Laser hair removal is an excellent procedure for the removal of unwanted hair. The procedure works best with very dark hair and very light skin. The laser works by the absorption of light energy by the hair follicle, and the destruction of the follicle by the ensuing energy. The darker the skin, the more the interference with the transmission of the laser light energy through the skin and to the follicle. In addition, the darker the skin, the more the laser will have an effect on the melanocytes or pigment cells of the skin. This can lead to some discoloration to the treated skin. It is best to talk to your plastic surgeon about the capabilities of the laser that he or she uses for laser hair removal and the experience with "darker skin" individuals. He or she will be able to discuss other options with you.

Laser Hair Removal

In order to treat fine lines and wrinkles, a plastic surgeon must first evaluate where the wrinkles are and whether they are there all the time or only when you make certain expressions. This helps to determine the best treatment for those wrinkles. Wrinkles around the eyes (crow's feet) can be treated very well with Botox injections into the muscles that cause these dynamic wrinkles in the skin. This treatment will last 3 to 6 months and works for all skin types. Deeper, more permanent furrows or static wrinkles can be treated by the placement of filler substances into the dermis to help plump out the wrinkles. Materials such as collagen and fat have been successfully used for years, and there are numerous new materials available or soon to be available to help treat deeper and more static wrinkles. New nonablative lasers can be used to soften fine wrinkles by stimulating the formation of collagen and plumping out these wrinkles. Because this type of laser does not affect the outer layer of skin, it can be used for all skin types as well.

The topical use of Vitamin A (Retin-A) or its derivatives, alpha hydroxy acids, and many other active agents work by means of the turnover of the outer layer of the skin and through slight edema (swelling) from skin irritation. These effects are temporary and will go away when the

irritation is removed for a prolonged period of time. Deeper resurfacing techniques are numerous and include chemical forces (chemical peels), mechanical forces (dermabrasion), and heat (laser ablation). All of these injure the outer layers of the skin and the response depends upon the depth of injury. The deeper one goes, the longer the recovery, the more collagen is created to heal the wound, and the more improvement one will obtain. The deeper the injury, the more potential that the cells that cause the olive coloration in your skin will be injured. There is not a magical answer to what is the best resurfacing technique for skin of color, but a discussion

of your goal with an experienced ASAPS-member plastic surgeon will allow him or her to help you decide how to best treat your wrinkles.

Skin Resurfacing