combined with protective measures, such as wearing a wide-brimmed hat and sunglasses, is recommended.4,5,14,15
Tinted iron oxide sunscreens without a white cast in richly pigmented skin could improve compliance. In addition, using topical technologies that contain ingredients with antioxidants and free radical quenchers may help to prevent dyschromia,14-16 which is a significant concern for those with richly pigmented skin and of Asian descent.14-17
Injecting fillers sub-dermally with longer, slower injection times may help decrease the risk of dyschromia.17,18 Healthcare providers should be informed on skin thickness variability among facial areas in richly pigmented patients, which affects optimal injection depth.17,18 During the procedure, skin cleansing products are addressed, along with judicious techniques to minimize unintended cutaneous injury or inflammation.
Clinicians may pretreat patients with products to prevent hyper or hypopigmentation before nonenergy or injectable treatments. However, this recommendation is primarily for patients with richly pigmented skin or those with a history of dyschromia or abnormal scarring.4,5,14-17 Melanocytes are hyper-reactive in richly pigmented skin, leading to more pigment disorders, such as hyper or hypopigmentation, a frequent sequela of inflammatory dermatoses, skin injury, or photodamage.14-17 Pretreatment prevention of hyper or hypopigmentation comprises topical arnica/bromelain or hydroquinone and agents to impact melanogenesis.4,5,14,15 Other options are products containing niacinamide, kojic acid (KA), azelaic acid (AzA), retinoids, and tranexamic acid (TXA). Pretreatment with skin care using a gentle
