Melanin makes the skin more sensitive and vulnerable to injury

Jessica Yadegaran:

Contrary to popular belief, darker skin is not tougher; in fact, while extra melanin does have its benefits -- sun protection and slowed signs of aging -- it makes the skin more sensitive and vulnerable to injury.

"If the skin is darker it is prone to scarring and hyper-pigmentation, so we have to be more careful with skin of color," says Terri Dunn, a Berkeley dermatologist. One-third of Dunn's patients are of Latin, Asian, Indian, Mediterranean or African-American descent, and thus require special skin care.

Even acne or laser hair removal should be handled differently on dark skin. And as cosmetic procedures -- and medi-spas -- grow in popularity, Dunn and other Bay Area specialists advise their dark-skinned patients to proceed cautiously and realize their skin is at risk. Many common cosmetic procedures are geared toward lighter skin, and it's only recently, as the country's ethnic population has grown to 40 percent, that science is playing catch-up, so to speak.

"In the past couple of years, devices, cosmetics and topical medications are being tested on people of different colors because we realize that the skin reacts differently," says Philadelphia dermatologist Susan Taylor, founder of New York's Skin of Color Center and author of "Brown Skin: Dr. Susan Taylor's Prescription for Flawless Skin, Hair and Nails."

"Even the FDA is requiring companies to make sure their clinical trials include individuals from different backgrounds."

Among the most common side effects are hyper- or hypo-pigmentation, dark or light skin spots that result from any type of trauma, be it a cut, burn, acne or eczema. Bleaching creams and retinoids can be used to treat hyper-pigmentation, Dunn says.

It's also a side effect of many cosmetic procedures. To avoid it, specialists prime the skin and use a lower-strength solution when doing chemical peels on darker patients. They leave it on for a shorter time, Dunn explains, and recommend longer intervals for optimum results. With microdermabrasion, they use linear strokes at a lower setting.

"There are lasers that transmit a long pulse and are better-suited for pigmented skin," Taylor says. "Physicians should test spots to check for side effects over a period of 24 to 72 hours. Also, either the dermatologist should do the procedure or someone who is trained by him. You don't want to go to a medi-spa where there isn't a physician."

In dark skin, popular fillers such as Restylane and collagen and even piercings and tattoos can cause keloids, or raised scar tissue, that must be surgically removed and tend to grow back. Laser hair removal, another simple procedure, can burn, blister and scab the skin if the laser is too strong.

When researching dermatologists, Taylor advises, ask if the physician has the FDA-approved lasers for ethnic skin, and what percentage of his clientele has dark skin. The best place to start, she says, is with recommendations from family and friends who've had good experiences.

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