Common Dermatologic Procedures and the Associated Complications Unique to Skin of Color

Abstract

BACKGROUND The skin of color (SOC) population in the United States continues to grow, and these patients are undergoing various cosmetic and surgical procedures at increasing rates. There is a paucity of data on the potential complications associated with surgical and cosmetic procedures in this patient population. OBJECTIVE We aim to educate dermatologic surgeons and clinicians on surgical and cosmetic procedures in patients of color and increase awareness of the potential complications unique to this patient population. MATERIALS AND METHODS A thorough PubMed literature search was performed to conduct this review. RESULTS There are a number of complications in SOC that require special attention, including keloids, postoperative infections, postinflammatory hyperpigmentation, and hypopigmentation. There are also various precautions to consider when performing cosmetic procedures, such as neurotoxin and filler injections, laser therapy, microneedling, and chemical peels. CONCLUSION Dermatologists should be aware of the potential cosmetic and surgical complications of this growing patient population to provide optimal evidence-based medical care.

Delayed skin discoloration spreading in the direction of gravity after injection of hyaluronic acid dermal fillers in both nasolabial folds

“…Some concern exists that the risk of postinflammatory hyperpigmentation (PIH) is higher in patients with skin of color (SOC); however, HA has been found to be safe for lips/perioral lesions in SOC if it is injected more deeply into the dermis, serial epidermal punctures are avoided, and linear threading techniques are used. 3 The occurrence of PIH is usually limited to the injection site due to minor trauma related to the puncture procedure. In the present case, hyperpigmented macules occurred at both injection sites and gradually spread downward.…”

Cosmetic Procedures in Patients With Skin of Color

“…• administer the filler in a deeper dermal plane to minimize the risk for hemosiderin deposition and bruising and • minimize the number of consecutive punctures and lay the filler down in a threadlike fashion to reduce erythema and hyperpigmentation (Adotama et al, 2021).…”

Follicular Unit Excision in Patients of African Descent: A Skin-Responsive Technique

“…This poses additional risks to African-descended individuals already prone to abnormal scarring. 7 Because FUE surgery graft attrition rates may vary from one part of the head to another within the same individual 8,9 and the difficulty level may not correlate with hair-curl tightness, 2 skin thickness and firmness may play critical roles in FUE outcomes. 2 In addition, African-descended patients have diverse hair curl types and skin characteristics due to millennia of migration and gene mixing.…”