Chemical peel facial treatments have become very popular in spas, beauty salons and clinics. However, if you are of a darker skin tone, chemical peels can cause burns and hyperpigmentation. In some cases, these side effects can last for years or even become permanent.
In 2022 on Reddit, an African American woman posted a pretty graphic before and after chemical peel photo in 2020. She got significant areas of hypopigmentation and hyperpigmentation.
Recently, an African American man named Neyo White went viral due to his major facial skin burns and white patches after a chemical peel treatment at an Atlanta spa. Mr. White’s facial skin developed both hyperpigmentation and hypopigmentation in various regions. His treatment entailed a 20% trichloroacetic acid (TCA) medical grade chemical peel. For those with darker skin, high-strength chemical peels are best avoided. Even weaker chemical peel treatments should only be undertaken under the guidance of experience professionals.
A short time after this video came out, Dr. Jason Emer announced on Instagram that he would be treating Mr. White and try to reverse all the pigment changes and skin damage. Mr. White plans to sue the Atlanta spa where he got the bad treatment.
Note that the aesthetician who did this treatment was interviewed by another aesthetician. Here is her side of the story. It is always possible that your skin will react entirely differently to that of most others who get the same treatment with no side effects. Any time you put strong chemicals on your skin (especially the facial area), there will always be some damage. Lets hope that Mr. White sees a reversal in his skin damage in the coming months.
It is not often that someone with Indian skin updates us on their long-term laser hair removal before and after results. Getting someone to do so on a regular basis for 10 years is even rarer. Luckily, “Makeup by Megha” has done just that for us, and it is invaluable. She is of East Indian (or South Asian) ethnicity with a wheatish brown skin tone.
It is almost impossible to get to see results and hear testimonials from people with Indian skin types here in the US. Partly because they make up less than two percent of the population. The vast majority of laser hair removal testimonials come from people of Caucasian origin who have fair skin and dark body hair (the best possible combination to see excellent results). During the past few years, we are also seeing more laser hair removal reviews from African Americans.
Megha got laser hair removal on her whole body! At an unbelievably low cost of just $600 for 6 initial treatments. She went to Skin Matters in Atlanta, where the current full body laser hair removal price is $998 for 8 sessions. Megha advises to check Groupon and Living Social for discount specials.
Great Laser Hair Removal Results in an Indian Female
I am glad to hear that Megha is delighted with her results. It also seems like she did not get any of the dreaded side effects of using lasers on dark skin (e.g., hyperpigmentation).
In Megha’s 10 year results video report below, she even shows us some of her sparse remaining hair on her legs. Very impressive. I am guessing that she must have received treatment from old laser technology when she started 10 plus years ago.
According to her earlier videos, her first treatment involved the Polymer laser. Later ones involved the Candela laser (I assume the Nd:YAG version). I will ask her to elaborate. As is common, the armpits gave the best results in terms of permanency. However, I am also very impressed with the minimal new hair growth on her legs.
The Journal of the American Academy of Dermatology (JAAD) recently published an interesting new article titled: “An update on cosmetic procedures in people of color.” Also on Instagram. It is part 1 of a series of papers that I am looking forward to reading this year. It seems like the AAD is finally focusing heavily on dermatological problems in darker skinned people.
The vast majority of before and after cosmetic treatment photos that you see online are of lighter skinned individuals. This situation is slowly changing to better reflect the diverse nature of the US population, where one-third of people are now of a darker complexion. Make sure to read my recent post on the use of machine learning in improving darker skin representation in medical textbooks and schools.
Differences in Fair versus Dark Skin
Note that the authors of this update are Dr. Rebecca L. Quiñonez; Dr. Oma N. Agbai; Dr. Cheryl M. Burgess; and Dr. Susan C. Taylor. The article starts with an interesting table that delineates key difference in dark versus light skin. Dark skin is defined as skin type 3-6 on the Fitzpatrick scale.
Of interest:
Dark and light skinned people have the same melanocyte quantity and size.
However, the melanosome size is much larger in dark skin. Moreover, the melanosome distribution is throughout the epidermis of darker skinned people. In lighter skin, it is contained in just the stratum basale and Malpighian layer.
People with darker skin have melanin type Eumelanin. Lighter skin consists of melanin type Pheomelanin. Not surprisingly, darker skin has much higher levels of melanin versus lighter skin.
Skin Problems in People of Color
Post-Inflammatory Hyperpigmentation (PIH) from acne. Source: JAAD via Dr. Cheryl Burgess.
Among the photos in this article is the one on the right from Dr. Burgess that shows how severely a person of color (African American in this case) can get impacted by problems such as post-inflammatory hyperpigmentation (PIH). The authors also outline differences in the facial skin aging of people of the main ethnicities in the US (White, Black, Hispanic and Asian). Moreover, morphological differences and varying cultural preferences mean that even people of color can not be considered as a monolithic entity (in terms of desired outcomes from surgeries and procedures).
Some conditions are more common in certain ethnicities (e.g., seborrheic keratoses in African American women). Different racial and ethnic groups are also more of less likely to suffer from post-inflammatory hyperpigmentation (PIH). The authors suggest focusing on other measures of skin types besides the most popular Fitzpatrick (FST) scale. Among alternatives include the Roberts Skin Type Classification System (RSTCS). This is a 4-part scale that is used to “assess and assign a numerical value to a patient’s phototype, hyperpigmentation, photoaging, and scarring capability”.
Cosmeceutical Agents and Melanogenesis Inhibitors
There now exist a wide range of cosmeceutical agents for people of color (POC). These can be used for pre-procedure and post-procedure management, as well as to address daily cosmetic concerns. I will be writing about these in detail on this blog in separate posts in the coming months. Note that even some non-prescription strength skin lightening creams can cause side effects with overuse, so always consult a dermatologist before use.
In this JAAD paper, the authors highlight some cosmeceutical agents and melanogenesis inhibitors that are popular in treating hyperpigmentation in darker skin types. Most of these act as tyrosinase inhibitors.
Hydroquinone.
Topical retinoids.
Hydroxy acids (lactic, glycolic, salicylic acid).
Azelaic acid.
Kojic acid.
Licorice extract.
Niacinamide.
When it comes to anti-aging, among the products that are commonly used by people of color include: antioxidants, peptides and growth factors. Photoprotection via sunscreen use is significantly lacking in the black population.
