Dual 1550‐nm Erbium Glass Fiber and 1927‐nm Thulium Fiber Non‐ablative Fractional Laser System Treatment in Patients With Skin of Color: A Review of Clinical Studies and Unmet Needs

ABSTRACT Objectives To review the efficacy and safety of the dual 1550‐nm erbium glass fiber and 1927‐nm thulium fiber non‐ablative fractional laser system in patients with skin of color (ie, Fitzpatrick skin types FSTs III–VI). Materials and Methods Efficacy, safety, and histologic outcomes were reviewed from 15 clinical studies examining the use of the 1550‐nm or 1927‐nm wavelength treatment in individuals with skin of color. Results Despite variability across study designs, consistent improvement was reported with the 1550‐nm wavelength for the treatment of scarring and melasma and the 1927‐nm wavelength for the treatment of melasma and photoaging. Postinflammatory hyperpigmentation (PIH) rates varied across studies. Studies directly comparing different settings reported reduced PIH rates with lower energy and/or density. Histologic studies confirmed dermal remodeling and reduced melanin after treatment. Conclusion The 1550/1927‐nm dual‐laser system is safe and effective. Reducing pulse energy and density may confer fewer adverse effects in patients with skin of color. Additional studies are needed, particularly for patients with FST VI and the 1927‐nm wavelength treatment.