Laser Glossary
Lasers are used in advanced skin treatments, providing an effective method for treating many common concerns, including excess hair, hyperpigmentation and uneven skin tone, stretch marks, skin tags, scarring and even skin that has lost tone and elasticity with age.
In the past, laser treatment has not been recommended for Black skin as there was a high risk of hyperpigmentation as well as treatments not producing successful results.
So how do you know which treatments are suitable for you and what to avoid? Don’t worry, Black Skin Directory is here to help you get to grips with laser skin treatments.
What are Lasers?
Laser treatments primarily work by finding colour or texture differences on the surface of the skin, before targeting the area of concern using heat energy. For example by detecting dark hair against lighter skin, the laser can deactivate the hair follicles to reduce hair growth. In hyperpigmentation treatment, the laser needs to clearly distinguish where the area of darker skin begins and ends to break down the excess melanin cells without affecting the surrounding skin. Unfortunately, on Black skin these colour differences are often too subtle, and the laser can’t recognize the area that needs treating. This leads to the wrong areas of skin being targeted resulting in poor treatment results.
Added to this, many laser treatments only penetrate the upper layers of the skin, exactly where the melanin cells (melanocytes) are found. The wrong laser treatment can activate these cells, causing unwanted hyperpigmentation. So it’s a double whammy, your concerns aren’t improved and there is a high risk of further concerns arising!
Fortunately, huge amounts of work has been done to make laser treatments that are suitable for Black skin. The Nd:YAG laser produces longer wavelengths, meaning it misses the melanocytes, reducing the risk of hyperpigmentation, while also effectively tackling your concerns. Meg McGinn, Head of Operations and Clinical Training at Every Skin Clinic adds that ‘The reason this wavelength is suitable is that the larger percentage of its attraction is to the blood supply of the hair rather than pigment. This ensures there is greater safety to the skin and less chance of pigmentation changes.’ The Diode laser also suitable for use on Black and darker skin tones.
Debbie Thomas, Laser Specialist and founder of D. Thomas Clinic notes ‘Almost all laser types will have a stronger reaction on darker skin, even the ones that claim not to see the melanin. So settings will need to be adjusted for this, the lower settings means safety but also can mean that more sessions are needed. Several lasers and light technologies are not suitable for darker skin tones because they are too attracted to pigment, they will injure the skin by burning due to the over absorption of laser light by the abundant melanin. So the right laser and the right practitioner is key for a safe and successful treatment.’
Laser 101
Laser can be used to treat almost any skin concern related to texture, skin laxity and hyperpigmentation. Many people also choose laser treatment to reduce unwanted hair growth, where plucking or shaving are causing hyperpigmentation and ingrown hairs. Stubborn hyperpigmentation that has not responded to alternative treatments can also be targeted with lasers along with rough texture and some scarring, such as icepick scars (small deep holes in the skin) or rolling scars which create an uneven, slightly lumpy, appearance on the skin, both commonly caused by acne. Laser can also be successfully used to treat stretch marks, skin tags and DPN.
Knowing when laser is the right treatment for your concerns is different for everyone. It’s important to make sure your skin is strong and able to tolerate the treatment, even at a low level. Your skin practitioner will be able to suggest the best skincare routine for you and whether you need to strengthen your skin first with alternative treatments such as chemical peels, before moving on to laser treatments.
When treating concerns on Black skin, avoid Ablative lasers (also known as CO2 or Fraxel lasers). They are designed to resurface, treat wrinkles and skin laxity and remove the upper layer of the skin while driving large amounts of heat into the lower layers to produce a tightening effect. This is far too harsh for Black skin, and comes with a very high risk of unwanted discolouration. If you are interested in comprehensive skin resurfacing to improve scarring, Advanced Aesthetician Andy Millward suggests considering the Venus Versa NanoFractional System as a good alternative. Whilst not strictly as laser, it works in a similar ablative way, but is suitable for all skin types including darker skin tones.
Not all lasers are created equally….or are even lasers
Similarly, BBL (Broadband Light Laser) isn’t suitable for darker skin tones. The wavelengths are too short and will target your natural skin tone, mistaking the melanocytes for unwanted pigmentation. This can lead to hyperpigmentation, but also burning, scarring and loss of pigment (hypopigmentation).
Commonly mistaken for laser, IPL (Intense Pulsed Light) Therapy is also not suitable for Black skin. This treatment is used for hair reduction, as well as brightening skin tone and treating hyperpigmentation and similar to many laser treatments, IPL works by targeting the darker areas of skin, or the hair follicle. However on darker skin tones, the light energy is scattered and unable to distinguish the darker areas clearly, which may lead to skin damage such as scarring, hyperpigmentation or burns. Not to mention the emotional distress.
Lasers are commonly used for tattoo removal as the heat energy can effectively break down the pigment of the tattoo in the skin. Laser tattoo removal is possible on Black skin, however it is important to find a highly experienced practitioner. They may perform more sessions at a lower strength in order to prevent damage to your skin. Debbie Thomas adds ‘Tattoo removal is very tricky, the ink can be successfully removed however there is a good chance that you can develop hypo-pigmentation in the shape of the tattoo. This may or may not correct over time.’
When laser is not suitable?
Laser is a great option for many people and their skin concerns. However there are a couple of situations where we recommend either waiting to start treatment, or trying something else.
Although there is no definitive evidence that using laser skin treatments while pregnant or breastfeeding is unsafe to you or your baby, there is also not enough information or data to confirm that it’s safe. As the safety is not fully understood and we know that during pregnancy skin can be very sensitive and unpredictable, it is best to wait until you aren’t pregnant and have finished breast feeding to undertake any laser skin treatments.
Despite the rapid improvements in laser technology over the last few decades, it is still unable to effectively reduce the growth of grey hair. A good alternative treatment for Black skin is electrolysis. Unlike laser, electrolysis doesn’t require a distinct colour difference between the hair and skin in order to work, and instead uses targeted heat energy through a sterile, disposable needle carefully inserted into the hair follicle to prevent hair growth.
Before, After and During Laser
The success of your laser procedure is very dependent on how you care for your skin before and after treatment.
It is important to avoid or pause any active ingredients such as AHA’s, BHA’s and Retinoids which may cause your skin to be more sensitive. You should do this 3 - 5 days before your treatment and your practitioner will be able to advise you of their exact requirements.
Make sure you are religious with sunscreen, this is crucial for laser preparation. Laser can significantly sensitise your skin especially to UV rays from the sun so it’s important to take steps to avoid any reactions. Meg Mcginn from Every Skin Clinic advises ‘clients of all skin types will still need to avoid sun exposure for two weeks before and after their appointments.’
Straight after your treatment, your skin will feel warm and may feel slightly itchy for a couple of hours. Your therapist will ask you to use hydrating and calming skincare products for a few days, so that your skin recover before easing back into using any active ingredients.
Does laser skin treatment hurt?
Many people compare the feeling of laser to having their skin snapped with a rubber band. You can expect a short sharp, slightly stinging sensation along with some warmth in the areas the laser has treated, but this usually subsides within a couple of hours after treatment. Most practitioners use a cool air devices or even ice cubes alongside the laser to provide immediate skin relief, reduce heat on the skin and prevent hyperpigmentation.
During your period, it’s common for laser treatment to feel even more sensitive and uncomfortable. Taking some paracetamol an hour prior to your treatment can be helpful or booking your treatment at a more convenient point in your cycle.
Your therapist may also start your treatment from a low setting and build up over time as your tolerance improves - this may also mean you need more treatments.
Questions to ask your laser practitioner
It is key that you have full trust in anyone performing laser treatments on you.
Ask how long they have been qualified for and how many Black clients they have treated. If they can show you any before and after images, even better!
Make sure you are both clear on the treatment plan, and how they intend to reduce the risks of hyperpigmentation and scarring.
Every laser practitioner should perform a patch test, at least 48 hours before your first treatment to make sure you are suitable for laser treatment. A patch test should also be performed if you’ve been on holiday and have a tan.
Risks & Costs
As with any cosmetic skin treatment there are risks and complications you should be aware of, and that your skin practitioner should discuss these with you during your consultation. On darker skin tones where some of these risks may be higher and it is important to find a practitioner that is experienced in treating Black skin in order to reduce these complications.
Skin irritation - It’s very normal to experience some warmth and itching for a few hours after your laser treatment, however in some instances this may continue for a longer period. If this occurs, speak with your therapist so they are able to adjust your treatment to suit your skin’s tolerance better
Pigmentation changes - Laser treatments can cause skin darkening (hyperpigmentation) or loss of pigment in the skin (hypopigmentation). This is most likely to occur if you are being treated by an inexperienced practitioner, who is not used to working with Black skin. These pigmentation changes may be temporary or permanent.
Blistering, burns or crusting of the skin - This is caused by the laser settings being too high, and again is usually due to the practitioner being inexperienced. This is something to be cautious of if you have Black skin, as although the injuries themselves will be treatable, they may lead to hyperpigmentation, hypopigmentation, or scarring which are more challenging to treat.
Very rarely, laser can trigger even more hair growth. This is usually caused when the laser settings are too low during treatment.
How much does laser skin treatment cost?
This is the million dollar questions because there are so many variables. Depending where you are laser prices can vary and the worst thing you can do is cut corners and compromise on safety to save your pennies and cents.
Expect to pay more for an experienced laser practitioner, who is also confident in treating Black skin. Large inner city based clinics in places like London New York or Los Angeles will cost more, the type and brand of laser machinery will also also impact the cost.
For hair reduction prices are usually charged per area and you can expect to pay around £75-£100 per session for a smaller area such as the underarms, through to around £300 for each leg. Laser skin treatments are usually priced based on time - a ten minute session can vary from £80 to £200. If the laser procedure is included as part of a facial treatment including chemical peels and LED Light Therapy, expect to pay more.
Most clinics offer packages for laser so you can spread the costs easily, but its important to make sure you can budget for the entire course so that you get the best results for your investment.