Treating colored skin poses difficulties, as many practitioners have experienced. Dr Mukta Sachdev says good technique hinges on good pre-, intra- and post-operative care and choice of patient.

Colored skin has the tendency to hyperpigment following trauma, so in the wake of procedures such as lasers, chemical peels or microdermabrasion, there is a chance that hyperpigmentation will occur at the treatment site. This post-inflammatory hyperpigmentation is a common adverse event in darker skin. According to one expert, maximising the success of an aesthetic procedure can be better achieved if the proper pre-, intra- and post-operative precautions are taken. Dr Mukta Sachdev, a consultant dermatologist at the Manipal Hospital in Bangalore, India, says that treating coloured skin can be particularly challenging, even for the most experienced cosmetic physician. “In India we have found that the patients do not use sunscreens as much as they should, as compared with the West, and Indian people are simply not aware of the benefits of these creams. The cosmetic implications—especially in darker skin—is that following a procedure, such as laser or microdermabrasion, the risks of hyperpigmentation will increase,” Dr Sachdev says.

According to Dr Sachdev, the use of sunscreens is mandatory before cosmetic procedures, and the patient should get into the habit of using these two to three times a day, at least 14 days prior to procedures. This gets the patient into the habit of using them, and they help in preventing unwanted hyperpigmentation post-procedure. Dermal filler procedures are also a common cause of post-inflammatory hyperpigmentation. Dr Sachdev says that perhaps a normal Caucasian skin might tolerate a Restylane or Perlane filler very well in terms of decreased risk of developing a post-procedural hyperpigmentation. However, in a darker skin, skin types IV to VI, patients can frequently have a pigmentation of the injection puncture wound where the filler was introduced into the skin.

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