Exclusion criteria were articles with no original data (unless a review was deemed relevant); articles not dealing with pre-/ post-procedural care for individuals with SOC; treatment other than with facial lasers, nonenergy devices, or injectables; and studies in a language other than English.
Fitzpatrick skin phototype (SPT), the most used skin classification system in dermatology, was developed in 1975 to assess the skin's tendency to burn with sun exposure.11 Original classifications included SPT I to IV; SPT V and VI were added later to include individuals of Asian, Indian, and African origin.12-14 As a result, providers often use phototypes to describe race or ethnicity, which was not the original intent. A patient's perception of their ethnicity and phototype may be different than that of a physician. Although at least a dozen alternative skin type classification systems have been proposed, more clinically relevant methods for describing SOC have yet to be adopted. Without a comprehensive means to define SOC, complexions of African, Asian, and Latino subjects are termed SOC.15 The majority of published cosmetic procedure data in SOC involves patients of East Asian descent with phototypes III and IV.16-20
The following terms were used for the literature search: "Aesthetic dermatology for ethnic skin AND skin of color (SOC); lasers AND fillers OR injectables AND chemical peels AND hyperpigmentation OR post-inflammatory hypopigmentation; aesthetic dermatology for ethnic skin patients; pre-/postprocedure measures for facial laser OR energy devices treatment in SOC OR ethnic skin; pre-/post-procedure measures for minimally invasive OR nonenergy aesthetic treatments; pre-/post-procedure measures for injectable treatment."
The review was structured but not systematic, given the limitations of available relevant articles on SOC. The literature review process is depicted in Figure 2. Publications from various ethnic regions were identified. Identifying SOC is important for dermatologists and plastic surgeons because physiologic differences in SOC increase the risk of procedure-associated complications, such as pigment alterations, hypertrophic scars, and keloids.
The literature review was conducted by a dermatologist and a physician/scientist using PubMed searches on January 20th, 2022. Google Scholar was used as a secondary resource. Two reviewers independently evaluated the results. Each selected clinical publication was graded based on reviewer consensus. The reviewers assigned a level of evidence for each procedure (level A, B, C [study type] and level 1 to level 4 [likelihood of change]) using pre-established criteria.21
RESULTS
The Algorithm
Algorithms depict an approach to a scientific problem. The purpose of a clinical algorithm is to guide medical decisionmaking by standardizing treatment regimens to encourage compliance with evidence-based recommendations. A welldesigned medical algorithm provides patient benefits in a cost-effective manner.21,22
Algorithms depict an approach to a scientific problem. The purpose of a clinical algorithm is to guide medical decisionmaking by standardizing treatment regimens to encourage compliance with evidence-based recommendations. A welldesigned medical algorithm provides patient benefits in a cost-effective manner.21,22
