In the pursuit of effective acne scarring treatment in individuals with skin of color, it is crucial to employ appropriate parameters and thorough counseling, as highlighted by Dr. DiAnne S. Davis, MD, FAAD, during a presentation at the American Society for Dermatologic Surgery Annual Meeting.
Dr. Davis, a board-certified dermatologist practicing in Dallas, emphasized the significance of acknowledging the unique characteristics of skin composition among patients with skin of color. During her presentation, she underscored the importance of assessing overall skin quality, degree of oiliness, and considering the broad absorption spectrum of melanin.
The use of lasers for acne scarring treatment, while promising, presents potential challenges, including dyschromia or post-inflammatory hyperpigmentation (PIH), particularly in individuals with skin of color. To mitigate these risks, practitioners must exercise caution, use the correct tools, and engage in comprehensive counseling with patients.
Dr. Davis stressed the importance of transparent communication with patients, evaluating the impact of scarring on their quality of life, and tailoring treatment options accordingly. Thorough genetic and scarring history, acne control, and strict compliance with sun protection (SPF) before treatment are integral components of this counseling process.
During the treatment phase, density is a critical consideration, especially when utilizing fractionated lasers. Studies indicate that higher energy and lower density settings can reduce the risk of PIH in patients with skin of color. Dr. Davis recommended a careful approach, advocating for the lowest density settings to minimize the risk of hyperpigmentation.
Moreover, employing larger spot sizes, avoiding bulk heating, and implementing pre- and post-cooling techniques contribute to further risk reduction. After treatment, adherence to complete sun avoidance is paramount, and the use of topical corticosteroids can be beneficial.
Dr. Davis conveyed an optimistic message, stating, “You can treat your skin of color patients.” However, she emphasized the need for practitioners to be mindful of adequate parameters, comprehensive counseling, and strict adherence to post-procedure protocols. By adopting these measures, dermatologists can navigate the challenges and deliver effective acne scarring treatments for individuals with skin of color.
