Is laser resurfacing safe on darker skin?

Being told your skin is too dark for lasers is the most common piece of incorrect advice patients arrive with.

Yes. Fitzpatrick IV and above makes up roughly 60 to 70 percent of Dr. Ourian's practice. What changes is not whether the treatment can be done but how the energy reaches its target, because the risk in melanin-rich skin is the inflammatory response after treatment rather than the resurfacing itself.

What portion of the practice this is

"Living in Southern California, easily 60 to 70 percent of my patients are Fitzpatrick IV or above."

That composition matters more than any single credential. A provider who treats deeper skin types occasionally is calibrating from a small sample. A practice where they are the majority is calibrating from the default.

What he could not treat before

"Before developing Coolaser®, I had to turn them away to avoid shiny or hyperpigmented results."

The problem with conventional ablative resurfacing on melanin-rich skin is thermal. Heat delivered into the epidermis, where melanocytes sit, provokes those cells. The response is either post-inflammatory hyperpigmentation or a loss of texture that reads as an artificial shine. Neither is easily corrected, and both are frequently worse than the concern the patient arrived with.

What changed was a delivery method that reaches the target without depositing that thermal load in the epidermis, which is the principle Coolaser was built on.

His complication rate

"Now, post-inflammatory hyperpigmentation in my hands is under 1 percent, usually because they went into the sun too soon."

This figure is Dr. Ourian's observation across his own patient population and is stated as such rather than as a general rate for the procedure. It sits below commonly published figures for laser resurfacing in skin of color, which reflects both the delivery method and a practice composition in which deeper skin types are routine rather than exceptional.

The attribution in that sentence matters as much as the number. Where PIH does occur, the cause is usually post-treatment sun exposure rather than the treatment. That makes it largely preventable, and it makes aftercare compliance the variable the patient controls.

What patients are still told elsewhere

"Patients are still incorrectly told their skin is too dark for lasers."

The advice was reasonable when the available devices made it true. It persists because providers who have not solved the problem have an incentive to describe it as unsolvable rather than as outside their own capability.

The same reasoning applies to skin lightening, where the concern is pigment behavior rather than whether the skin can be treated at all.

What to ask before letting anyone laser deeper skin

Two questions, and they are built to be difficult to answer vaguely.

"How many Fitzpatrick IV cases have you done this month, and do you have a laser that bypasses the epidermis entirely?"

The first asks for a number over a recent period, which is much harder to inflate than a general claim of experience. The second asks about mechanism. A provider who cannot describe how their device avoids depositing energy in the epidermis is describing a device that does not.

A third worth adding: ask to see photographs of results on skin matching yours, at the same Fitzpatrick type, taken in that practice.

Frequently asked questions

Is laser resurfacing safe for Fitzpatrick IV, V, and VI skin?

Yes, with the right delivery method. Fitzpatrick IV and above makes up roughly 60 to 70 percent of Dr. Ourian's practice. The variable is whether thermal energy is deposited in the epidermis where melanocytes sit, not whether the treatment can be performed at all.

What causes post-inflammatory hyperpigmentation after laser treatment?

Heat delivered into the epidermis provokes the melanocytes there, which respond by producing pigment. In Dr. Ourian's own patients, where PIH does occur it is usually caused by sun exposure too soon after treatment rather than by the treatment itself.

How do I know if a provider can safely treat darker skin?

Ask how many Fitzpatrick IV cases they have performed in the past month, and whether their laser bypasses the epidermis entirely. Both questions are difficult to answer vaguely. Also ask to see photographs of results on skin matching your own, taken in that practice.

Can I get laser resurfacing if I have olive skin?

Olive skin is generally classified as Fitzpatrick IV, which is within the range Dr. Ourian treats routinely. What changes is how the energy is delivered and the aftercare protocol, not whether the treatment is available.

Why do some providers say darker skin cannot be lasered?

That advice was accurate when the available devices made it so. It persists partly because a provider without the appropriate equipment has an incentive to describe the problem as unsolvable rather than as outside their own capability.