Why is melanin content in the skin a concern for pigment alteration after treatment?

• A. Melanin content has no effect on pigment alteration.
• B. Higher melanin increases risk of PIH or hypopigmentation; adjust energy, wavelength, and cooling accordingly.
• C. Higher melanin decreases risk of PIH.
• D. Melanin only affects hair pigment, not skin changes.

Answer: (B)

Melanin content in the skin affects pigment alteration after treatment because melanin strongly absorbs laser energy. When there’s more pigment in the epidermis, more energy is deposited there, increasing the risk of thermal injury to pigment-producing cells. That damage can lead to pigment changes such as post-inflammatory hyperpigmentation or hypopigmentation after treatment. To reduce this risk in darker or more pigmented skin, practitioners adjust parameters: choose wavelengths with less epidermal melanin absorption, use lower fluence, and employ longer pulse durations with effective cooling to protect the surface while still targeting the hair follicle. Incremental sessions and careful test spots are also prudent. The other statements overlook how melanin’s absorption of light drives pigmentary risk, or misstate its effect on skin pigment.