Dark Skin - Patients ask, Dr. Ringpfeil answers
Please feel free to use the blog below to share information about Dark Skin or to ask Dr. Franziska Ringpfeil a question that might be of interest to others.
Philadelphia and Mainline Center of Dermatology and Cosmetic Surgery
African American and Ethnic Skin Care
Dark skin - Some common treatments:
- Acne
- Acne Scars
- Keloids
- Dermatosis
- Laser hair removal
- Tattoo removal
- Melasma
Training and working at four inner-city university hospitals in NYC and Philadelphia allows us the opportunity and experience to treat a diverse range of skin ethnicity. People of different origins ineed have significant differences in the composition of their skin.
On one hand, darker pigment protects our skin from the sun but on the other hand inflammation of the skin could result in significant unwanted discoloration. As darker skin runs the potential risk of discoloration, different lasers, procedures, and medications may be appropriate to safely and effectively treat not only medical but also cosmetic conditions.
As a large portion of our patients are from a diverse and mixed ethnic background, we invested in technology that is specifically suited to their skin condition and it could even be said that it is ‘color blind’. We provide various treatments including peels that correct dark pigmentation, remove dark ‘moles’ (dermatosis papulose nigra) and treat keloids with unique cryoscope technology.
Sun spots after treatment with picosecond laser
Treatment of Keloids
Keloids are a genetic condition that is more common among black and the Mediterranean. For more information about keloids and possible treatments please visit our keloids page.
Keloids treatments on black skin
Treatment of Acne Scars on Darker Skin
Treating acne scars on dark skin requires special considerations. Improper treatment can result in permanent damage to the skin without improving the scar texture. Fortunately, there are now two new technologies that allow us to treat scars with minimal risk of damaging the healthy skin around the scar.
With the Picosure laser, we can safely soften scar tissue. This is followed by the Infini microneedling treatment that triggers collagen production and raises the skin in the scarred area. A new treatment protocol has been developed for darker patients that is now able to achieve results that were previously not possible.
Acne scar and skin texture treatment
Treatment of Acne on Dark Skin
For post-inflammatory hyperpigmentation to be prevented, it is imperative to control inflammation caused by acne as early as possible. Topical medications that contain irritating ingredients should also be avoided.
Various treatments including Picosure laser, Microdermabrasion, Photodynamic therapy, and Melanage treatments can help lift dark pigment and restore the original and lighter complexion for those who find it difficult to control their acne and have focal or widespread dark marks.
Laser Hair Removal for Dark Skin
For dark skin, there is no laser hair removal that is safe and effective. NDYag lasers can permanently reduce 80-90% of the hair in 6-8 treatments. Other laser types can be less effective and can cause hyper and hypopigmentation.
In contrast, the diode laser (often referred to as "the laser for all skin types") requires more treatments and is not suitable for darker Indian or African American skin tones. There is a high risk of hyperpigmentation with IPL hair removal, and the effectiveness of hair removal is very low.
The Alexandrite laser hair removal treatment should never be performed on Mediterranean or darker skin.
Please visit our Laser Hair Removal page for more information about potential treatments for dark skin.
page for more information about potential treatments for dark skin.
Hair removal for dark skin
Hello Dr. Ringpfeil,
I have had the old dark spots all over my legs due to mosquito bites and chicken pox. I have tried over the counter creams to try to remove them with no luck.
I don’t wear skirts or dresses unless I have pantyhose.
I am not sure what else to do, what would you recommend?
Thank you
Some dark marks that occur in the wake of insect bites or other inflammatory conditions can take a really long time to resolve. You might need a combination of in -office, prescription and home care regimen. Please schedule a complimentary consultation with our aestheticican for evaluation and discussion of treatment options.
do you recommend micro-needling for African American skin? if so what precautions do you take/recommend to assure minimal/no discoloration or keloids form?
Thank you
I believe microneedling to be very safe for all skin colors. Because of the absence of heat, it does not cause post-inflammatory hyperpigmentation. If you keloid with any injury including regular blood draw, microneedling is not for you. In those with history of keloids, a test spot should be performed by the salon or MedSpa that performs your microneedling. If you use microneedling at home, you can perform the test spot by yourself.
I believe I sent an email to this agency a while ago. I asked my supervisor who does she go to (I just relocated to the city) and such a conincident she mention dr. Ringpfei 🙂 !
I was telling my supervisor that I have accumulated terrible razor burns/bumps on my binki line and underarms. Growing up I thought it was normal. Now that I am an adult I hate it and it’s unwanted. I am darkskinned & is curious to know if there are ways to lighten my arms and binki area and prevent the ingrown hair?
Hi Nelly,
Razorbumps can be avoided by laser hair removal. With the hair reducing, the existing razorbumps also resolve quickly. We operate several different lasers and have one for safe treatment of the darkest skin tones. Please set up a complimentary consultation with our aestheticians. You can use the online booking system on our website http://www.ringpfeildermatology.com or you can call the office between Monday and Saturday at 610-525-5250.
Hello Dr. Ringpfeil,
I have dark spots on my cheeks from acne scars and I have very dark circles under my eyes. Is there a treatment that will get rid of the dark spots and under eye cirlces, also allowing my skin to glow? And to allow me to have a even skin tone?
Dark spots from acne should be treatable. The treatment differs based on the base color (red or brown) of these dark marks and also depends on your skin tone and ethnicity. Dark circles under the eyes might be challenging to treat if the skin that is dark rather than a projection from loss of fat under the skin. You may schedule an appointment with our aestheticians if you would like to learn about your options to even out your skin tone.
I’ve had hyperpigmentation ever since I can remember when I was growing up I never wore shorts or skirts bec it was so embarrassing it’s mostly on the back of my legs and my inner thighs and I have some scars from when I was younger that are still on my skin. My knees are really dark too. I have patches of discoloration around my knees and inner thighs and buttocks and behind my knees too. What’s the fastest way to get rid of this. Which laser treatment works best on African American skin with caramel like complexion?
Hyperpigmentation associated with past trauma is difficult to treat and the phrase “get rid off” does not always apply. There are several ways to reduce hyperpigmentation. Various types of physical exfoliation and chemical cell turn over will get you in the right direction. If a laser can be used, it would probably be the picosecond laser. Most other lasers will not help with this or could make it worse. You will need a consultation for a customized plan.
I was diagnosed with proprionibacterium acnes on my face. I have been put on doxycycline for a month and asked to use Cetaphil facial cleanser and Cerave moisturizer. I’m still breaking out which looks like hives or heat rash on my face.
You should be reevaluated. If you are a patient in our practice, you know that we have short notice appointments available. Please use the online booking tool to look for an appointment with your dermatologist that is convenient for you. If your dermatologist is not in our office, please phone his/her office and explain the situation so that you can be evaluated soon.
Good afternoon Dr. Ringpfeil. I am a long distance potential patient. I called the office requesting a call. I do understand you cannot fully consult with me because I am not a patient, but I would greatly appreciate it if you could reach out to me if possible before I schedule an appointment miles and miles away. Thank you much.
We offer convenient online consultation for those who live miles away from the office. This provides the platform to ask questions. Please follow the prompts on our home page.
Hi Dr. Ringfeil,
I was recently diagnosed with a nickel allergy by my allergist. My allergy is from things I ingest, not from jewelry. Recently my skin has flared up with itchy pumps and I know its from nickel. Do you have extensively experience with severe nickel allergy? I started to get dark spots when the red inflamed bumps go away. I would like to get these flare-ups under control and fade my dark spots.
Thank you in advance.
Dark marks can occur after any type of rash on the skin, whether an immunologic reaction to nickel, acne etc. In most people and on average, this type of pigmentation resolves gradually over the course of a year. You can speed it up with fading agents. Some fading agents can be applied widely, others work better as spot treatments. Please schedule a consultation so that the correct treatment can be advised. An internal nickel allergy is rare and an allergist/immunologist is the specialist who can help you with prevention.
I very recently had an accident involving hot boiling water being spilled on my chest…. Causing what I believe to be 2nd degree burns. Luckily it wasn’t too large of an area and it wasn’t as bad as could have been. What is the Best treatment as far as products to help leave minimal scaring…. I am a faired skin African American 42 year old female.. Burn has blistered and I am applying 1st Aid burn cream (prescription strength) I have a Aloe Gel but because some dead skin has rubbed off not sure if I should use it yet… What would work best for Healing with minimal scaring?? Thank You in Advance
Diligent sun protection is the best possible treatment of a burn wound after all oozing has stopped and a bandage is no needed. In addition, twice daily application of a peptide containing topical such as Neocutis Biogel for 4 weeks is appropriate. While Neocutis’ technology was originally developed for burn victims that had large surface burns, it works for all burn wounds, large or small.
Dr. Ringpfeil, My daughter is 11yrs old. Her hair kerps falling out in the back. She has had this problem since she was little. She scrathes the back of her hair constantly. She does have eczema but I have not notice any redness or patches in the back of her head. Do you treat children that are experiencing hair growth/loss issues? I’m notsure what to do, any recommendations?
Thank you
Connie
Chronic rubbing or friction can indeed create hair loss in the affected area. It does not result in permanent hair loss. We see bald patches on infants when they predominantly lay on the back of their scalp for many hours during night time sleep. We see it after infancy when hair is twirled or the scalp is rubbed. If you believe that the hair thinning is related to your daughter scratching or rubbing the back of her scalp, then treatment should be directed against scratching. In the absence of a rash or redness in the area, it is likely that rubbing this area became a stress outlet for her, analogous to nail biting or any other habit to avert stress. Children tend to grow out of certain habits. Occupational therapy is probably one of the most effective treatments but might place too much emphasis on something that needs correction. Simpler measures such as Yoga or meditation might be easier to pursue and help us in more generalized ways to cope with stressors. An 11 year old might be too young for meditation but Yoga should work, especially if a family member goes to Yoga class with her.