LETTER TO THE EDITORLANCER ETHNICITY SCALE (LES)

The Lancer Ethnicity Scale (LES) was devel-oped as a clinical evaluation protocol in determin-ing the best approach to the cosmetic laser pa-tient, which must be done before initiating vari-ous cosmetic laser or chemical peel protocols.Ethnic composition and diversity play an over-whelming role in possible end results. ‘‘Consider-ing a patient’s natural skin color, thickness, elas-ticity, pore size, and density are of great impor-tance. A detailed ethnic history, however, mayuncover critical issues that are key to a successfuloutcome in various cosmetic procedures, includ-ing laser and chemical exfoliation surgery. Post-procedural healing rate, potential complications,and final end results may be more easily pre-dicted when LES data is factored in.

As a standard procedure, regardless of the pa-tient’s physical features of color (skin, hair, eyes),the ethnic origin of all known grandparents and thepatient’s parents are determined. I have often foundthat a patient with a clinical Fitzpatrick skin type Ior II may have genetic origins of skin types III, IV,V, and VI. If you factor in this additional historicalinformation, clinical experience would dictate thedegree of caution for such a patient who would oth-erwise, based on clinical appearance alone, betreated more aggressively. Given the same clinnicalexpertise in a specific cosmetically sensitive proce-dure, the results would be significantly different inclinically similar patients if one had consideredmore distant ancestry (Fig. 1). Perhaps an alterna-tive approach in treatment should be consideredbased on LES types (Fig. 2). This reasoning could beextended to other forms of laser surgery.

We live in a wonderful world of mixed eth-nicity, but it sets up more significant challengesin the clinical practice of cosmetic laser surgery.The Lancer Ethnicity Scale provides a method topre-surgically skin type our patients and moreclearly predict outcome in order to give patientsthe greatest satisfaction and the least potentialfor adverse reactions and disappointments.

Harold A. Lancer, MD, FAAD

Assistant Clinical ProfessorU.C.L.A. School of Medicine9735 Wilshire Blvd., Penthouse SuiteBeverly Hills, CA 90212

Fig. 1.

Fig. 2.

Lasers in Surgery and Medicine 22:9 (1998)

© 1998 Wiley-Liss, Inc.