Laser Treatments for Asian and Darker Skin Tones: How to Lower the Risk of Dark Marks

By Your Health Magazine Contributor

Your Health Magazine Contributor

. https://YourHealthMagazine.net

More Beauty Skin Care & Gorgeous Smiles Articles

Laser Treatments for Asian and Darker Skin Tones: How to Lower the Risk of Dark Marks

By Dr. Dan Xu, MD, CCFP

Many of my patients with medium and deeper skin tones arrive with the same worry: “Will a laser make my skin darker?” It is a fair question. Most people have heard a story about someone who tried to remove a spot and ended up with a bigger, darker patch.

The good news is that this risk is well understood, and it can usually be managed. This article explains why it happens and what patients can do to lower it.

Why darker skin reacts differently

Skin colour comes from melanin, made by cells called melanocytes. People with more natural pigment have more active melanocytes. When the skin is irritated or inflamed, by acne, a burn, a scratch or a treatment that creates heat, these cells can respond by making extra pigment.

The result is called post-inflammatory hyperpigmentation, or PIH: flat brown, grey-brown or dark patches that appear where the skin was inflamed. It is not a scar, and it usually fades with time, but that can take months. It is more common and longer-lasting in skin of colour, including many East Asian, South Asian, Middle Eastern, Latin and Black skin types.

Most lasers work by delivering energy that the skin absorbs as heat. More heat means more inflammation, and more inflammation means a higher chance of PIH.

Not all lasers carry the same risk

The type of device matters a great deal:

• Ablative resurfacing lasers (such as fully ablative CO2) remove layers of skin and create the most heat. They carry the highest risk of pigment changes in darker skin.
• Fractional lasers treat tiny columns of skin and leave healthy skin in between. Recovery is faster and the risk is lower, especially at conservative settings.
• Intense pulsed light (IPL) targets pigment broadly. Because normal skin pigment also absorbs the light, it needs extra caution in medium to deep skin tones and is often not the first choice.
• Picosecond lasers deliver energy in pulses lasting trillionths of a second. They break up pigment mainly through a rapid pressure effect rather than prolonged heat, which is one reason they are often chosen for pigment concerns in skin of colour. A picosecond laser such as PicoSure Pro can be set to low energies for this purpose.
• Radiofrequency and ultrasound devices do not target pigment, so they are generally considered lower-risk for pigment changes.

No device is risk-free. The provider’s settings and plan matter as much as the machine.

Settings include the energy level, the size of the treated spot, how many passes are made and how far apart sessions are spaced. For medium and deeper skin tones, providers often choose lower energies and longer gaps between sessions, accepting slower progress in exchange for a lower chance of pigment changes. Results may take more sessions this way, but the overall outcome is often better because the skin has time to settle between treatments.

Melasma needs special care

Melasma, the blotchy brown patches that often appear on the cheeks, forehead and upper lip, is common in women with medium skin tones. It is driven by hormones, sunlight, visible light and heat. Aggressive laser treatment can make melasma worse.

When melasma is present, treatment usually focuses on daily sun protection, topical treatments and, if lasers are used, gentle low-energy sessions spaced well apart. The goal is long-term control, not a single “cure”.

What patients can do to lower the risk

Every patient’s plan should come from their own provider, but these are the steps patients with medium and deeper skin tones are commonly advised to discuss.

Before treatment

1. A proper skin assessment. Freckles, sun spots, melasma and acne marks all need different plans, so it helps to know what each spot is.
2. Avoiding tanning in the weeks before treatment. Tanned skin has more active pigment cells.
3. A test spot. Many providers treat a small, hidden area first and wait a few weeks to see how the skin reacts.
4. Skin preparation. Some patients are given pigment-calming skincare before laser treatment.
5. A history of dark marks. If acne or small injuries have left dark marks in the past, the skin is more likely to react, and providers usually adjust their approach.

After treatment

1. Daily sun protection. Patients are usually advised to use a broad-spectrum sunscreen every day. Tinted sunscreens also help block visible light, which can worsen pigment.
2. Keeping the skin calm. Gentle cleansing and simple moisturising are typical, with stronger products paused until the provider says otherwise.
3. Not picking at crusts or flakes.
4. Avoiding heat such as saunas, hot yoga and long hot showers for a short time.
5. Reporting darkening early. PIH responds best when it is addressed early.

Questions to ask your provider

• How much experience do you have treating my skin type?
• Which device and settings do you plan to use, and why?
• Do you recommend a test spot?
• How many sessions should I expect, and how far apart?
• What is the plan if I develop dark marks?

A good provider will welcome these questions.

The bottom line

Having a medium or deep skin tone does not rule out laser treatment. It means the treatment plan should be built around your skin. Choosing the right device, starting conservatively, protecting your skin from the sun and acting early on any darkening make a real difference to both safety and results.

Sources

• DermNet. Postinflammatory hyperpigmentation. https://dermnetnz.org/topics/postinflammatory-hyperpigmentation
• DermNet. Melasma. https://dermnetnz.org/topics/melasma
• American Academy of Dermatology. Melasma: overview. https://www.aad.org/public/diseases/a-z/melasma-overview
• DermNet. Laser resurfacing. https://dermnetnz.org/topics/laser-resurfacing
• American Academy of Dermatology. How to select a sunscreen. https://www.aad.org/public/everyday-care/sun-protection/shade-clothing-sunscreen/how-to-select-sunscreen

About the author

Dr. Dan Xu, MD, CCFP, is a Canadian physician and the founder of ID Cosmetic Clinic, a physician-led medical aesthetics clinic serving Toronto. Dr. Xu focuses on laser and injectable treatments for Asian and diverse skin tones and is an Allergan/Juvéderm trainer.