Fitzpatrick skin types are referred to as FST or FSP, and are used to classify skin coloring and response to UV radiation.

The Fitzpatrick skin phototypes (FSP) were developed in Boston in 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 used the scale to determine the amount of UV therapy used to treat skin disorders without causing phototoxicity or irritation from UV light.

It has been used by medical professionals to assess the risk of sunburn. It was thought that people with lighter skin tones would need a shorter exposure than people with a higher FSP.

The scale is still used to determine the dose of photo-therapy, UV, or laser therapy a person can have to treat certain skin disorders.

The current scale classifies skin from types I to VI. Type I refers to skin that always burns, while type VI refers to skin that never burns. In general, a lower FSP means a person’s skin burns more easily than it tans. A higher FSP means that a person’s skin does not burn easily.

The Fitzpatrick scale was also used to determine the risk of skin cancer from exposure to UV rays.

The scale is intended for the purpose of determining the amount of UV therapy a patient can have.

The scale is also often used to determine the setting on a laser when performing laser hair removal. Lasers can cause burns and depigmentation when the correct setting is not used for patients with darker skin coloring or those who have a tan. Because most lasers target pigment, a person’s potential risk of possible burns or depigmentation may be greater if they have a darker skin tone.

“The Fitzpatrick skin types, the scale’s limitations, and proposed alternatives are all discussed in this article.”

“The FSP scale has some limitations that it can’t overcome.”

Limitations in describing skin of color

The scale did not have classifications for darker skin tones. The scale only included types I to IV and was considered Anglo-Irish. The types V and VI were added later.

It may not be surprising with its problematic beginning that the Fitzpatrick scale still provides limited options for People of Color.

FSP does not take into account the skin color ranges of people with darker skin color. People of Color and people who are mixed race are not included. This contributes to healthcare inequalities.

A 2021 review notes that the scale is not accurate when used for educating people about their risk of developing skin cancers.

According to 2020 research, some professionals who do not identify as People of Color may misuse the FSP scale and may not accurately educate their clients about the risk of developing skin cancer.

FSP and race

Some professionals may incorrectly use FSP to classify race, according to a 2020 survey conducted anonymously among dermatological professionals. The authors also reported that dermatologists who do not identify as having skin of color may misuse the FSP classification system more often.

Subjectivity and language

The language used in the skin coloring model may make it difficult for people of color to classify their FSP.

The descriptors used in the scale focus on the words “tan” and “burn,” which can mean different things to different people. Labeling your skin based on its tendency to tan or burn may not be reliable.

According to a 2019 review of research, a number of participants in separate studies were unable to classify themselves by FSP as a result of the scale’s limitations.

In a 2015 study involving 556 people in South Africa with FSP types V and VI, 96.8% of participants reported that the sun affected their skin. Of 390 Black African participants in the study, 95.6% described themselves as photosensitive. The authors of this study propose that FSP VI should only be used for individuals who are 100% not photosensitive.

Rather than using words like “burn” or “tan,” 2020 research suggests that using different terms may help people identify their photosensitivity risk better. Proposed terms include:

  • skin irritation
  • It was tender.
  • It was itching.
  • The skin becomes darker from sun exposure.

Sun cancer risk

“The FSP model can’t determine your risk of skin cancer in people of color.”

People of all skin colors can develop skin cancer. In the United States, skin cancer affects approximately 4.5 million People of Color each year, according to research.

Darker skin tones have increased melanin. Larger amounts of melanin provide more protection against UV radiation compared with people with lesser amounts of melanin. This can lead to fewer of the early signs of aging brought on by UV light exposure.

But according to the American Academy of Dermatology Association, even people who never sunburn can get skin cancer.

“A person’s skin cancer risk is based on a number of factors, including skin color and sensitivity to the sun, but also include:”

  • Family history.
  • Sun exposure history
  • It is possible that medication may increase risk.

Some people and professionals may underestimate their skin cancer risk. This may lead to less protection being taken. It could lead to a later diagnosis of skin cancer. A later diagnosis can lead to a worse outcome.

The Fitzpatrick skin type classification system is not up to date.

The model may not reflect your risk of skin cancer. It is possible that you will not be able to meet all of the Fitzpatrick characteristics.

It may be difficult to identify your skin type using the descriptors. The classification system can be used by a dermatologist to determine the appropriate settings for laser therapy.

The Fitzpatrick skin types include:

Fitzpatrick skin type classification Description
Fitzpatrick skin type I skin always burns, never tans, and is sensitive to UV exposure
Fitzpatrick skin type II skin burns easily and tans minimally
Fitzpatrick skin type III skin burns moderately and tans gradually to light brown
Fitzpatrick skin type IV skin burns minimally and always tans well to moderately brown
Fitzpatrick skin type V skin rarely burns and tans profusely to dark
Fitzpatrick skin type VI skin never burns, is deeply pigmented, and is least sensitive to UV exposure

Your FSP can help a skin care professional determine your ideal settings when you are receiving phototherapy.

When it comes to sun exposure and skin sensitivity, people of all FSP identifications should apply sunscreen daily to receive maximum protection from UV light. Sun exposure can increase your risk of photoaging and skin cancer.

Tanning beds and other artificial tanning machines are harmful for everyone, regardless of skin type.

According to the Centers for Disease Control and Prevention, your risk of Sun also higher if you live near the equator. The closer to the equator you are, the more intense the sun’s rays are, so being vigilant about sun protection is crucial.

People who spend a lot of time outdoors, such as farmers and construction workers, may also have an increased risk of skin cancer due to UV radiation.

If you have a Family history. of melanoma, you may be at a higher risk of developing it yourself, regardless of your FSP. If you have a Family history. of melanoma or a personal history of any type of skin cancer, it’s especially important that you see a dermatologist for regular full-body exams and to conduct self-exams at home.

People with skin cancer have a better outlook when it is diagnosed early.

Cancer risk and sun protection

People of all skin tones can develop skin cancer and should take protective measures to limit their UV exposure, which includes:

  • applying water-resistant, broad-spectrum sunscreen of at least SPF 30 daily, regardless of FSP
  • reapplying sunscreen every 2 hours, after sweating or after getting out of water
  • performing a skin exam at home once per month
  • getting their skin checked at least once per year by a skin care specialist such as a dermatologist; those with a history of skin cancer may need more frequent exams
  • Sun exposure and shade should be limited.
  • A wide-brimmed hat is worn outdoors.
  • wearing clothing and shoes that protect your skin from the sun
  • wearing UV-blocking sunglasses
  • Sun lamps can increase your skin cancer risk.

Here are some things you should know about your skin and how to protect it.

Types 1 and 2

If you have a skin type that is 1 or 2, you have a higher risk.

Types 3 and 4

People with FSP 3 or 4 have a lower risk of skin cancer than people with types 1 and 2. You may still be at risk of developing.

  • Sun damage.
  • Sun exposure causes aging of skin.
  • melanoma and other skin cancers

Types 5 and 6

If your skin type is FSP 5 or 6, you generally have a lower risk of skin cancer compared with people of lighter skin tones. But according to the AAD, you may be more likely to develop an aggressive form of skin cancer or receive a later diagnosis.

The Skin Cancer Foundation notes that Black people who have been diagnosed with melanoma are often diagnosed at a later stage, contributing to a poorer overall outlook.

This may be due to something.

  • There is a lack of public awareness about skin cancer.
  • The early identification of skin cancer in people of color is less.
  • The soles of the feet are where skin cancer is more likely to appear.
  • There is a lack of medical educational materials that feature people of color.
  • There is a lack of access to healthcare.

It is important to schedule regular skin exams if you are at an increased risk of skin cancer. Talk to your doctor about how often you should come in. Skin screening could be more frequent than an annual checkup.

You can also talk with a doctor about how and when you should do your own skin checks.

If you notice a change in your skin, you should make an appointment with a dermatologist.

  • There are new growths on your skin.
  • Growths that have grown larger.
  • A spot that looks different from others.
  • A spot that changes.
  • There are sores that will not heal.
  • A dark line under a nail or toenail.

Despite its limitations, Fitzpatrick skin typing is still widely used. Some researchers have proposed alternatives to more accurately assess photosensitivity and skin cancer risk in People of Color. These methods include:

  • Genetico-Racial Skin Classification: This self-reported classification is based on race and genetic origin. It has 6 categories:
    • Nordics are a group of people.
    • Europeans
    • Mediterraneans
    • The people of Pakistan and India.
    • Africans.
    • Asians
  • Glogau wrinkle Scale: This scale is used for people who self-identify as white. It uses photographs to determine the extent of photoaging.
  • Goldman World Classification of Skin Type: This classification system uses skin color, response to questions about burning, tanning, and post-inflammatory hyperpigmentation based on race and ethnicity.
  • Kawada Skin Classification System for Japanese Individuals: This self-reported scale was created to describe skin types in Japanese people and their sensitivity to UV light, sunburn, and tanning.
  • Lancer Ethnicity Scale: This scale can be used along with FSP or on its own. It distinguishes skin types based on geography and heredity to determine risks for cosmetic laser surgery or chemical peels.
  • Modified Fitzpatrick Skin Type: This modified FSP scale includes changes to better assess phototype, skin color, and burning or tanning in Indian people.
  • Roberts Skin Type Classification System: In this system, skin phototype, hyperpigmentation, photoaging, and scarring are assessed to determine skin type and the skin’s predicted response to injury and inflammation.
  • Von Luschan chromatic scale: This scale determines race classifications by skin color using opaque glass tiles, which are compared to a person’s skin color.
  • Willis and Earles Scale: This scale was created for use with people of African descent to help classify skin color, UV light reaction, and any pigment-related disorders.

Technological methods, such as using a Wood’s lamp exam to determine the FSP or a spectrophotometry exam to determine skin darkening caused by increased melanin, have also been tried.

“The Wood’s lamp exam was not successful at distinguishing above FST 2 and the exam can have high personnel and equipment costs.”

Fitzpatrick skin types are used to determine the correct settings for phototherapy. FST can be used to determine settings for laser skin treatments that can cause damage to the skin, which can lead to photoaging and changes in appearance.

FSP may also be used to determine skin cancer risk from UV light exposure. However, many additional factors, such as Family history. and geography, can contribute to skin cancer risk.

People of Color may not fit neatly into one of the six types, which is why the FSP scale is not suitable. The FSP scale has limitations that have led to a limitation of education about skin cancer risk in people of color, which may contribute to the diagnosis of skin cancer in later stages.

Modifications of the FSP scale have been proposed. The FSP scale is not widely used.