Laser Patch Test Protocol | Seattle Plastic Surgery

Professional, medical-grade skin procedures often use substances that in the wrong hands or performed on the wrong patient can cause problems. One of the best examples of this is lasers and skin tones. Certain lasers are better for some skin tones than others. The Q-switch laser we use for laser hair removal allows master estheticians to switch between different laser wavelengths so that they can treat all skin tones. Unfortunately, this is not possible with all forms of lasers and light therapy. To help ensure the best treatment is performed on every patient, our master estheticians created a laser patch test protocol.

Understanding The Fitzpatrick Scale & Laser Treatments

The Fitzpatrick scale is a way to measure the way skin reacts to UV rays. It is related to the amount of melanin in your skin. There are six Fitzpatrick skin types:

  • Type I: People with Type I Fitzpatrick skin tend to have little melanin and their skin will always burn over tan when exposed to UV rays. They also have a higher skin cancer risk. People with this type are most likely to have red or blonde hair.
  • Type II: A Fitzpatrick Type II will often burn and rarely tan. However, they can and likely have tanned at least once during their lifetime. Like Type I, they overall have minimal epidermal melanin.
  • Type III: A person with a Fitzpatrick Type III skin tone will sometimes burn and sometimes tan. They may also notice that they tan more gradually. This type tends to have noticeable melanin production. It is the last skin tone that does not require a patch test for procedures that can cause hyperpigmentation.
  • Type IV: The inverse to Type II, a Type IV Fitzpatrick skin type, rarely burns and often tans. This is not to say a Type IV can never burn, it is simply rare and less likely than the three skin types lower on the scale. There is also a significant reduction in skin cancer risk.
  • Type V: A Fitzpatrick Type V tans easily and can do so without burning at all. There is still slight UV sensitivity, however, and in extremely rare circumstances can burn. Still, someone with a Type V skin tone may have never significantly burned before.
  • Type VI: The last and most melanated skin tone on the Fitzpatrick scale, someone with a Type VI skin type is very UV resistant. This means they never burn and always tan when exposed to prolonged UV rays. While the skin cancer risk is lower, it is not nonexistent. People with a Type VI skin tone should still wear SPF daily and avoid unprotected, prolonged sun exposure. Anyone can get skin cancer regardless of skin tone.

Darker skin tones absorb more laser energy because many lasers are specifically calibrated to target melanin. Thus, if the wrong type of laser is used, or at the wrong strength, it can hinder melanin production. This then can lead to lighter patches of skin known as hyperpigmentation. Therefore, for patients with a skin tone above a Fitzpatrick III, our master estheticians require a patch test for most laser procedures (except laser hair removal and some tattoo removal procedures).

Patch Testing: What It Involves & Why It’s Done

As mentioned, there are lasers suitable for use on higher Fitzpatrick type skin. However, with the aid of brightening cream and the patch test, it may be possible for patients of darker skin tones to undergo laser and light procedures traditionally considered ideal for lighter skin tones. If the patch test is positive, your master esthetician will likely decide the procedure is not suitable for you.


If you and your master esthetician decide to move forward with a laser patch test protocol, they will likely have one of our physicians prescribe our prescription strength brightening cream. This cream—used for several weeks before the actual procedure—helps temporarily deactivate melanin production. This does not change your skin color when applied topically at the prescribed dosage.

Along with brightening cream, your master esthetician will advise that you cease retinol usage and similar products. You should and can continue a basic skincare routine as well as wearing SPF. 

Patients who are a lower Fitzpatrick type can—and sometimes should—undergo a patch test. Brightening cream is usually not part of the preparation regimen in these cases. Though, you may need to quit using certain medications (if possible) or get physician clearance.

Patch Test Appointment

After four weeks of brightening cream or otherwise following the preparation routine, you will come in for a patch test appointment. The patch test area should be free of makeup and shaved. After cleaning and disinfecting the area, your master esthetician will administer a pulse of the laser to the patch test area. If wanting to undergo a laser procedure on the face, the patch test area is generally behind the ear.

Afterward, your master esthetician will examine your skin’s immediate result to the patch test. It is normal for some redness and irritation to occur, but if anything abnormal occurs immediately, this is easy to identify a positive result. Though, unless severe, they may still want to monitor the patch area over the next two weeks.

Monitoring & Evaluation

In the coming two weeks, you will monitor the patch. Your master esthetician will provide instructions on what to look for. After about two weeks, your master esthetician will call you to discuss the results of the patch test. They may also request you upload pictures so they can evaluate them as well. 

If you receive a negative result, you will continue to use brightening cream and can schedule your laser session. Though, if the result is positive, you are likely not a candidate for the specific laser or light treatment patch tested.

Frequently Asked Questions

Do I Have To Do A Patch Test?

People with Fitzpatrick skin tone Type III and above need to do a patch test to avoid hyperpigmentation or other problems. Some patients—regardless of Fitzpatrick Type—may also be required to have a patch test due to certain medication conditions, taking certain medications, or a history of adverse reactions. Patients can also opt for a patch test even if they do not fit the requirement criteria.

What Laser Procedures Is A Patch Test Performed For?

Nearly any laser or light-based treatment may involve a patch test for certain patients. Some patients with a low Fitzpatrick type may need to be tested for laser hair removal procedures. This usually happens if they have hair that is light, but not blond or red. In general, you may undergo a patch test with procedures such as:

What Can I Do & Not Do After A Patch Test?

After your patch test, your master esthetician may provide you with a few instructions to follow to produce a reliable result. This may include:

  • Do not shower or get the area wet for 48 hours
  • Keep the tested area out of the sun/protected from direct sunlight
  • Avoid applying makeup to the area for 48 hours
  • Skip the gym or strenuous activities for about two days
  • Do not unnecessarily touch, scratch, or pick at the tested area
  • Report any severe reactions to your master esthetician
  • Do not shave or wax the area during the duration of the patch test (do shave before the test)

Otherwise, patients can return to work and the majority of their daily activities immediately. Outside of limitations on exercise and getting the area wet, there are no major limitations.

Why Does It Take Two Weeks To Evaluate It?

If you have ever had another form of patch test such as to test for allergies, you may know that some types of patch tests are only observed for 48 hours. Our estheticians need to monitor the healing process of laser treatments to make sure no scarring appears. This helps prevent any unwanted side effects or complications in the long run.

How Much Is A Laser Patch Test At Seattle Plastic Surgery?

The cost of a laser spot test at Seattle Plastic Surgery is $95. This includes the purchase of brightening cream and the administering of the test spot in-office. If you do not require brightening cream, the cost may be reduced. Additionally, if you require multiple test spots, the cost may increase.

When I first considered laser hair removal I studied all about it, readign grossly outdated web articles and was left somewhat apprehensive but decided to "go for it". At my first session i was very nervous of what torturous pain I would have to endure absolutely painless.
The best part was the results. They really exceeded my expectations.


Heather Trice is a great esthetician. She is very knowledgeable and professional. Heather takes time to explain the procedure and suggests what else can be done for better results. Good overall experience and would recommend


Very easy and convenient to book an appointment with. Very professional and competent staff and doctor. I felt very taken care of and at ease thru out my entire procedure. Now Iv been back for my second time and I will be coming back in the future. I am extremely happy with the results. 5 STARS!!


I have always had great service and results at Seattle Plastic Surgery! I need to visit more often!


The Best Master Estheticians At Seattle Plastic Surgery

Master estheticians are a type of esthetician with more advanced training. This includes instruction in medical terminology and conditions of the skin. It also certifies them to perform medical-grade laser and chemical peel procedures. The master estheticians at Seattle Plastic Surgery have combined experience of over a decade and are all state-certified. Seattle Plastic Surgery offers the best laser patch testing in Seattle and Tacoma to allow more people to undergo laser procedures.

Seattle Plastic Surgery is a plastic surgery practice and medical spa located in the heart of Seattle, Washington. With a convenient location in the First Hill neighborhood, Seattle Plastic Surgery has proudly served the Greater Seattle area for over two decades.

To learn more and schedule a free consultation with a master esthetician, call us at 206-324-1120. You can also reach out online via chat, contact form, and Price Simulator.