LANCER ETHNICITY SCALE (LES)
The Lancer Ethnicity Scale (LES) was developed as a clinical evaluation protocol in determining the best approach to the cosmetic laser patient, which must be done before initiating various cosmetic laser or chemical peel protocols. Ethnic composition and diversity play an overwhelming role in possible end results. ''Considering a patient's natural skin color, thickness, elasticity, pore size, and density are of great importance. A detailed ethnic history, however, may uncover critical issues that are key to a successful outcome in various cosmetic procedures, including laser and chemical exfoliation surgery. Postprocedural healing rate, potential complications, and final end results may be more easily predicted when LES data is factored in.
As a standard procedure, regardless of the patient's physical features of color (skin, hair, eyes), the ethnic origin of all known grandparents and the patient's parents are determined. I have often found that a patient with a clinical Fitzpatrick skin type I or II may have genetic origins of skin types III, IV, V, and VI. If you factor in this additional historical information, clinical experience would dictate the degree of caution for such a patient who would otherwise, based on clinical appearance alone, be treated more aggressively. Given the same clinnical expertise in a specific cosmetically sensitive procedure, the results would be significantly different in clinically similar patients if one had considered more distant ancestry (Fig. 1). Perhaps an alternative approach in treatment should be considered based on LES types (Fig. 2). This reasoning could be extended to other forms of laser surgery.
We live in a wonderful world of mixed ethnicity, but it sets up more significant challenges in the clinical practice of cosmetic laser surgery. The Lancer Ethnicity Scale provides a method to pre-surgically skin type our patients and more clearly predict outcome in order to give patients the greatest satisfaction and the least potential for adverse reactions and disappointments.