We Asked Our Founder's Dermatologist Part II: Should Asians Avoid Laser?

Annie Chiu, M.D. is an LA-based Chinese American board-certified dermatologist with quite the list of accomplishments. She graduated with top honors from Stanford University and UC Berkeley, runs her own private practice, The Derm Institute, and regularly gives lectures and seminars on advanced cosmetic procedures and techniques. She’s no stranger to the media, appearing on TV shows like The Doctors, and receiving the title of “Skin Genius” from Elle Magazine. She also happens to be the personal dermatologist of our founder, Yu-Chen Shih, who found her after years of searching for someone who truly understands Asian skin. She finally found a true expert in Dr. Chiu, and has since nicknamed her “The Asian Skin Whisperer”.

In this three-part series, we sit down with Dr. Chiu to get your questions about Asian skin care answered. In Part II, we’re diving into all the details about laser resurfacing treatments. One of the most popular cosmetic procedures today, lasers are non-invasive and effective in treating everything from wrinkles to acne to discoloration. But how does it affect ultra-sensitive Asian skin types? Dr. Chiu weighs in.  

We've often been told that Asians should avoid laser procedures. Do you agree?

I disagree! I actually think lasers can be great for Asian skin. The key is finding someone with experience treating Asian skin, which is definitely more finicky when it comes to light and energy devices due to an increased risk in discoloration.  Here’s why: 

Asian skin types are more prone to hyperpigmentation due to increased pigment producing cells in the skin. In Asian countries, the devices and settings they use are often different, and the treatments are typically administered in a manner that is slower and gradual, with many many many treatments in a row if not indefinitely. In America, due to cost and a generally more immediate gratification need, settings are often a bit higher to deliver results in less number of sessions. Because any treatment that imparts controlled injury (like laser) can be riskier and cause a “burn” on Asian skin. When these patients are treated with a similar protocol as someone of lighter skin, the risk of post-inflammatory hyperpigmentation goes up. This can be corrected over time with treatments like bleaching cream, but it can be traumatizing – not to mention time-consuming and expensive! Patients tend to blame the procedure itself, but really the issue lies with providers not knowing how to administer it correctly. Only experienced, confident practitioners are able to tailor the procedures to their client’s specific skin type.

Chains that provide package deals for laser treatments are trending. How do you feel about them?

I feel the chains do great package deals for laser hair removal. But again, if you are a person with skin of color, or have a tan, definitely let your provider know. I am always going to encourage those at higher risk of adverse side effects to seek out physicians who personally perform the laser themselves over an extender technician. Package pricing does seem enticing because it typically discounts costs for the treatment.  My recommendation is to try the treatment and provider for 1-2 sessions prior to committing to a long-term package. 

What are your tips for someone with Asian skin who is interested in lasers?

Nowadays, a lot of cosmetic dermatology is delegated from the provider to non-physician extenders, such as nursing staff. Not to say that they are not capable, but there sometimes can be less experience or gap in knowledge. (i.e. the nuances of how to adjust settings for different skin types) Typically with lasers in more difficult skin types such as Asian skin, I advise going to a practice where the procedure is at least initially performed by a physician, who can adjust settings as they watch your skin react, turning it up or down to optimize it for you.   

For any patient who has skin of color, optimal settings means having the settings at a point where it is high enough to be effective but also safe at the same time. This sweet spot is called the “therapeutic window”. It is different for every individual and takes some experience to find as it is a more narrow window in Asian patients.

Often, when practitioners or extenders at a chain use lasers, the main goal is to not have an adverse event. So packages often start with very low energies that are not therapeutically effective enough, but you are now locked into a package. There is a high chance that patients are being undertreated and are paying too much for multiple treatments they don’t need. 

Finding an experienced physician who personally performs or very tightly oversees their extenders is ideal for Asian patients so that you can get the optimal treatment in the least number of sessions. Do not be fooled by price per session. What you are looking for is value in the results.