In dermatology, a patient's skin color is an important consideration as the amount of pigmentation can greatly affect the results of treatment. Different ethnic groups face different issues with their skin and physicians have several options to treat patients of every skin tone.
"My patients of color really have different issues than my Caucasian patients," says Dr. Brooke Jackson. "Particularly when talking about cosmetic procedures, one of the biggest issues of ethnic patients is hyperpigmentation, or darkening of the skin." Dr. Jackson says that it's important to not only treat the areas of hyperpigmentation, but to identify and treat the cause. "I do try to be a little bit more aggressive with my treatments in those patients trying to get them cleared up more quickly. A lot of it is just educating patients because very often the ethnic patients come in concerned about the dark spots but they're not necessarily concerned about what caused them. We have to correct the underlying issue as well."
Actual Botox results of Dr. Brooke Jackson
Patients of color also face different cosmetic issues in regards to how they want to look following treatment. Dr. Jackson says her patients are very concerned with looking natural. "It can really be more of an issue of self esteem. Patients don't want to be accused of not wanting to be what their racial identity is. So usually with those patients we start them off with just a little bit of relaxing with Botox and maybe a little bit of filler around the nasal labial folds." She says that patients of color tend to show their aging around the mid and lower face and fillers treat those areas beautifully.
With all facial fillers, there is a concern about bruising at the injection site. In patients of color, this can be especially tricky because the bruising can cause some hyperpigmentation. As Dr. Jackson describes, "We let all of our patients know to ice the skin. One of the keys is injecting very slowly. With one particular filler, Sculptra, patients of color do tend to have a little bit more of a fibroplastic response. You want to inject a little bit less and see the patients a little less frequently. Generally with my Caucasian patients I will use Sculptra but do their sessions about every 4 weeks. Usually with my African American patients I'll stretch that out almost 2 months between sessions."
Actual Restylane results of Dr. Brooke Jackson
Dr. Jackson says that with careful application, lasers can be used on patients with darker skin. Lasers for hair removal target dark pigmentation in hair, but can also cause burns on dark skin. With a longer pulse duration and deeper penetration, Dr. Jackson says patients can be treated more safely.
It's important to be careful of the possible complications that patients of color face. There is a risk of hyperpigmentation and scarring, and it's important to work closely with patients and identify any medications they might be taking and their level of sun protection. "With a lot of patients of color they are not using any kind of religious sun protection and unfortunately a lot of patients of color are also taking medications that might increase their risk of sun sensitivity such as high blood pressure diabetic medications. That can play a role in their issues of hyperpigmentation. So I try to get as many patients of color as possible on some sort of skin protection."
As cosmetic procedures become more acceptable among their peers, Dr. Jackson says she's seeing a larger percentage of ethnic patients. "A lot of my baby boomers are coming in just to maintain their look. They want to be the best 50 or the best 60 that they can be rather than looking like they walked out of a Hollywood movie theater. It's a little more acceptable and they know a lot of their colleagues and friends are having something done," says Dr. Jackson. "They're not necessarily trying to look like they're 20, they really just want to be the best 50 that they can be."