Until recently, in-office options were limited by skin shade. Now, thanks to advanced technology and inclusive-minded dermatologists, possibilities abound.

Women of different skin tones
Credit: Delmaine Donson/Getty

Uneven pigmentation, sun damage, a rough and bumpy complexion, unwanted hair — these are universal issues we seek the help of dermatologists for. But getting successful fixes hasn’t always been available to many skin colors: Older lasers and peels posed a strong risk of discoloration or scarring on shades darker than “medium.” Essentially, anyone with brown or black skin hoping to even out their tone or texture or smooth their body was simply out of luck.

Thankfully, those days are behind us, but only recently. With an eye toward inclusivity, professional equipment and formulas have been modernized. “An improved device works with any skin tone, and the right doctor can customize a treatment to deliver real, lasting benefits,” says dermatologist Mona Gohara, M.D., a Shape Brain Trust member.

The key words, however, are the right doctor. Certain technologies are advanced enough to use on dark pigments, but dermatologists receive no formal training to treat skin of color. That’s a shocking fact considering that 40 percent of Americans identify as people of color. The important first step in pursuing care is finding a doctor who is well versed in treating your skin. “Don’t be afraid to ask about your dermatologist’s experience with patients with a similar skin type and color as your own,” says Nada Elbuluk, M.D., a dermatologist and a professor at the University of Southern California. (Related: Black-Owned Beauty Brands to Support Today, Tomorrow, and Always)

Once you land on a qualified pro, your doctor will see where you fall on the Fitzpatrick scale. “This scale classifies skin based on its response to UV light,” says Dhaval Bhanusali, M.D., a dermatologist in New York. “It helps us understand which laser options are safe for patients.” The scale ranges from type 1 (very fair, burns easily in the sun, never tans) to type 6 (melanin-rich skin that tans in the sun, never burns, and can be prone to hyperpigmentation).

But your analysis doesn’t stop at skin tone. Medical history weighs into your protocol as well. “We ask if the patient has had any skin conditions, sensitivity to skin care, or prior treatments. We also want to know about current medications and allergies, as well as occupation and the amount of sun exposure you get,” says Dr. Elbuluk.

Ethnicity is also important to consider when customizing a treatment, but it doesn’t determine your skin type, says Dr. Gohara. Even though someone may appear to have light skin, they still may be prone to hyperpigmentation due to their heritage. “When you’re getting a procedure, it’s important that you share information about how you scar with your doctor so they know how to adjust their approach,” says Dr. Gohara. Here are the treatment options that all shades can now consider:

Chemical Peels

An in-office chemical peel is universally beneficial when done correctly. “These peels break down the glue that holds the skin cells together, allowing them to slough off and reveal new skin that’s more radiant, even, and smooth,” says Dr. Gohara. There are varying strengths. A superficial peel, for example, contains acids that penetrate only the top layer of skin and can help address pigmentation, tone, and texture. Medium and deep peels penetrate the second layer of the skin and also help address deeper wrinkles and texture changes. (Related: Your Guide to At-Home Chemical Peels)

“We can use superficial, medium, and deep peels on light skin tones, but we tend to apply only superficial peels for people with dark skin because we want to avoid side effects like skin discoloration,” says Dr. Elbuluk. “Superficial peels are still very effective, especially when we can perform a series of three to six of them a few weeks apart.” Depending on the depth, you may experience redness and peeling after the treatment, and recovery time will vary from hours to a few weeks. “It’s important to stop using certain products, like retinoids, a week before the peel and to be diligent about wearing sunscreen before and after it,” says Dr. Elbuluk.

Laser Hair Removal and Skin Treatments

Laser hair removal was once safe and effective only for people who had both fair skin and dark hair. It was a technology limitation: the tool worked best when there was a lot of contrast. “If the laser couldn’t distinguish between the two, it would burn the skin instead of zap the hair,” says Dr. Bhanusali.

New devices have solved this problem by adjusting the wave lengths. Longer wave lengths — emitted by Nd:YAG and diode lasers — focus their heat on the second layer of skin, bypassing the first layer to avoid potential scarring. That makes them ideal for brown and Black women. That same customizable wave length technology is applied to skin treatments as well. Acne, wrinkles, age spots, and tattoos can all be treated on melanin-rich skin by targeting pigment and stimulating a wound-healing response to reverse signs of aging. “Another feature that makes them so skin-friendly is their ability to simultaneously cool the area, counteracting the heat from their energy,” says Dr. Gohara. “That means less trauma and therefore less hyperpigmentation or scarring risk.” (Related: I Was ThisClose to Lasering Off My Pubes for Life—Here's What Stopped Me)

Collagen Stimulators

There are also treatment options that don’t use light or heat at all. These tend to be safe for everyone since there’s no risk of burning the skin. “I perform microneedling on all tones,” says Kim Nichols, M.D., a dermatologist in Connecticut. “Pricking the skin with tiny needles promotes collagen production, which over time plumps and smooths skin.”

She prefers to do the treatment in combination with plasma-rich platelet therapy, which involves applying a layer of the growth factors taken from a vial of your blood onto your face to speed healing and results. Another option: Ultherapy, which uses ultrasound waves to tighten skin, says Dr. Goahara. The energy aims at the collagen layers under the epidermis, so there are no changes to the complexion — no matter your skin color.

Shape Magazine, December 2020 issue