Harvard dermatologist Thomas Fitzpatrick. M.D., Ph.D., first developed the Fitzpatrick scale in 1975 to gauge how skin of different colors reacted to UV light exposure. This model is used to evaluate a clients propensity to post-inflammatory hyperpigmentation (PIH). The melanin content should warn the service provider that any surface inflammation can trigger hyperpigmentation.
Depending on the Fitzpatrick you can decide what chemical acids you can use and what setting of machines to use. For lower Fitz types surface stimulation is typically not an issue. Unless they suffer from a barrier issue like rosacea. Darker Fitz types need to be treated with care when selecting the peel solution. Lower percentages with higher pH in peel solutions are better. Using ingredients that have melanogenesis inhibiting ingredients is best. Don’t assume how the client’s skin will respond. As you do treatments you will get to know how the skin responds.
Fitzpatrick 1 – Pale White
Common hereditary backgrounds – Typically Nordic, Scandinavian
Visual Reaction to Sun – Always burns, never tans
Sensitivity to chemical peels – Very resilient
Adverse responses to UV Rays – Skin cancer, hypopigmentation
Firtzpatrick II – White
Common hereditary backgrounds – Typically Irish, English, Welsh
Visual Reaction to Sun – Usually burns
Sensitivity to chemical peels – Resilient
Adverse responses to UV Rays – Skin cancer, Telangiectasias
Firtzpatrick III – Light Brown (Naturally Tan)
Common hereditary backgrounds – Asian, mediterranean (Italian, Greek)
Visual Reaction to Sun – Mildly burns, tans relativley well
Sensitivity to chemical peels – Moderately responsive
Adverse responses to UV Rays – Skin cancer, Telangiectasias and Hyperpigmentation
Firtzpatrick IV – Moderate Brown
Common hereditary backgrounds – Hispanic, Middle Eastern, African American, Native American
Visual Reaction to Sun – Very rarely burns, tans well
Sensitivity to chemical peels – Sensitive
Adverse responses to UV Rays – Hyperpigmentation
Firtzpatrick V – Dark Brown
Common hereditary backgrounds – Hispanic, Middle Eastern, African American, Native American, Southeast Asian
Visual Reaction to Sun – Very rarely burns, tans easily
Sensitivity to chemical peels – Moderately sensitive
Adverse responses to UV Rays – Hyperpigmentation
Fitzpatrick VI – Black
Common hereditary backgrounds – African American, Southeast Asian
Visual Reaction to Sun – Least likely to burn, tans very dark
Sensitivity to chemical peels – Very sensitive
Adverse responses to UV Rays – Hyperpigmentation
The Fitzpatrick Scale is meant to be used a guide but now a days so you can’t assume and need to ask questions about someone’s background. For example someone can be a Fitz II or III and you think they are one hereditary background but they may have some other hereditary backgrounds. Always do a complete consultation and skin analysis so you can create a skincare plan for your client.