Lasers, like the skin concerns they treat, are complicated. Historically, the light-emitting devices used to inhibit hair growth and zap dark spots have been seen as a no-go for black women because of the rumoured potential for burns and hyperpigmentation. But, despite their long-standing reputation, experts say the generalisation that lasers aren't safe is nothing more than a myth.
"There are many new laser devices that are safe and effective for black complexions," says Adebola Dele-Michael, MD, FAAD. "There are also many experienced dermatologists who offer these laser treatments." To help sort through the clutter of information out there, we spoke to dermatologists who specialise in treating black skin to break down everything — yes, everything — you should know about laser treatments.
What is laser, anyway?
"A laser is a focused light where all the energy packets target in one direction," explains Jenna Lester, MD, head of the new Skin of Color Clinic at University of California, San Francisco. "Normal light is usually scattered everywhere, but with laser, you get energy focused in one particular location."
In the case of permanent hair removal, one of the most common laser procedures, Dr. Lester says, “The laser energy is absorbed by the target, which in this case is the hair follicle. It heats up the target enough to destroy it.” Once the follicle is damaged, it delays or totally prevents further hair growth. "Any laser can be used on any part of the body since it's all skin," says Dr. Lester. "What's important is the type of laser and the person using it." Dermatologists also recommend laser treatments for treating hyperpigmentation, acne scars, broken capillaries, and sun spots.
Are lasers safe for black women?
According to experts, the short answer is yes. Carlos Charles, MD, dermatologist and founder of Derma di Colore, tells us that the idea that black women can't use lasers is all wrong. "That's a huge misconception, and several lasers can be safely used on brown and black skin," Dr. Charles says. "The most important factor is that laser procedures are performed by a skilled, board-certified dermatologist who is experienced in using laser devices on dark skin."
So where does the misconception come from?
The long-held theory has been that, because lasers target pigment, a laser could get "confused" and target the natural pigment of darker skin rather than the hair follicle, resulting in a burn. Yes, Dr. Lester explains, there were instances of that happening — but the advancement of laser technology allows for reliable treatment in dark skin that didn't exist years ago.
"To be clear, anyone can get a burn with any laser," Dr. Lester says. "However, many devices like the Nd:YAG laser have great wavelengths that sidestep this issue." Many popular brands, like Candela, Deka, and Quantum Systems, utilise Nd:YAG, which is a sophisticated type of laser technology that yields maximal results with minimal absorption into skin tissue.
What skincare concerns can lasers treat?
Lasers are very commonly used for body hair removal, and Dr. Lester says that many of her black patients see her for hair removal on the cheek and neck area as well. "It's prevalent among black women to get ingrown hairs on that area," she explains. In extreme cases, it can be used to treat hirsutism, which is when women experience male-pattern hair growth on the face, chest, and back. "That can be an inherited variant, or a result of a condition like polycystic ovarian syndrome," Dr. Lester says. Additionally, Dr. Charles assures that lasers are safe and effective for treating inflammatory acne, hyperpigmentation, acne scarring, and some cases of melasma.
What types of lasers and treatments should black people avoid?
Even though most experienced professionals do recommend many laser services for their patients of colour, there are a few treatments that the experts say to approach with caution. "Resurfacing lasers should generally be avoided," Dr. Lester says. "Lasers like Fraxel and CO2 can be dangerous because they're taking off a layer of skin," which can result in permanent hyperpigmentation when used on dark complexions.
Are there specific complexions that aren't cleared for laser treatments?
Another laser misconception is that the devices are especially unsafe for darker-skinned black women, compared to medium-brown and light black complexions. However, experts say that notion is generally false. The Fitzpatrick scale, according to Dr. Dele-Michael, was designed to determine which complexions can be treated by particular lasers. "Fitz 1-2 are individuals that sunburn and do not tan after sun exposure," she explains, "while Fitz 3-6 are individuals that have the ability to tan."
According to Dr. Dele-Michael, Fitz 5 and 6 are usually darker complexions that can develop skin injury if certain lasers wavelengths are used to treat the skin. However, misuse of lasers on any skin tone may result in unwanted injury. With that in mind, Dr. Dele-Michael recommends speaking to a board-certified dermatologist (always check their credentials on the General Medical Council register) beforehand — no matter your complexion.
The bottom line, Dr. Lester says, is making sure your skin is in good hands, and that you pay attention to how your face feels during laser services. "Your skin shouldn't be wildly painful, raw, or open during laser," she says. "If that is the case, then something went really wrong." Dr. Lester also recommends that her patients avoid heavy complexion makeup a week leading up to treatment, and to avoid waxing. "These products have pigment and can lead to burning, and waxing may remove the target for the laser," she warns.
Above all, don’t let beauty myths and misinformation limit you when it comes to treating your skin. “Laser is something I recommend to all of my patients if they’re interested and if it’s a fit,” says Dr. Lester. “It’s safe and effective when done at the hands of an experienced professional." So, now that you're armed with the facts, feel free to go forth and find a place and person you trust to embark on your laser journey.