Asian skin treatments

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Why is the approach of treating darker skin types different?

Ethnic skin type can be defined as Type 3 skin or darker.  This skin type tans easily, and comprises of persons of Asian, Middle Eastern, Mediterranean and Hispanic background. Treatment of darker skin is markedly different compared to the Caucasian counterpart.  Darker skin types tend to scar more easily, additionally disorders of pigmentation such as melasma tend to be more common. Acne scarring can be more obvious in darker skin types, and harder to treat.

Factors such as post inflammatory hyperpigmentation (darkening of treated/ affected skin) and hypopigmentation (lightening of treated skin), leaves little in the way of error for treatment. The use of lasers and IPL have to be precise or scarring and pigment changes may follow. Parameters will have to be exact to achieve results whilst minimising any complications.

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Prescription creams

Creams contain a special agent to inactivate the melanocytes (pigment producing cells of the skin), additionally we often compound a free radical scavenger to counter act the effects of UV radiation. Vitamin A is also frequently prescribed to patients. The regular use of a correct sunscreen is very important in treating darker skin types.

Dermatologists, Dr Davin Lim and Dr Shobhan Manoharan have extensive experience in performing cosmetic skin procedures on darker skin types, having trained in Australia, UK, Ireland, Malaysia and the United States. Our dermatologists can compound specially made creams depending on your skin condition and sensitivites.

Chemical peels

Chemical peels refer to a broad range of chemical treatments for the skin. Peels regenerate and resurface the skin at varying depths depending on the agent and concentration used. Superficial peels remove the dead layers of the skin and can help improve uneven pigmentation, whilst medium depth peels target the deeper layers of the epidermis. Deeper peels have the ability to stimulate collagen production, which improves both texture and tone. In darker skin types, a more conservative peel regime is needed to reduce the chance of post inflammatory darkening of treated skin.

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Fractionated laser/ Fraxel/ Profractional

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Fractional laser has provided a revolution in the treatment of facial rejuvenation, especially in darker skin types. Fractional lasering induces thousands of micro-punctures whilst leaving surrounding tissues intact. This allows the skin to heal much faster than if the entire skin was treat at once. Fractionation stimulates collagen production in addition vaporizing both superficial and deep pigmentation. It promotes the skin’s healing process to create new, tighter tissue, with improved skin texture.

In darker skin types we prefer the use of Erbium laser as it has less tendency for complications in darker skin types. In dark skin types, the ProFractional laser is much safer than Fraxel.

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Photorejuvenation in darker skin types is best treated with two methods combined in the one treatment- a method called Fractionated Photo Rejuvenation.

The first treatment is conducted with BBL or broadband light- a more specific and accurate form of IPL (intense pulse light).  In darker skin types a more accurate method of delivering light is needed due to the lesser contrast of the surrounding normal skin. The second treatment performed immediately after BBL- this process, known as fractionation breaks up the deeper areas of pigmentation.  Recovery time is generally less than 3-4 days at most.  One treatment with fractionated photorejuvenation will give at least a 50-60% improvement in the majority of patients.

We generally recommend 2-4 treatments in darker skin types to increase the safety margin of treatments.

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The basic rules of scar revision applies to all types of skin, however in darker skin types the prevention and treatment of post inflammatory changes (darkening of the skin after tretment)applies more importantly.  Fractionated lasers such asFraxel and ProFractional have improved  treatment of acne scarring in all skin types.

As a rule the use of Erbium laser as delivered by ProFactional delivers a safer option for darker skin types than Fraxel.  With Fraxel laser, the tissue surrounding the scarred areas are also heated up, resulting in post inflammatory pigment changes in some patients- to date we have not had any permanent complications with Profractional laser resurfacing.

More on considerations before Fraxel/ Fractional laser treatments

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Several methods maybe used to remove blemishes in darker skin types. Moles can be removed with a shave excision technique, followed by erbium resurfacing.  Scarring is minimal, and recovery time is generally less than one week.

Severe acne can lead to permanent scarring, however in darker skin types this can be more drastic due to changes in pigmentation. This is called post inflammatory Hyper pigmentation.

Changes in pigmentation can be addressed by-

1. Prevention.  The regular use of sunscreen will reduced the incidence of pigment changes
2. Aggressive treatment of acne and inflammation. In severe cases Roaccutane/Oratane should be considered.
3. Treatment of post inflammatory hyperpigmentation can be possible with Fractionated laser resurfacing and bleaching creams.

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Melasma, a form of facial pigmentation, can be more resistant to treatment in darker skin types. We approach the treatment of this condition in the same way as fair skin. A realistic aim is to improve melasma by 50-60% in darker races.

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Confidence in your treating physician is important, especially with darker skin types. Laser trained and procedural dermatologist are best equipped with expertise and the latest technology to give optimal results to our patients. At Westside Dermatology, all treatments are performed by our highly qualified Dermatologists trained in managing darker skin types so you can be sure that you are in experienced hands.

A referral from your GP is advised for Medicare claims. Call us directly on 07 3871 3437 to make a booking or enquire about the referral process.

Westside’s Radiant Skin Program $1290 (3 fractional treatments and home chemical peel kit - this is an ideal laser treatment for darker skin types. It improves pigmentation, melasma, and fine wrinkling with mimimal downtime, and maximal results.)

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moreDr. Davin S. Lim

Dr Davin Lim,  Cosmetic Dermatologist

Asian skin is vastly different compared to Caucasian skin type.  Conditions such as scarring, and pigmentation are more commonly seen.Treatments such as laser has to be precise. It is often safer to under treat rather than over treat due to the inherent risks of pigmentation changes- either darkening or patterned lightening of skin.

IPL or intense pulse light should not be used in Asian skin type as a sole method of treatment. The incidence of post inflammatory changes, grid patterning and burns are too high to justify this as the primary treatment.  With the event of Fractionated laser devices, such as Scition ProFractional, it enables the treating dermatologist to treat darker skin types with confidence and predictability.   Fractionated laser resurfacing can address skin rejuvenation, skin tightening and treat conditions such as melasma with excellent results.

The use of a high factor sunscreen – at least an SPF 30 forms the foundation of all treatments that are aimed at treating pigmentation.

Dr Davin Lim, Dermatologist. In addition to attaining his specialist qualifications via the Australasian College of Dermatologist, Dr Lim has undergone cosmetic laser training in Harvard University and also in leading cosmetic clinics in  Asia and frequently treats darker skin types.