Lasers Must Treat Skin Biology, Not Color: Eliot F. Battle, MD

Eliot F. Battle, MD, cofounder and CEO of Cultura Dermatology & Laser Center in Washington, DC, and cochair of Skin of Color Update, says choosing laser parameters on skin color alone puts patients at risk. Speaking at the 2026 Skin of Color Update conference in New York, New York, he argued that the Fitzpatrick classification leaves out the biology that determines how each patient’s skin responds to treatment.

Beyond the Fitzpatrick Scale

Battle has traditionally taught laser physics and practical technique at the meeting, but this year he focused on what skin type misses. He explained that 2 patients with Fitzpatrick skin type 4 are not interchangeable because age, genetics, and inflammation shape how their skin reacts to energy-based devices. He called the Fitzpatrick system incomplete and expects artificial intelligence to eventually combine this biological information into safe and effective treatment settings. “We don’t just treat skin color; we treat skin biology.”

Battle cautioned against relying on manufacturer presets, which are generalized by skin color rather than tested across the full range of biological profiles clinicians see in practice. Until treatment can be tailored more precisely, he favors restraint. “I think that we have to treat [it] more conservatively. If not, we’re going to harm people.”

Closing Gaps in Skin of Color Care

Battle noted that general and esthetic dermatology are closely intertwined in skin of color, because many conditions and treatments leave hyperpigmentation that requires addressing color and texture together. Gaps remain across the field, he said. Most research participants still have skin types 1 through 3, patients of color are often grouped into one category, and laser technology has seen little fundamental innovation in decades. He called for devices and research that reflect the full diversity of patients.