Cosmetic procedures in skin of color.

An increasing proportion of patients undergoing aesthetic procedures are individuals with skin of color (Fitzpatrick skin types IV-VI). Racial or ethnic differences exist in perceptions of beauty, the prevalence of specific cosmetic concerns, as well as optimal approaches to treatment. Most important, is the need to avoid treatment-associated pigmentary alterations and keloid scarring, of which there is a greater risk in patients with skin of color. Here we review leading esthetic concerns in the darker skinned patient and discuss approaches to treatment.