Why Your Fitzpatrick Skin Type Matters

What is a Fitzpatrick Level?

To put it simply, the Fitzpatrick Scale is a classification system that measures the amount of melanin present in an individual’s skin. The scale ranges from I-VI (1-6), with Type I having the least melanin and Type VI having the most. To determine your Fitzpatrick level, you will need to evaluate your natural complexion (hair color, eye color, and skin tone), ethnic background, and how your skin reacts to the sun. Your doctor may ask you questions about how easily you tan versus burn, and whether you tend to freckle. This information will be compared against the Fitzpatrick scale like so:

TYPE I

Sun sensitivity: Highly sensitive - Always burns, never tans.

Complexion: Very pale skin, blue or green eyes, natural redhead or blonde. Freckles common.

Risk: High risk for skin cancer and vascular damage.

TYPE II

Sun sensitivity: Very sun sensitive - Burns easily, tans minimally.

Complexion: Pale skin, blue or green eyes are common.

Risk: High risk for skin cancer and vascular damage.

TYPE III

Sun sensitivity: Sensitive - Sometimes burns, tans gradually. Complexion: Fair skin, brown eyes, brown hair.

Risk: Risk for hyper or hypopigmentation. Moderate risk for skin cancer and vascular damage.

TYPE IV

Sun sensitivity: Minimally sensitive - Rarely burns, tans easily.

Complexion: Olive or light brown skin, brown eyes, dark hair. Common for those of Mediterranean Caucasian descent.

Risk: High risk for hyper or hypopigmentation. High risk of scarring. Moderate risk for vascular damage.

TYPE V

Sun sensitivity: Rarely sun sensitive.

Complexion: Brown skin, brown eyes, dark brown to black hair. Common for those with Middle Eastern heritage.

Risk: High risk for hyper-/hypopigmentation. High risk of scarring, especially with trauma. Moderate risk for vascular damage.

TYPE VI

Sun sensitivity: Rarely sun sensitive.

Complexion: Deeply pigmented brown skin, brown eyes, dark brown to black hair.

Risk: Very high risk for hyper-/hypopigmentation. Very high risk of scarring, especially with trauma. Moderate risk for vascular damage.

Why does your Fitzpatrick level matter?

Your Fitzpatrick level provides insight on how your skin reacts to sunlight and heat, which can be used to determine the best and safest skin treatment options for your individual skin type. This information can also be used to predict and evaluate your risk factor for certain conditions, such as skin cancer and risk to your blood vessels, which feeds the skin. As such, after determining your Fitzpatrick level, you will want to follow the accompanying guidelines to ensure your skin stays healthy and beautiful!

What to know about your Fitzpatrick level: Types I and II

If you are a Fitzpatrick I or II, your skin is very sensitive to the sun, and is low in melanocytes. You have a heightened risk of sunburn, melanoma, and developing signs of aging like fine lines and wrinkles. Types I and II will want to take extra care to avoid direct sun exposure. Sunscreen should always be worn, and age-defense skin care should start at or before age 25.

If you missed the memo, and you’re now doing damage control on sun-aged skin, have no fear: people with lower Fitzpatrick levels have the widest range of skin treatment options. There are a variety of laser facials and chemical skin peels available to treat undesirable skin tone and texture, and they carry a much lower risk for these paler skin types.

What to know about your Fitzpatrick level: Types III and IV

If you are a Fitzpatrick III or IV, your skin is more prone to tanning than burning, but is still relatively prone to UV damage. Levels III and IV are common for people of Mediterranean, Asian, and/or Latino descent.

This Fitzpatrick level comes with a lessened risk of developing skin cancer when compared to Type I and II, but that doesn’t mean you can forget about protecting your skin altogether! Sunscreen should be used at all times - even on cloudy days when UV rays seem deceptively inactive.

People with Fitzpatrick levels IV through VI should also be careful when scheduling more aggressive skin treatments, such as laser facials or high-level chemical peels. This type tends to be more prone to hyperpigmented (noticeably dark) scarring, so the potential risk may outweigh the potential benefit. Your physician may suggest radiofrequency resurfacing to replace laser-based procedures, or swap out high-level chemical peels with a lighter formula.

What to know about your Fitzpatrick level: Types V and VI

If you are a Fitzpatrick V or VI, your skin is the least prone to sun damage out of all of the types, but more prone to issues with lasers. You likely don’t experience sunburn very often, and when compared to Types I and II, you have a much lower risk of skin cancer. However, your risk of sun cancer still isn’t zero - and, thanks to an abundance of melanin in your skin, it can be a little trickier to recognize the warning signs. Your skin may not burn easily, but you don’t need to experience sunburn to develop sun damage.

Experts advise people with Fitzpatrick levels V and VI to be extra vigilant with self-examination, especially when it comes to areas that are not directly exposed to sunlight. Signs of skin cancer often develop on the palms of the hands or soles of the feet in these skin types. A good rule of thumb is to learn the “ABCDEs” of skin cancer, and consult your physician if you notice a mole with any of these traits:

A = Asymmetry. If one half of the mole does not match the other half, have it checked out.

B = Borders. If your mole has uneven, irregular, or notched borders (it is not circular), it is best to have your doctor take a look.

C = Colors. Moles can come in a variety of colors like brown, black, pink, or orange. However, if one singular mole contains multiple colors, this can be a warning sign.

D = Diameter. If your mole is larger than ¼ inches in diameter (roughly the size of a pencil eraser), your doctor should examine it. It is usually best to have these lesions removed, as they can become cancerous over time if left unchecked.

E = Evolution. Healthy, benign moles are unlikely to change over time. If you notice your mole begin to change in size, shape, elevation, and/or color - or, if it begins to crust, scab, or bleed - talk to your doctor.

Beyond sun damage, people with Fitzpatrick levels V and VI should avoid aggressive facial treatments. Lasers are generally off-limits, strong chemical peels and microneedling can be risky. The potential for hypo- or hyperpigmented scarring and any history of keloids should be noted when considering any type of cosmetic procedure that involves creating an incision in a highly-visible area. These skin types can look to radiofrequency treatments and light peels as alternative options.

Protecting Your Skin

While there are differences between each skin type, all 6 Fitzpatrick levels share a major commonality: sun protection is crucial for everyone. SPF should be worn by all skin types at all times, even when spending time indoors and during cloudy weather. To learn more, check out our blog about the different types of sunblocks!