title: Special considerations for darker-skinned patients.
abstract: Today, lasers are being used to treat an increasing number of medical and aesthetic challenges with great success. However, the effects of laser treatments upon darker-skinned patients differ from those on Caucasians in several aspects; this makes their use not without risk. First of all, skin of color has a greater epidermal melanin content than Caucasian skin, and this increase in epidermal pigmentation acts as a competing chromophore. Furthermore, with epidermal melanin acting as a competing chromophore, the light dosage that reaches the actual target is reduced, and higher fluence is necessary to produce a desirable effect. Although effective cooling and longer wavelengths with decreased melanin absorption have been used, the treatment of patients with Fitzpatrick skin types > IV remains associated with a significant risk of side effects. Thus, careful selection of laser and light source parameters in conjunction with skin cooling are important in obtaining desirable clinical outcomes in ethnic skin.
authors.affiliation: Division of Dermatology, Department of Medicine, University of Hong Kong, Hong Kong, SAR, China; Wellman Center of Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Mass., USA.
authors.forename: Henry H L
authors.initials: HHL
authors.lastname: Chan
mesh_terms: D002921:Cicatrix / Q000601:surgery; D062109:Dermatologic Surgical Procedures; D005006:Ethnicity; D006204:Hair Removal / Q000379:methods; D006801:Humans; D053685:Laser Therapy / Q000379:methods; D008543:Melanins / Q000502:physiology; D010859:Pigmentation Disorders / Q000601:surgery; D012867:Skin / Q000737:chemistry / Q000528:radiation effects; D012871:Skin Diseases / Q000601:surgery*; D012880:Skin Pigmentation / Q000528:radiation effects*
chemical_list: D008543:Melanins