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Fitzpatrick Classification Scale

Dermatologists use the Fitzpatrick Classification Scale to classify a person's complexion and tolerance to sunlight. The Fitzpatrick scale classifies skin types from I to VI.

This classification can identify patients who may be at increased risk for developing problems, such as skin discoloration (dyschromia) and darkening or lightening of areas of the skin (hyper- or hypopigmentation), following certain skin rejuvenation procedures (e.g., microdermabrasion, chemical peels, laser resurfacing).

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Fitzpatrick Skin Types:

  • Type I – Very white or freckled skin, always burns with sun exposure (very fair; often in people with red or blond hair and blue eyes)
  • Type II – White skin, usually burns with sun exposure (fair; often in people with red or blond hair and blue, green, or hazel eyes)
  • Type III – White or olive skin tone, sometime burns with sun exposure (fair; seen in people with any hair or eye color
  • Type IV – Brown skin, rarely burns with sun exposure (common in people of Mediterranean descent)
  • Type V – Dark brown skin, very rarely burns with sun exposure (common in people of Middle-Eastern descent)
  • Type VI – Black skin, never burns with sun exposure

The patient's skin type is an important factor used by dermatologists and other health care providers (e.g., dermatologic surgeons [dermasurgeons], certified laser technicians, aestheticians) to help determine which cosmetic procedure, or combination of treatments, is best for each patient.

In general, skin types I–III have a lower risk for problems (e.g., skin discoloration, blotchiness, darkening or lightening of the skin [hyper- and hypopigmentation], burns, scarring) following cosmetic skin treatments and skin types IV–VI have a higher risk.

Certain cosmetic procedures, such as dermabrasion, microdermabrasion, and some laser treatments, should be performed with caution on people with skin types IV–VI. In these patients, the risks are weighed against potential benefits, and other treatments (e.g., nonablative laser rejuvenation) may be considered.

Other factors to be considered include the following:

  • Age of the patient
  • Area of skin to be treated
  • Level of skin damage (e.g., mild, moderate, severe; often caused by sun exposure)
  • Treatment goals (e.g., reduce fine lines, wrinkles, skin discoloration)

Nonablative laser rejuvenation can improve the texture and appearance of the skin and reduce uneven skin tone, without damaging the outer layer of the skin (epidermis). Nonablative lasers (e.g., visible light lasers, mid-infrared lasers [Nd:YAG lasers]) bypass the epidermis and deliver energy to the underlying layers of skin (dermis), stimulating collagen growth and skin tightening.

These procedures can be used in patients with all skin types, and may be better choices for patients who have skin types IV–VI. Nonablative resurfacing may cause fewer side effects and result in faster recovery times.

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Original Date of Publication: 29 Jun 2007
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