The Other BBL Treatment That's Harming Melanated Skin

As the skin-care industry expands, learning how to properly treat melanated skin is still too often an afterthought. Monique Diaz Doolin learned this the hard way after receiving broadband light (BBL) therapy, offered to her as a no-risk "facial" by an aesthetician at a medical spa.

While light therapy is commonly used to treat everything from blemishes to hyperpigmentation, the wrong type of laser, flawed application, or improper aftercare can leave permanent scarring. Instead of leaving with rejuvenated skin, Doolin's body went into shock — and she says she wound up in the emergency room and was treated for first- and second-degree burns. She's not the only Black customer to have had a bad experience with this type of treatment. Although BBL therapy is trending and the cosmetic laser market is projected to reach $4.1 billion by 2027, according to recent reports, other BIPOC women have had adverse reactions, too.

Also known as a "photofacial," BBL therapy is an FDA-approved treatment designed to treat acne scars, sun spots, rosacea, wrinkles, and more. Although it's not technically a laser — BBL uses intense pulsed light instead of the narrow beam of light of a laser — it is commonly marketed as a gentle laser treatment.

According to Duke Health, the treatment is considered safe, but it's not recommended for people with dark skin tones. That's because intense pulsed light is not safe for tanned or dark skin, which can absorb too much light and cause burns, hypopigmentation (lightened areas), hyperpigmentation (darkened areas), and scarring.

"You need to be selective about who is performing these treatments, because darker skin types are super reactive," says board-certified cosmetic and general dermatologist Rosemarie Ingleton, MD. "Everything bothers [our] skin, so you need to find someone experienced in treating our sensitive skin type. If you go to an aesthetician for a facial and they start introducing advanced techniques, you should be cautious."

In a white-dominated industry, where only five percent of aestheticians are Black (and there's an even smaller portion of Black dermatologists), it's challenging to find a skin-care practitioner well-versed in treating Black skin. Many basic aesthetician programs are focused on teaching sanitation practices — which is also important, obviously, but the nuances of skin care can fall to the wayside. And like in many other industries, much of the educational materials center white skin, so hiring other folks of color doesn't necessarily guarantee quality care alone.

"Unfortunately, a lot of facialists do not have an education when it comes to treating dark skin and skin of color," licensed aesthetician Nikki Jackson-Sagirius says. "There was only one chapter devoted to skin of color when I attended aesthetician school — not just Black skin. All skin of color was condensed to one chapter." Rather than relying on what she learned in school, Jackson-Sagirius sought continuing her education and looked for experts on melanated skin to grow her own knowledge.

"Do your due diligence as a consumer; make sure the person you are going to is well-versed on Black skin and skin of color. Just because a treatment is available does not mean it is right for your skin," Jackson-Sagirius says. "People assume Black skin is tougher and we can tolerate the sun a little more, but our skin is actually delicate and [must] be treated gently."

Licensed aesthetician Carolyn Terry believes stereotypes like "Black don't crack" encourage Black women to believe that caring for our skin is less important than caring for our hair and nails. Rather than learning to follow a consistent skin-care regimen over time, we are more susceptible to the idea of a quick fix, she says.

"I see a lot of Black women with beautiful skin. [We're] appealing to women that wash their face, put on moisturizer, and go — they do not even apply sunscreen," Terry says. "Skin-care treatments are for us, but a lot of our clients don't let us start at the beginning, move to the middle, and graduate to the end."

Ultimately, though, experts agree: it's up to practitioners to stop offering treatments that fall outside the limits of their training and scope of practice. "These mishaps are the fault of the aestheticians that agree to perform these procedures," Terry says, adding that she refuses to provide advanced skin therapy treatments to first-time clients.

While considering a skin-care practitioner, here are some tips to remember.

Find an experienced, licensed professional via word-of-mouth, and ask your friends who they recommend. Check out their social media handles, but don't rely on those to get the full story — seek out photos and read their reviews on other sites, too. Verify they are licensed in your state to perform the services they are offering.

Take your skin-care consultation just as seriously as you would any medical appointment by preparing a detailed list of questions in advance. Ask specific questions about their experience level, their experience treating clients with your skin tone, and the potential risks of the treatment you're seeking out.

Verify whether your desired treatment is safe for Black skin, and steer clear of treatments with a high risk of scarring and hyperpigmentation for darker skin (such as deep chemical peels). A good aesthetician should be able to identify which treatments to avoid based on your skin type, but do your own research, too.

Be open and honest before, during, and after your treatment. Let your practitioner know whether you have been on medications or are using products like retinoids prior to your appointment. Even if your last treatment went well, communicate if anything feels different this time around.

Follow the aftercare instructions provided by your practitioner. They are designed to help prevent infection and scarring, and they are the only way to help you get the results you paid for.

When it comes to skin care, one mistake can lead to a lifelong deformity. As the global medical spa market expands and advanced skin-care treatments become more accessible, it's increasingly important for Black women to protect themselves by understanding the risks.