the skin loses collagen and becomes thinner, making underlying blood vessels and pigmentation more visible. Fat loss under the eyes can also create hollows that accentuate darkness. This is true for people of all ethnicities and races.
  • Lifestyle Factors: Fatigue, dehydration, a poor diet, stress and smoking can all contribute to the more prominent appearance of dark circles. However, these causes are almost always temporary in nature.
  • Medical issues such as thyroid disorders and anemia, plus nutritional problems such as iron or vitamin K deficiency can also contribute.

Treatment Options

Topical agents such as vitamin C, retinoids, hydroquinone and niacinamide may help lighten hyperpigmentation around the eyes and brighten the surrounding area. But these ingredients must be used cautiously to avoid irritation, which can worsen pigmentation. Check out some of the non-prescription lightening creams that contain these ingredients. Chemical peels or laser therapies can help but require expertise to prevent burns or scarring in darker skin.

For structural causes, dermal fillers or fat grafting may help restore lost volume. It is also imperative to take care of your diet, drink plenty of water, get sufficient amounts of quality sleep every night, and manage overall stress. Also avoid excessive exposure to direct UV sunlight. The use of sunscreen is critical. Consulting a dermatologist experienced in treating skin of color can help identify the most appropriate strategies for reducing the appearance of dark circles.

For allergies or eczema, the use of antihistamines and gentle moisturizers can minimize inflammation. The use of makeup and color-correcting concealers in peach or orange tones can also neutralize darkness in people of color.