Laser Surgery in Dark Skin

Although challenging, effective laser surgery in patients with darker skin tones can be achieved despite a higher inherent risk of side effects. Although the incidence of undesirable postoperative sequelae has decreased with the development of advanced laser technology and individualized treatment parameters, these risks may never be eliminated completely. Consequently, thorough patient preoperative preparation and education regarding the risks of cutaneous laser therapy will remain an essential component of treatment in darkly pigmented patients. In the future, as more refined laser techniques evolve, the ability to safely and effectively treat these patients will improve.

[1]  S. Kilmer.  Laser treatment of tattoos , 1997 .

[2]  H. Chan,et al.  Laser treatment of congenital facial port‐wine stains: Long‐term efficacy and complication in Chinese patients , 2002, Lasers in surgery and medicine.

[3]  H. Chan,et al.  Q‐switched ruby versus long‐pulsed dye laser delivered with compression for treatment of facial lentigines in Asians , 2006, Lasers in surgery and medicine.

[4]  B. Zelickson,et al.  Pulsed dye laser therapy for sun damaged skin , 1999, Lasers in surgery and medicine.

[5]  T. Alster,et al.  Optimizing treatment parameters for hair removal using a topical carbon-based solution and 1064-nm Q-switched neodymium:YAG laser energy. , 1997, Archives of dermatology.

[6]  S. Kunachak,et al.  Q-Switched ruby laser therapy of acquired bilateral nevus of Ota-like macules. , 1999, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[7]  D J Goldberg,et al.  Laser treatment of pigmented lesions. , 1997, Dermatologic clinics.

[8]  D. Goldberg,et al.  Treatment of Hori's Nevus with the Q‐Switched Nd:YAG Laser , 2000, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[9]  H. Chan,et al.  An in vivo trial comparing the clinical efficacy and complications of Q-switched 755 nm alexandrite and Q-switched 1064 nm Nd:YAG lasers in the treatment of nevus of Ota. , 2000, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[10]  T. Alster.  Cutaneous resurfacing with CO2 and erbium: YAG lasers: preoperative, intraoperative, and postoperative considerations. , 1999, Plastic and reconstructive surgery.

[11]  R. Fitzpatrick,et al.  Facial resurfacing in patients with Fitzpatrick skin type IV * , 2002, Lasers in surgery and medicine.

[12]  E. Tanzi,et al.  Lasers in dermatology: four decades of progress. , 2003, Journal of the American Academy of Dermatology.

[13]  J. Nelson,et al.  Cryogen spray cooling and higher fluence pulsed dye laser treatment improve port-wine stain clearance while minimizing epidermal damage. , 1999, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[14]  T. Alster,et al.  Comparison of four carbon dioxide resurfacing lasers. A clinical and histopathologic evaluation. , 1999, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[15]  Ivani Greppi.  Diode laser hair removal of the black patient , 2001, Lasers in surgery and medicine.

[16]  P. Bitter,et al.  Noninvasive Rejuvenation of Photodamaged Skin Using Serial, Full‐Face Intense Pulsed Light Treatments , 2000, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[17]  J. Ruiz‐Esparza,et al.  UltraPulse Laser Skin Resurfacing in Hispanic Patients: A Prospective Study of 36 Individuals , 1998, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[18]  I. Hashimoto,et al.  Successful Treatment of Dark‐colored Epidermal Nevus with Ruby Laser , 1995, The Journal of dermatology.

[19]  Y. Sue,et al.  A comparison of Q-switched alexandrite laser and intense pulsed light for the treatment of freckles and lentigines in Asian persons: a randomized, physician-blinded, split-face comparative trial. , 2006, Journal of the American Academy of Dermatology.

[20]  E. Tanzi,et al.  Fractional Photothermolysis: Treatment of Facial and Nonfacial Cutaneous Photodamage with a 1,550‐nm Erbium‐Doped Fiber Laser , 2007, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[21]  Murad Alam,et al.  Clinical Application of Lasers in Asians , 2002, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[22]  H. Chan,et al.  A retrospective study looking at the long‐term complications of Q‐switched Ruby laser in the treatment of nevus of Ota , 2001, Lasers in surgery and medicine.

[23]  R. Anderson,et al.  Laser treatment of tattoos in darkly pigmented patients: efficacy and side effects. , 1996, Journal of the American Academy of Dermatology.

[24]  H. Chan,et al.  An In Vivo Study Comparing the Efficacy and Complications of Diode Laser and Long‐Pulsed Nd:YAG Laser in Hair Removal in Chinese Patients , 2001, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[25]  T. Alster,et al.  Pulsed dye laser treatment of hypertrophic burn scars. , 1998, Plastic and reconstructive surgery.

[26]  E. Tanzi,et al.  Comparison of a 1450‐nm Diode Laser and a 1320‐nm Nd:YAG Laser in the Treatment of Atrophic Facial Scars: A Prospective Clinical and Histologic Study , 2004, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[27]  E. Ross,et al.  Nonablative laser skin remodeling. , 2002, Dermatologic clinics.

[28]  C. Goh,et al.  Treatment of Acquired Bilateral Nevus of Ota-Like Macules (Horiʼs Nevus) with a Combination of the 532 nm Q-Switched Nd: YAG Laser Followed by the 1,064 nm Q-Switched Nd , 2006 .

[29]  R. Weiss,et al.  Rejuvenation of Photoaged Skin: 5 Years Results with Intense Pulsed Light of the Face, Neck, and Chest , 2002, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[30]  Jin Wang Kim,et al.  Skin Resurfacing with Laser in Asians , 1997, Aesthetic Plastic Surgery.

[31]  I. Orengo,et al.  The Q‐switched ND: YAG Laser Effectively Treats Tattoos in Darkly Pigmented Skin , 1996, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[32]  P. Friedman,et al.  Use of the 308-nm excimer laser for postresurfacing leukoderma. , 2001, Archives of dermatology.

[33]  T. Alster.  Complications of Carbon Dioxide Laser Resurfacing. An Evaluation of 500 Patients , 1998, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[34]  Y. Sue,et al.  Intense Pulsed Light for the Treatment of Refractory Melasma in Asian Persons , 2004, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[35]  T. Alster,et al.  Erbium:YAG laser resurfacing for refractory melasma. , 1999, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[36]  E. Tanzi,et al.  Treatment of Facial Rhytides With a Nonablative 1,450‐nm Diode Laser: A Controlled Clinical and Histologic Study , 2003, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[37]  T. Alster,et al.  Laser treatment of darker skin tones: a practical approach , 2000 .

[38]  R. Geronemus,et al.  Multicenter study of noninvasive radiofrequency for periorbital tissue tightening , 2003, Lasers in surgery and medicine.

[39]  A. L. Timko,et al.  Treatment of pseudofolliculitis barbae in skin types IV, V, and VI with a long-pulsed neodymium:yttrium aluminum garnet laser. , 2002, Journal of the American Academy of Dermatology.

[40]  K. Khatri,et al.  Comparison of erbium:YAG and carbon dioxide lasers in resurfacing of facial rhytides. , 1999, Archives of dermatology.

[41]  E. Tanzi,et al.  Single‐Pass Carbon Dioxide Versus Multiple‐Pass Er: YAG Laser Skin Resurfacing A Comparison of Postoperative Wound Healing and Side‐Effect Rates , 2003, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[42]  E. Tanzi,et al.  Treatment of Atrophic Facial Acne Scars with a Dual‐Mode Er:YAG Laser , 2002, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[43]  Rei Watanabe,et al.  Evaluation of the treatment of port-wine stains with the 595-nm long pulsed dye laser: a large prospective study in adult Japanese patients. , 2006, Journal of the American Academy of Dermatology.

[44]  A. Kauvar,et al.  Pulsed alexandrite laser for the treatment of leg telangiectasia and reticular veins. , 2000, Archives of dermatology.

[45]  T. Alster,et al.  Comparison of Long‐Pulsed Diode and Long‐Pulsed Alexandrite Lasers for Hair Removal: A Long‐Term Clinical and Histologic Study , 2001, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[46]  E. Tanzi,et al.  Cutaneous laser surgery in darker skin phototypes. , 2004, Cutis.

[47]  H. Chan,et al.  The Use of Variable Pulse Width Frequency Doubled Nd:YAG 532 nm Laser in the Treatment of Port‐Wine Stain in Chinese Patients , 2000, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[48]  A. Grobbelaar,et al.  The long-term results of ruby laser depilation in a consecutive series of 346 patients. , 2002, Plastic and reconstructive surgery.

[49]  J. Handley,et al.  Evaluating the Efficacy of Treatment of Resistant Port‐Wine Stains With Variable‐Pulse 595‐nm Pulsed Dye and 532‐nm Nd:YAG Lasers , 2004, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[50]  S. Zimmo,et al.  Alexandrite Laser Hair Removal is Safe for Fitzpatrick Skin Types IV‐VI , 2000, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[51]  C. Jones,et al.  Retinoic acid and CO2 laser resurfacing. , 1999, Plastic and reconstructive surgery.

[52]  R. Anderson,et al.  Ineffective treatment of refractory melasma and postinflammatory hyperpigmentation by Q-switched ruby laser. , 1994, The Journal of dermatologic surgery and oncology.

[53]  E. Tanghetti,et al.  Multipass Treatment of Photodamage Using the Pulse Dye Laser , 2003, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[54]  S. Kunachak,et al.  Q‐switched Nd:YAG laser treatment for acquired bilateral nevus of Ota‐like maculae: A long‐term follow‐up , 2000, Lasers in surgery and medicine.

[55]  T. Alster,et al.  Prevention and Treatment of Side Effects and Complications of Cutaneous Laser Resurfacing , 2002, Plastic and reconstructive surgery.

[56]  T. Alster,et al.  Long-pulsed Nd:YAG laser-assisted hair removal in pigmented skin: a clinical and histological evaluation. , 2001, Archives of dermatology.

[57]  Marc Clement,et al.  Selective non-ablative wrinkle reduction by laser , 2000, Journal of cutaneous laser therapy.

[58]  T. Alster,et al.  Nonablative Laser Skin Resurfacing using a 1540 nm Erbium Glass Laser: A Clinical and Histologic Analysis , 2002, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[59]  Sandy S Tsao,et al.  Long-pulsed neodymium:yttrium-aluminum-garnet laser treatment for port-wine stains. , 2005, Journal of the American Academy of Dermatology.

[60]  S. Vlachos,et al.  Hair induction after laser-assisted hair removal and its treatment. , 2006, Journal of the American Academy of Dermatology.

[61]  J. Dover,et al.  Laser surgery of leg veins. , 2002, Dermatologic clinics.

[62]  R G Wheeland,et al.  Laser-assisted hair removal. , 1997, Dermatologic clinics.

[63]  E. Tanzi,et al.  The Use of Fractional Laser Photothermolysis for the Treatment of Atrophic Scars , 2007, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[64]  K. Arndt,et al.  New approaches to the treatment of vascular lesions , 2000, Lasers in surgery and medicine.

[65]  J. Nelson,et al.  Prospective Study of Pulsed Dye Laser in Conjunction With Cryogen Spray Cooling for Treatment of Port Wine Stains in Chinese Patients , 2003, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[66]  T. Alster,et al.  Treatment of Nevus of Ota by the Q‐switched Alexandrite Laser , 1995, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[67]  J. Ruiz‐Esparza,et al.  Long-term effects of one general pass laser resurfacing. A look at dermal tightening and skin quality. , 1999, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[68]  Z. Tannous,et al.  Utilizing fractional resurfacing in the treatment of therapy‐resistant melasma , 2005, Journal of cosmetic and laser therapy : official publication of the European Society for Laser Dermatology.

[69]  E. Tanzi,et al.  Long‐Pulsed 1064‐nm Nd: YAG Laser‐Assisted Hair Removal in All Skin Types , 2004, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[70]  E. Tanzi,et al.  Single-Pass Carbon Dioxide Versus Multiple-Pass Er: YAG Laser Skin Resurfacing , 2003 .

[71]  E. Tanzi,et al.  Side effects and complications of variable-pulsed erbium:yttrium-aluminum-garnet laser skin resurfacing: extended experience with 50 patients. , 2003, Plastic and reconstructive surgery.

[72]  H. Eun,et al.  Copper vapour laser treatment of port‐wine stains in brown skin , 1997, The Australasian journal of dermatology.

[73]  S. Iyer,et al.  A double-blind, side-by-side comparison study of low fluence long pulse dye laser to coolant treatment for wrinkling of the cheeks , 2001, Journal of cosmetic and laser therapy : official publication of the European Society for Laser Dermatology.

[74]  T. Alster,et al.  Comparison of the Long‐Pulse Dye (590–595 nm) and KTP (532 nm) Lasers in the Treatment of Facial and Leg Telangiectasias , 1998, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[75]  H. Chan,et al.  A Retrospective Study on the Efficacy and Complications of Q‐Switched Alexandrite Laser in the Treatment of Acquired Bilateral Nevus of Ota‐Like Macules , 2001, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[76]  S. Imayama,et al.  Response of naevus of Ota to Q‐switched ruby laser treatment according to lesion colour , 2000, The British journal of dermatology.

[77]  E V Ross,et al.  Nonablative skin remodeling: Selective dermal heating with a mid‐infrared laser and contact cooling combination , 2000, Lasers in surgery and medicine.

[78]  R. Anderson,et al.  Fractional Photothermolysis: A New Concept for Cutaneous Remodeling Using Microscopic Patterns of Thermal Injury , 2004, Lasers in surgery and medicine.

[79]  T. Alster,et al.  Laser-assisted hair removal: side effects of Q-switched Nd:YAG, long-pulsed ruby, and alexandrite lasers. , 1999, Journal of the American Academy of Dermatology.

[80]  T. Alster,et al.  Are all infrared lasers equally effective in skin rejuvenation. , 2002, Seminars in cutaneous medicine and surgery.

[81]  T. Alster,et al.  Q-switched alexandrite laser treatment (755 nm) of professional and amateur tattoos. , 1995, Journal of American Academy of Dermatology.

[82]  T. Alster,et al.  Effect of pretreatment on the incidence of hyperpigmentation following cutaneous CO2 laser resurfacing. , 1999, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[83]  D J Goldberg,et al.  Nonablative treatment of rhytids with intense pulsed light , 2000, Lasers in surgery and medicine.

[84]  E. Tanzi,et al.  Laser surgery in dark skin. , 2003, Skinmed.

[85]  M. Griffin,et al.  Laser Resurfacing in Pigmented Skin , 1995, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[86]  Murad Alam,et al.  Nonablative laser and light treatments: Histology and tissue effects—A Review , 2003, Lasers in surgery and medicine.

[87]  E. Tanzi,et al.  Improvement of Neck and Cheek Laxity With a Nonablative Radiofrequency Device: A Lifting Experience , 2004, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[88]  F. Johnson,et al.  Intense pulsed light treatment of hirsutism: case reports of skin phototypes V and VI. , 1999, Journal of cutaneous laser therapy.

[89]  M. Elgart.  Defining skin of color. , 2003, Cutis.

[90]  Chien‐Chih Lee,et al.  Hair Removal by Long-Pulse Alexandrite Laser in Oriental Patients , 2001, Annals of plastic surgery.

[91]  J I Youn,et al.  Histological responses of port wine stains in brown skin after 578 nm copper vapor laser treatment , 1996, Lasers in surgery and medicine.

[92]  S. Lanigan,et al.  Incidence of side effects after laser hair removal. , 2003, Journal of the American Academy of Dermatology.

[93]  H. Chan,et al.  The use of lasers and intense pulsed light sources for the treatment of pigmentary lesions. , 2004, Skin therapy letter.

[94]  H. Chan,et al.  Recurrence of nevus of Ota after successful treatment with Q-switched lasers. , 2000 .

[95]  R. Sheehan-Dare,et al.  Pulsed dye laser treatment of port-wine stains in pigmented skin. , 2000, Journal of the American Academy of Dermatology.

[96]  D. Goldberg,et al.  Histologic evaluation of a millisecond Nd:YAG laser for hair removal , 2001, Lasers in surgery and medicine.

[97]  R. Ashinoff,et al.  The removal of cutaneous pigmented lesions with the Q-switched ruby laser and the Q-switched neodymium: yttrium-aluminum-garnet laser. A comparative study. , 1994, The Journal of dermatologic surgery and oncology.

[98]  A. P. Kelly,et al.  Treatment of pseudofolliculitis barbae with the diode laser. , 1999, Journal of cutaneous laser therapy.

[99]  R. Fitzpatrick,et al.  The Treatment of Melasma with Fractional Photothermolysis: A Pilot Study , 2005, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[100]  G. Moreno‐Arias,et al.  Treatment of nevus of Ota with the Q‐switched alexandrite laser * , 2001, Lasers in surgery and medicine.

[101]  S. Chang,et al.  Successful Removal of Traumatic Tattoos in Asian Skin with a Q‐switched Alexandrite Laser , 1998, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[102]  David J Goldberg,et al.  Non‐ablative laser treatment of facial rhytides: A comparison of 1450‐nm diode laser treatment with dynamic cooling as opposed to treatment with dynamic cooling alone , 2002, Lasers in surgery and medicine.

[103]  Goh Cl,et al.  Treatment of Acquired Bilateral Nevus of Ota‐Like Macules (Hori's Nevus) with a Combination of the 532 nm Q‐Switched Nd:YAG Laser Followed by the 1,064 nm Q‐Switched Nd:YAG Is More Effective: Prospective Study , 2008 .

[104]  T. Alster,et al.  Single‐pass CO2 laser skin resurfacing of light and dark skin: extended experience with 52 patients , 2003, Journal of cosmetic and laser therapy : official publication of the European Society for Laser Dermatology.