If you’ve ever considered a skin treatment or been to a skin clinic, you might have heard of the Fitzpatrick skin type scale. But what is it exactly? And why does it matter?
The Fitzpatrick skin type scale is a scientific way of classifying different skin tones that helps clinicians understand how your skin responds to ultraviolet (UV) light.
The scale was originally developed in 1975 by Dr Thomas B. Fitzpatrick a Dermatologist at Harvard. The scale was designed to help make UV-based treatments, such as phototherapy for psoriasis, safer. However, the scale has proven to be very useful as an effective guide when selecting the safest and most effective treatment settings for many types of Laser and other energy-based skin treatments which is why it is still widely used today.
Why does your skin type matter when having cosmetic skin treatments?
Each of the different skin types responds differently, not only to UV, but also to heat, light and trauma. This is why people with higher Fitzpatrick skin types, such as those with darker or more melanin-rich skin, are more prone to forming much darker skin at the site of a healing wound. For example, when a pimple heals up, the skin can go very dark in that spot. This is an example of increased pigmentation due to the inflammation that has occurred due to the pimple. We call this phenomenon post-inflammatory hyperpigmentation (PIH), and it can happen after any type of trauma or stress to the skin, especially in darker skin.
The Six Fitzpatrick skin types
The Fitzpatrick skin scale starts at one (I), which is very fair skin that always burns and never tans. The scale goes up to type six, (VI) which describes very dark skin that never burns and becomes even more deeply pigmented when exposed to the sun. Skin colour is a reasonable guide to your Fitzpatrick skin type, but a more accurate classification is based on your personal history of sunburn and tanning. It’s not solely based on skin colour or ethnicity. Here is a simplified self assessment scale. You can use to get your approximate Fitzpatrick skin type.
| Fitzpatrick Type | Skin Colour | Sunburn Response | Tanning Ability |
|---|---|---|---|
| I | Very fair, often with red or blonde hair | Always burns, never tans | None |
| II | Fair | Usually burns, tans poorly | Minimal |
| III | Light olive or beige | Sometimes burns, tans gradually | Moderate |
| IV | Light brown | Rarely burns, tans easily | High |
| V | Brown | Very rarely burns, tans profusely | Very high |
| VI | Deep brown to black | Never burns, deeply pigmented | Profound |
A More Precise Assessment
For a more accurate assessment of your Fitzpatrick skin type, we prefer to use the assessment tool published by the Australian Radiation Protection and Nuclear Safety Agency. This assessment tool asks you questions about your physical traits, your sun sensitivity history, and your tanning habits. The answer to each question gives you a score from 0 to 4, and these scores are added up to determine your Fitzpatrick scale. You can visit the government website and see the scale for yourself [https://www.arpansa.gov.au/sites/default/files/legacy/pubs/RadiationProtection/FitzpatrickSkinType.pdf]
Is The Fitzpatrick Skin Type Scale Perfect?
It’s pretty good, but it’s not perfect. It’s widely used and very helpful. However, it can be inaccurate, especially for anyone with mixed heritage. The scale has an element of subjectivity because it relies upon self-reporting, which often varies. There are more objective Skin typing tools, such as spectrophotometric skin colour measurement and pigment protection factor assessments. However, these require specialist equipment and are generally only used in certain types of medical research.
Final thoughts
Knowing your Fitzpatrick skin type rating is useful. It helps guide safer, skincare and better treatment outcomes while also reducing your risk of unwanted side-effects. It’s also helpful when you are doing your research into which skin treatments you may wish to undertake, but the most important thing to remember is that you want to find a reputable and experienced team of medical professionals who will assess your skin and guide your treatment choices safely.