Patients with darker skin phototypes are more susceptible to complications after dermatological procedures such as lasers and peels due to the higher probability to develop an inflammatory response to a physical or chemical irritation. Among the undesirable reactions, it is possible to highlight the hyperchromia, the hypochromia, hypertrophic scars, and keloids. The dark-skinned patients’ demand for cosmetic procedures is increasing; therefore dermatologists should update their knowledge in this field. Regarding chemical peels, it is important to evaluate the best substances and their concentrations, the care before and after the procedure, and the best indications for darker skins. While in Caucasians, the peels are predominantly indicated for photoaging treatment, in African descendent people, peels are commonly indicated for melasma, postinflammatory hyperpigmentation, acne, and pseudofolliculitis barbae. In general, the very superficial and the superficial peels are well tolerated on black skin; medium peels can be performed with caution, and deep peels should be avoided, since the risk of dyschromia and scarring is high. Among the types of chemical peels, which can be used with safe and efficacy for dark black skin, there are glycolic acid peels, salicylic acid, retinoic acid, and Jessner solution. Physical peelings can also be performed isolated or in combination with chemical peels.
Black skin Dark skin Peels Glycolic acid peels Salicylic acid Retinoic acid Jessner solution Trichloroacetic acid Chemical peel Spot peel Melasma Postinflammatory hyperpigmentation Acne Pseudofolliculitis barbae
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