Fitzpatrick’s skin types

Dark skin is a commonly used phrase to describe people of color. Other terms used to describe darker skin types include ethnic skin, brown skin, and pigmented skin. The unifying feature represented is pigmented skin (i.e., shades of tan, olive, brown, and black). Such individuals are often classified as Fitzpatrick s skin types IV through VI. These individuals represent many of the faces of North America, South America, Africa, the Caribbean, Asia, Malaysia, and Australia. 

Peel indications differ between light and dark skin. Key indications in Fitzpatrick s skin types I-III include photodamage, rhytides, acne. 

Superficial salicylic acids have been shown to be safe and efficacious for treatment of PIH. In a study of five patients with Fitzpatrick s Skin Types V and VI with PIH, pretreatment for 2 weeks with hydroquinone 4% cream followed by a series of five 20-30% salicylic acid chemi-... 

As with other superficial peeling agents, Jessner s peels are well tolerated with few contraindications. However, there is scant published information on the use of Jessner s peels in Fitzpatrick s skin types V and VI. One study by Ejaz et al. has reported comparable... 

They occur predominantly on chronically sun-exposed skin, such as the face and the dorsum of hands, and in fair-skinned individuals (especially Fitzpatrick s skin type 1 and 2) [2]. There is also a high prevalence among those receiving chronic immune suppression as organ ttansplant recipients [3]. AKs are intraepidermal skin tumors, and a risk factor for SCC development. It... 

Dark skin as well as ethnic skin, brown skin, black skin and pigmented skin are terms used to describe skin of color. Such individuals are classified as Fitzpatrick s skin types IV through VI. Over the years, this racial group has... 

In a histometric, immunohistochemical and ultrastructural study, TCA peeling in concentrations of 10,20 and 30% were compared with dermabrasion in nine dark-skinned patients (Fitzpatrick s IV and V) with photodamage [24]. Both procedures induced increasing amounts of types I and III collagen. However,... 

Generally, the phenotype that predisposes an individual to an increased risk of skin cancer is red or blond hair, blue eyes, and fair skin. These characteristics are surrogate measure of the sensitivity of the skin to sun exposure and the tendency to develop nevi, freckles, and sunburns based on the skin type. Freckles, which may appear abruptly after the first high dose of UV radiation sun exposure, represent clones of mutated melanocytes, and their presence is associated with an increased risk of melanoma.12 The Fitzpatrick classification of skin type is used to determine the response pattern of the skin to UV radiation and assess the risk for melanoma. There are six Fitzpatrick skin types Type I skin always burns and never tans, type II skin burns easily and tans rarely, type III skin burns sometimes and tans usually, type IV skin burns rarely and always tans, type V skin always tans and is moderately pigmented (brown), and type VI skin always tans and is darkly pigmented (black). Fitzpatrick I and II skin types are commonly affected by NMSC and MM. The susceptibility to skin cancer, both NMSC and MM, is related to the melanin content of the skin and the skin s response to UV radiation. 

In general, there are few conlraindicalions to salicylic acid chemical peeling. Salicylic acid peels are well tolerated in all skin types (Fitzpatrick s I through Vt) and all racial-ethnic groups. General contraindications... 

Skin phototype should be evaluated to minimize the risk of abnormal pigmentation occurring post treatment. Skin types IV-VI, according to Fitzpatrick s classihca-tion, should typicahy not undergo medium and deep... 

Lactic acid is an alpha-hydroxy acid not previously utilized in chemical peeling for melasma In a small group of 24 patients, lactic acid was found to be an efficacious and safe peeling agent for melasma treatment and was as effective as Jessner s solution [323]. In a group of seven Indian patients (Fitzpatrick skin types IV-V) treated with lactic acid peeling for superficial acne scarring, improvement was noted [324]. 

Table 2.1 Fitzpatrick s classification of sun-reactive skin types...

Figure 15.32 Type II Fitzpatrick patients with thick sebaceous skin are often ideal candidates for deep perioral peels. In this patient treated with unoccluded Baker s solution, only the slightest depigmentation is noted associated with a shinier skin. This is the kind of patient that would be most pleased with the procedure...

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