Skin of Color Savvy: News Update—Managing Cosmetic Concerns in Skin of Color

Welcome to Skin of Color Savvy: The Art and Science of Treating Patients of Color!

In the latest News Update episode of Skin of Color Savvy: The Art and Science of Treating Patients of Color, host DiAnne S. Davis, MD, FAAD, a board-certified cosmetic dermatologist practicing in Dallas, Texas, delves into the nuanced and evolving world of aesthetic dermatology in patients with melanin-rich skin.

In this podcast, hosted by Skin of Color Society (SOCS) and HCPLive, Davis offered an evidence-informed, culturally responsive conversation on how best to approach cosmetic concerns in patients of color. Davis began by identifying the most common cosmetic issues in her practice: hyperpigmentation and acne.

She noted that in melanin-rich skin, the primary concern is often not the initial lesion, such as a pimple or eczema patch, but the post-inflammatory hyperpigmentation (PIH) that lingers. Patients frequently seek help to even their skin tone and reduce the need for cosmetic camouflage.

In discussing cosmetic consultations, Davis emphasized the importance of patient-centered care. She uses a mirror and cotton-tip applicator to allow patients to point out their concerns and explains how patient priorities often differ from clinical observations. While the physician may notice active lesions, the patient may be most concerned about a blemish that has persisted for months. Davis also factors in patient lifestyle, social habits, and skin behavior over time to personalize treatment strategies.

A major theme in the episode is the management of complications from previous cosmetic treatments performed by non-specialists. Davis sees many patients with melanin-rich skin who have experienced burns, scarring, or dyschromia from laser procedures done at outside facilities. She used these examples to advocate for dermatologists to be transparent about their training and experience and encourages patients to ask questions before undergoing treatment.

The conversation turns to social media’s influence, which Davis views as a double-edged sword. While platforms have democratized access to skin care information, they’ve also spread myths—especially regarding lasers and sunscreen in skin of color. She regularly educates patients who wrongly believe that laser treatments are unsafe for darker skin or that sunscreen isn’t necessary, stressing the importance of managing expectations and explaining that cosmetic improvement is a long-term journey.

When discussing treatment safety, Davis offered granular insight into laser selection and protocol customization for patients of color. She considers factors such as prior treatment response, old scars, pigment retention, and lifestyle. For example, she often delays laser procedures for patients who will be exposed to high levels of UV radiation (e.g., frequent travelers or outdoor workers) to avoid exacerbating hyperpigmentation. She also explains the importance of selecting conservative laser settings and spacing treatments appropriately.

On the topic of chemical peels, Davis advocated for their safe and effective use in treating pigmentary concerns in skin of color, noting that superficial and very light-medium depth peels are generally well tolerated. She praised the recent innovations in peel formulations that allow for customized, layered application, making this an increasingly versatile option.

As a central clinical pearl, Davis advised dermatologists and health care providers to perform test spots when in doubt. She described her protocol—typically testing behind the ear or on an inconspicuous area and monitoring the response over 1 to 2 weeks—as a critical step in minimizing adverse outcomes. She underscored that while device protocols can be shared among colleagues, every patient’s skin responds differently.

In another segment, Davis shared her “wish list” for patient behaviors: show up on time, don’t assume sunscreen isn’t necessary, and abandon overly complicated 20-step skin care routines. Instead, she encouraged simplicity, emphasizing that too many products can compromise skin health rather than improve it.

She closed the conversation by sharing her best-kept secret to radiant skin: consistency. Davis emphasized that maintaining results requires sticking to a personalized regimen long-term—even after reaching aesthetic goals—just like brushing your teeth daily after visiting the dentist.

To learn more about SOCS’s mentorship programs and initiatives, visit Skin of Color Society.

Editor's note: This episode was summarized using artificial intelligence tools.