While the main medical skin treatments available to Asian patients for addressing discoloration, wrinkling, and loss of youthful sheen include laser resurfacing and chemical peels, both can cause skin discoloration if they wound to even a medium-depth.
Mild lasers that penetrate more superficially lessen the chance of post-treatment blotching, over-pigmentation (post-inflammatory hyperpigmentation), and patches of lost pigmentation but provide much less improvement.
Chemical peel agents weaker than 20% trichloroacetic acid (TCA) are generally preferred.
The Erbium laser is preferred to stronger lasers like the CO2 laser, which treats deeper and more effectively but will more readily damage the melanocytes that produce the skin's pigment.
Recently, a number of more advanced fractional lasers offering different energy wavelengths, spot sizes, and pulse durations have been introduced and appear to be much kinder to more heavily pigmented skin. Clinical studies are ongoing.
Pretreatment using Retin A® and hydroquinone, a skin bleaching agent, helps to lessen but not eliminate pigmentary risks of laser surgery or chemical peels.
Patients of northern east Asia lineage tend to have more milky-white complexions (less melanin) than those from the more southern areas and are generally better candidates for skin resurfacing.