What’s my skin type? - The Fitzpatrick Skin Type Scale And Its Flaws

In 1972 Thomas B. Fitzpatrick introduced the Fitzpatrick Skin Type Scale which describes an individual’s skin color and their tendency to burn or tan after being exposed to sunlight. It was created so that dermatologists could use this classification to anticipate skin reactions to phototherapy. Phototherapy is used in several dermatological treatments which use filtered UVA or UVB lights as an immunosuppresants to treat inflammatory diseases. Basically, a lower Fitzpatrick skin type means that you tend to burn more easily and tan less compared to a higher Fitzpatrick skin type (IV-VI).

It’s important to note the scale was originally limited to skin types I-VI and that the scale was later extended to include phototype V-VI. At this time you might sense the problems with the scale (all shades of brown and black were summarized in V and VI...). 

But first let's define Fitzpatrick Scale I-VI:

The obvious controversy with this scale is it does not adequately address the various shades of skin of color.

Another issue is that it makes assumptions about sun sensitivity.

For example, when I told my colleagues that my sister is sensitive to direct and long sun exposure and reacts in an almost allergic manner, they could not believe it...

Assuming a skin type V does not burn and always has high UV-light tolerability is simply FALSE!

Another issue: The scale is fully subjective!

Many research groups have proposed several other ways to categorize skin types which are important especially in dermatology (mostly in phototherapy and laser and cosmetic therapies). However, at this point, none of the proposals can comprehensively account for what we see in clinical practice. 

Since we all still use the Fitzpatrick scale, I find it extremely important to also point out it’s flaws.The right estimation of your Fitzpatrick skin types has important “therapeutic consequences” for in Lasertherapie has important “therapeutic consequences” ( Ajay N Sharma, Laser Fitzpatrick Skin type Recommendations). And, most importantly, it is  intended to reflect sun sensitivity and is NOT a characterization for race phenotypes.

Xx Mimi