Dr Tympanidis teams up with international cosmetic business guru Wendy Lewis
Dr. Tympanidis describes to Wendy Lewis the best laser practices for safe treatment of darker skin tones in the July/August 2020 issue of PRIME, International Journal of Aesthetic and Anti-Ageing Medicine
“Whenever a laser is used on skin of colour patients, minimising inflammation and erythema are top of mind. Any incidence of irritation can transform into hyperpigmentation as skin of colour is more sensitive and reactive towards irritation. There is also a greater risk of irritation, inflammation and redness that may lead to discolouration, whereas in fair skin types, these common side effects usually resolve. As a result, it is advised to be more conservative and adopt commonsense parameters to stay safe.
According to dermatologist Penelope Tympanides who practices in Athens and London, ‘Lower fluences are recommended for higher SPT to minimise excessive thermal injury to the epidermis, which can be associated with disfiguring pigmentary alterations (hyper or hypopigmentation). Long pulses allow the skin to have piecemeal time to properly cool from the treatment heat, preventing inflammation and thus pro-inflammatory hyperpigmentation. Patient selection, as well as realistic expectations, are critical.
When I deal with dark skin types, I treat in a very conservative way. I always offer patients a “trial” treatment in a small area at a week to 10 days prior to starting the actual treatment. Darker skin patients are warned about the probability of hyperpigmentation, or other complexion issues that may arise with treatment, as well as potential scarring.’
She continues, ‘When selecting the right wavelength, consider chromophore (especially risk of absorption by epidermal melanin). Longer wavelengths are associated with less epidermal absorption and therefore offer greater safety in patients with a higher SPT. Conservative treatment parameters may consist of settings that minimise the extent of epidermal and dermal injury, which often requires a greater number of sessions, for example, lower fluences and longer pulse durations for laser hair removal.
I use rigorous epidermal cooling, including choosing slower treatment speeds when using lasers with contact cooling, pausing between passes to reduce bulk heating, and applying ice packs post‑procedure. I will consider using topical steroids post‑treatment to reduce inflammation, especially when significant erythema or oedema is noted. This may also prevent the likelihood of post-inflammatory hyperpigmentation to some extent.’”