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superinfections typically present with pain,
increased erythema, exudates, erosions, and
crusting. Infections should be cultured and treated
with broad-spectrum oral antibiotics to reduce
long-term risk of scarring. When treating patients
of dark skin types, the development of acne erup-
tions, HSV infection, or bacterial superinfections
can intensify the likelihood of pigment issues and
discoloring of the soft-tissue envelope. Every
effort should be made to prevent these complica-
tions or treat them aggressively should they occur.
SUMMARY
Ethnic skin presents a unique challenge for laser
skin rejuvenation because of higher density of
larger melanosomes, thicker collagen bundles,
and increased fibroblast responses. Special con-
siderations need to be made when considering
laser therapy for ethnic patients for the treatment
of skin laxity, dyschromia, hypertrichosis, keloids,
and hypertrophic scarring. Lasers may be safely
used in patients with dark skin tones by choosing
fractional technologies with appropriate wave-
lengths, lower fluences, longer pulse durations,
and maintaining careful attention to preprocedural
and postprocedural management strategies.
When considering the use of lasers, the treatment
goals should reflect individual patient complaints
and the realistic expectations of laser skin rejuve-
nation. Patients should be counseled on the risks
of laser therapy, including scarring, postinflamma-
tory hyperpigmentation, and hypopigmentation.
With this in mind and in the hands of an experi-
enced laser surgeon, laser resurfacing in darker
skin types IV through VI may eliminate unwanted
hair, improve the appearance of fine wrinkles,
and even skin tone, texture, and pigmentation.
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Posttreatment acneiform eruptions. A common
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Richter et al