Patients of African descent often require special consideration when it comes to receiving cosmetic procedures, specifically with laser, light, and energy-based procedures. They are particularly vulnerable because any kind of significant trauma, be it from a laser or other device, can cause permanent pigmentary changes and scarring. For the clinician, cosmetic procedures in patients with skin of color can therefore be challenging. Because of enhanced technology and scientific advances, the demand to seek procedures to address these patients’ cosmetic concerns has reached new heights. Patients with skin of color have various motivations and goals including attaining an even skin tone, removing unwanted hair, and/or reducing the signs of aging. The American Society of Plastic and Reconstructive Surgery revealed that cosmetic procedures among minority patients increased from 12% of all cosmetically treated patients in 1992 to 20% in 1998. Of the 11,000,000 esthetic procedures performed in the United States in 2005, 6% were African American (up from 4%), 8% were Hispanic (up from 5%), and 4% were Asian (up from 3%).

This article provides a systematic overview of laser, light, and other energy devices for patients of African descent. It also reviews complications in skin of color and some treatment options for these adverse events.