Cosmetic Considerations in Dark-Skinned Patients

This review highlights the considerations for cosmetic procedures in patients with dark skin, emphasizing the need for dermatologists to tailor treatments appropriately. Although individuals with darker skin have similar epidermal thickness and melanocyte numbers compared to those with fair skin, they exhibit more compact stratum corneum, greater melanosome dispersion, and increased melanocyte activity, which can affect treatment outcomes. Superficial chemical peels and microdermabrasion are generally safe for dark-skinned patients, while medium-depth peels require extreme caution and deep-depth peels should be avoided due to the risk of pigmentary and textural complications. Recommendations for these patients include prolonged treatment intervals, the use of priming agents, and strict sun protection. Injectable treatments like botulinum toxin and hyaluronic acid fillers are considered safe. However, caution is advised with lasers and energy-based devices due to the higher melanin content, which can lead to pigmentary or textural changes if aggressive treatment protocols are used. High energy settings, pulse stacking, short wavelength lasers, and short treatment intervals should be avoided to minimize risks.