Fitzpatrick Skin Types

SKIN

Fitzpatrick Skin Types

The Fitzpatrick skin phototypes (FSP) were developed in Boston 1975
 for use with phototherapy. The scale’s original purpose was to help determine a patient’s risk of burning or tanning when exposed to UV light.

Fitzpatrick initially based the scale on a person’s skin and eye color to determine the amount of UV therapy used to treat skin disorders without causing phototoxicity, or irritation from UV light.

Fitzpatrick Skin Types are used by medical professionals to assess risk for sunburn and skin cancer.

People with Skin Type I are usually pale, blonde or red hair, freckled with blue eyes and likely to experience severe sun damage from ultra-violet exposure. 

People with Skin Type II are usually fair with blue eyes, light or fair skin. They manage to get a light tan with repeated exposure to sun, but have a high risk for skin cancer (including melanoma, the deadliest type of skin cancer). 

People with Skin Type III have sensitive skin and although their skin is still white, it is slightly darker than those with skin types I and II.  Their skin sometimes burns and may tan to a light bronze, but their risk for skin cancer remains higher than average. 

People with Skin Type IV have dark hair and light Mediterranean, olive looking skin – beige with light brown tint. They typically tan with ease and seldom get burned. Their risk to develop skin cancer is less that those with skin types I-III, but still present. 

People with Skin Type V has an olive or dark skin tone and includes light-skinned African-Americans, Indians and those of Middle Eastern decent. They tan easily and very rarely burn and skin cancer is not common among people with this skin type.

People with Skin Type VI have a dark skin colour and usually of African decent. Their skin rarely burns and although skin cancer is not common among people with this skin type, they should still take the necessary precaution to protect their skin against skin cancer

Fitzpatrick Skin Type I:

This skin type is believed to be highly susceptible to premature ageing and skin cancers (including melanoma, the deadliest type of skin cancer) and one is therefore advised to take extreme care, use sunscreen and protect yourself from harmful UV rays as extreme sun exposure can result in serious damage, premature ageing and skin cancers such as squamous cell carcinoma SCC, Basal cell Carcinoma BCC and Melanoma.


The Role of Pheomelanin:It has been recognised that the type of melanin that blondes and red-heads have –pheomelanin – seems to be important in skin cancer risk. This type of melanin acts as a co-conspirator in causing a person to be more at-risk for developing skin cancer. In other words, this type of melanin that causes blonde and red hair actually increases the risk for cell death such as seen in sunburn. Melanin filters out UV radiation, but it also actually increases the UV harmful effects and causes cell death, particularly when the melanin is the kind found in light hair or skin. Pheomelanin acts with the sun’s UV rays to increase sun damage. Pheomelanin or red melanin can vary widely, depending on whether your ancestors were Irish, Swedish or Dutch, and some of these variations are known to be associated with greater risk for skin cancer.


Skin Type I individuals are conducive to the usual aesthetic treatments and most treatments can safely be done without the danger of adverse side effects such as hyper- or hypopigmentation occurring. Aggressive Ablative resurfacing treatments (not done at Sinclair Aesthetics) such CO 2 laser , Erbium Yag laser and Phenol peels can result in permanent hypopigmentation (whitish skin that has lost its pigmentation) and should be avoided.

Fitzpatrick Skin Type II:

These skin types are therefore advised to take extreme care, use sunscreen and protect themselves from harmful UV rays as extreme sun exposure can result in serious damage, premature ageing and skin cancers such as squamous cell carcinoma SCC, Basal cell Carcinoma BCC and Melanoma.


Skin Type II individuals are conducive to the usual aesthetic treatments and most treatments can safely be done without the danger of adverse side effects such as hyper- or hypopigmentation occurring.

Aggressive Ablative resurfacing treatments (not done at Sinclair Aesthetics) such CO 2 laser , Erbium Yag laser and Phenol peels can result in permanent hypopigmentation (whitish skin that has lost its pigmentation) and should be avoided.

Fitzpatrick Skin Type III:

Skin Type III individuals are also susceptible to basal cell carcinoma and squamous cell carcinoma. These skin types are therefore advised to take care, use sunscreen and protect themselves from harmful UV rays as extreme sun exposure can result in serious damage, premature ageing and as mentioned earlier life threatening skin cancers, including melanoma.

Skin Type III individuals are conducive to the usual aesthetic treatments and most treatments can safely be done without the danger of adverse side effects such as hyper- or hypopigmentation occurring.

Aggressive Ablative resurfacing treatments (not done at Sinclair Aesthetics) such CO 2 laser , Erbium Yag laser and Phenol peels can result in permanent hypopigmentation (whitish skin that has lost its pigmentation) and should be avoided.

Fitzpatrick Skin Type IV:

They should therefore still take care, use sunscreen and protect themselves from harmful UV rays as extreme sun exposure can result in serious damage, uneven skin tone, premature ageing and possible skin cancers.

Skin type IV can be prone to an overactive production of melanin following sun exposure which can result in the uneven pigmentation of melasma especially if they are on hormonal therapy such as the oral contraceptive or during pregnancy.

Those with a higher level of skin type such as skin type IV -can be prone to an overactive production of melanin following certain light and laser skin rejuvenation treatments or laser hair removal and thus proper preparation of the skin and sun avoidance is recommended prior to aesthetic treatments such as laser / light and peels. This can help prevent permanent discoloration or scarring of the skin.

Fitzpatrick Skin Type V:

Although skin cancer is not common among people with this skin type, they should still take the necessary precaution to protect their skin against skin cancer. Individuals with this skin type should still protect themselves from the sun as chronic sun exposure leads to uneven skin tone and pigmentation.

Skin Type V also reacts differently and at times more severely to common conditions such as acne, eczema, dermatitis, psoriasis and seborrheic dermatitis (dandruff) which can lead to potential problems with pigmentation, or uneven darkening or lightening of skin colour as the formation of melanin is a dynamic process and responds to various stimuli. Thus the the skin is more reactive to an insult which can lead to dark marks called Post Inflammatory Hyperpigmentation PIH. PIH may takes years to fade thus wearing a sunscreen is essential to prevent PIH. This skin type can also produce less pigmentation called Hypopigmentation or lightened areas, after a burn or other injury.

There is a greater risk of keloid (raised, often large scars) development because darker skin has a better bed of collagen. Studies suggest that the fibroblasts which make collagen, are larger and more numerous and active. Damage to darker skin is therefore associated with a greater incidence of keloids and hypertrophic scars.

Fitzpatrick Skin Type VI:

should still take the necessary precaution to protect their skin against skin cancer, namely wear sunscreen with a SPF higher than 15 and seek the shade between 10am and 4pm. Individuals with this skin type should still protect themselves from the sun as chronic sun exposure leads to uneven skin tone and pigmentation.

Acral lentiginous melanoma, a very virulent form of the disease, is more common among darker-skinned people. These melanomas tend to appear on parts of the body not often exposed to the sun, and often remain undetected until after the cancer has spread. Individuals should therefore check their skin regularly from head-to-toe and pay careful attention to any suspicious growths, especially on the palms, soles of the feet and on mucous membranes.

Skin type VI also reacts differently and at times more severely to common conditions such as acne, eczema, dermatitis, psoriasis and seborrheic dermatitis (dandruff) which can lead to potential problems with pigmentation, or uneven darkening or lightening of skin colour as he formation of melanin is a dynamic process and responds to various stimuli. Thus the the skin is more reactive to an insult which can lead to dark marks called Post Inflammatory Hyperpigmentation PIH. PIH may takes years to fade thus wearing a sunscreen daily, is essential to prevent PIH. This skin type can also produce less pigmentation called.

Hypopigmentation or lightened areas, after a burn or other injury. There is a greater risk of keloid (raised, often large scars) development because darker skin has a better bed of collagen. Studies suggest that the fibroblasts which make collagen, are larger and more numerous and active. Damage to darker skin is therefore associated with a greater incidence of keloids and hypertrophic scars.

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