Fitzpatrick skin type

Unsafe in Fitzpatrick skin type higher than V... 

Unsafe in Fitzpatrick skin type more than V Cannot be used in summer Resorcinol may be a sensitizing agent Additional histological studies are necessary to understand the mechanism of action in facial rejuvenation... 

Bleaching products such as hydroquinone 4-8% are particularly useful in patients with dyschromias and in patients with Fitzpatrick skin types lll-VI... 

In cases of patients with olive skin (Fitzpatrick skin type 3 or 4), the application of Kligman preparation is recommended to prevent reactive hyperpigmentation. 

After the procedure, the patient is advised to use water-based lotion creams and potent sunscreens. The erythema gradually resolves over about a 2-month period. During this time, makeup foundation is encouraged. In patients with dark skin (Fitzpatrick skin type 3 or 4), the application of Kligman preparation is recommended to prevent reactive hyperpigmentation. Systemic Isotretinoin is required in some patients and can be prescribed as soon as 2-3 weeks after the procedure, if no other surgical intervention is planned in the near future. 

In 2002, Grimes reported the efficacy of combination salicylic acid/TCA 10% peeling [1]. She treated patients with moderate to severe melasma with this combination regimen. In the series, nine patients were classified as Fitzpatrick skin type IV, eleven were skin type V, and seven were skin type VI. Many of the subjects included in the study had not responded to salicylic acid or glycolic acid peels. The concentration of salicylic acid was 20 and 30%, and the TCA concentration was 10%. A series of four peels was performed at 2-week intervals. Thirty percent of the patients experienced moderate improve-... 

There is minimal published data on the use of combination peeling protocols in deeply pigmented skin (Fitzpatrick skin types IV-Vl). The author has reported the efficacy of combination peeling with salicylic acid 20 and 30% in combination with 10% TCA for recalcitrant melasma patients. This peeling regimen was well tolerated with minimal side effects in darker racial ethnic groups (see Salicylic acid/TCA peel section). 

The most common risk factors for skin cancer development after transplantation include increased age, excessive ultraviolet (UV) light exposure, high degree of immunosuppression, Fitzpatrick skin types I, II and III, history of skin cancers, and infection by human papillomavirus.77... 

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. 

As the risk increases with the skin phototype, it is obvious that a patient with Fitzpatrick skin type III will have fewer pigmentary changes than a patient with Fitzpatrick type V. Skin type V most often develops hyperpigmentation. That... 

It can cause ochronosis the patient soon develops a blue-black patch that is not easy to treat. Ochronosis can appear even if the patient has not had a peel beforehand. Ochronosis usually appears after concentrations higher than 4% have been applied, but lower concentrations can cause it in patients with Fitzpatrick skin type V or VI. 

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]. 

Active infections or open wonnds Active retinoid dermatitis Cardiac disease Continned UV light exposure Fitzpatrick skin types IV to VI Hepatic disease Herpes simplex infection History of certain skin diseases (i.e., rosacea, seborrheic dermatitis, atopic dermatitis, psoriasis, vitiligo)... 

In patients with Fitzpatrick skin types IV to VI, the use of salicylic acid as a very light chemical peeling agent seems to result in a much lower incidence of PIH Combination peels have replaced 50% TCA as the gold standard for medium-depth peels... 

Figure 2.1 Patient with Fitzpatrick skin type VI. Patient would have an inaeased risk of developing postinflamtnatory hyperpigtnentalion following certain chemical peels...

Although very light and light peels can be used in virtually all skin types, caution must still be taken in patients with darker skin, specifically Fitzpatrick skin types IV to VI (see Table 2.1). A thorough knowledge of the subtleties of these chemical peels will allow the practitioner the ability to treat all skin types safely and effectively. 

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