Facial resurfacing in patients with Fitzpatrick skin type IV

Background and Objectives Though post‐inflammatory hyperpigmentation (PIH) is probably the most common complication of laser resurfacing and appears to correlate directly with the intensity of the patient's natural pigmentation, there is very little data that specifically addresses the risks of dyspigmentation in more darkly pigmented patients (Fitzpatrick skin types IV and above). The objective of this study was to evaluate the long‐term dyspigmentation of patients with skin type IV having radial laser resurfacing. Study Design/Materials and Methods A retrospective review of the clinical efficacy, incidence of dyspigmentation and other adverse effects, as well as the pre/post‐operative protocol of 22 patients with Fitzpatrick skin type IV who were a minimum of 1 year post‐operative following facial laser resurfacing. Results The average patient achieved greater than 50% improvement, indicating adequate treatment being delivered. PIH occurred in 68% of patients, starting 1 month post‐operative and lasting 3.8 months. There was no correlation to pre‐treatment or type of laser used as far as incidence of PIH. True hypopigmentation was not seen in this group of 22 patients. Conclusions PIH is the most common complication of facial resurfacing in patients with skin type IV. It is not preventable by choice of laser or skin care regimen pre‐operative, but appears to respond to appropriate treatment once it has developed. Lasers Surg. Med. 30:86–92, 2002. © 2002 Wiley‐Liss, Inc.