Supplement Individual Article: Algorithm for Pre-/Post-Procedure Measures in Racial/Ethnic Populations Treated With Facial Lasers, Nonenergy Devices, or Injectables
October 2022 | Volume 21 | Issue 10 | SF3509903 | Copyright © October 2022
Published online September 30, 2022
Michael Gold MD FAADa, Andrew F. Alexis MD MPHb, Anneke Andriessen PhDc, Sunil Chilukuri FAAD FACMSd, David J. Goldberg MD JD FAADe, Komel V. Grover MBAf, Shasa Hu MD FAADg, Z. Paul Lorenc MD FACSh, Stephen H. Mandy MD FAADri, Heather Woolery-Lloyd MD FAADi
aGold Skin Care Center, Nashville, TN; Vanderbilt University School of Medicine and Nursing, Nashville, TN
bVice-Chair for Diversity and Inclusion for the Department of Dermatology; Professor of Clinical Dermatology at Weill Cornell Medical College, New York, NY
cRadboud UMC Nijmegen, Andriessen Consultants, Malden, NL
dDirector of Cosmetic Surgery, Refresh Dermatology, Houston, TX
eSkin Laser & Surgery Specialists of NY and NJ, Hackensack, NJ; Icahn School of Medicine at Mt. Sinai, New York, NY
fSwiss American CDMO, Dallas, TX
gDr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL
hLorenc Aesthetic Plastic Surgery Center, New York, NY; Lenox Hill Hospital, New York, NY
iDr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami FL
Abstract
Background: Cosmetic procedures with lasers, nonenergy devices, and injectables are increasing in popularity among patients with skin of color. Published algorithms address measures to reduce side effects related to aesthetic procedures; however, none focus on reducing adverse events in skin of color.
Methods: An expert panel of dermatologists and plastic surgeons conducted face-to-face and online meetings to develop an algorithm for measures before, during, and after using aesthetic devices (energy and nonenergy-based) and injectable treatments based on the best available evidence for skin of color. Published algorithms and literature searches for aesthetic procedures provided guidance for the current algorithm. A modified Delphi method was used to reach a consensus to apply outcomes of literature searches, along with expert opinion, resulting in the current algorithm.
Results: The four sections of the algorithm outline an approach to optimize outcomes with specific before, during, and after procedure considerations. Pre-procedural consultation includes the development of a specific treatment plan based on individual patient goals and risk profile (including history and signs that may predict a higher risk for pigmentary or scarring complications). Before the procedure, sun avoidance and sunscreen use are emphasized; herpes simplex virus 1 prophylaxis and bleaching agents are administered if indicated. During the procedure, skin cleansing products are addressed, along with judicious techniques to minimize unintended cutaneous injury or inflammation. Post-procedural sunscreen and gentle skincare that may include skin-lightening agents or formulations designed to prevent infection and promote optimum healing are advised.
Conclusions: The algorithm strives to optimize treatment outcomes for patients with skin of color by providing their physicians with guidance on measures before, during, and after office-based medical aesthetic procedures.
J Drugs Dermatol. 2022;21:9(Suppl 1):s3-10.
INTRODUCTION
Demographic shifts as well as advances in minimally invasive and non-ablative technologies, have broadened the spectrum of patient populations undergoing aesthetic procedures. Over the past decade, the proportion of cosmetic procedures performed on patients with skin of color who belong to varying self-identified racial/ethnic groups in the United States (US) has increased considerably.1 This population, which is characterized dermatologically as having skin of color (SOC) exhibits variations in the prevalence of specific aesthetic concerns as well as nuances in the approach to treatment due to a greater propensity toward pigment alterations or hypertrophic/keloidal scarring following skin injury or inflammation.1-4
