- The Fitzpatrick scale categorizes skin based on color and reaction to sun exposure.
- Skin types I–III are at high risk of sunburn and skin cancer due to UV damage.
- Types IV–VI are at lower risk, but are prone to vitamin D deficiency and developing hyperpigmentation due to certain professional skin care procedures.
- All skin types are at risk of skin cancer and everyone should be mindful of warning signs.
The Fitzpatrick skin type scale classifies skin into six separate categories based on color and response to sunlight. Type I is the lightest in color and most sensitive to sun exposure; type VI is the darkest and most sun-resistant.
This scale is widely recognized in dermatology as a useful tool, and is established as a universal scientific model for measuring skin color and the effects of ultraviolet (UV) on skin.
What Is the Fitzpatrick Scale?
The Fitzpatrick scale was established in 1975 by American dermatologist Thomas B. Fitzpatrick. It was originally intended as a way to estimate appropriate doses of UV light for PUVA therapy, a form of light therapy for severe skin diseases.
This scale is now used to evaluate a person’s risk level with regard to a range of health concerns, such as skin cancer and vitamin D deficiency. It can also help assess a person’s risk of developing hyperpigmentation and signs of photoaging as a result of sun exposure.
Why it matters
Knowing your Fitzpatrick skin type will enable you to better understand how UV radiation is likely to affect your skin, and can help you take the appropriate sun protection measures. As unprotected sun exposure is the leading cause of skin cancer, it is important to arm yourself with this knowledge.
This skin typing system will not necessarily apply to everyone with complete accuracy; everyone’s skin is unique, and most people demonstrate characteristics associated with multiple skin types. The Fitzpatrick scale is intended to provide a baseline.
Which Fitzpatrick Skin Type Are You?
The correlation between skin color and response to UV exposure is related to the chemistry of melanin. Two types of melanin exist in skin: eumelanin and pheomelanin. Eumelanin is a dark pigment, which may be either brown or black; pheomelanin is lighter, and may be red, pink or yellow in color.
These two forms differ in how they react to UV radiation. Eumelanin absorbs UV light, thereby providing a mild sun protection effect. Pheomelanin, on the other hand, responds to UV radiation by triggering a state of oxidation that worsens the damage caused to skin.
The ratio between these two types of melanin will determine a person’s skin color and sensitivity to sun exposure. Skin types I–III are characterized by light skin and a high likelihood of sun damage due to the high concentration of pheomelanin. Types IV–VI have higher eumelanin content, and therefore have skin that is darker and more resistant to sun exposure.
Fitzpatrick skin type I
This type has the lightest skin color and is the most sensitive to sun exposure. People with this skin type almost never tan, and will quickly develop painful sunburns that lead to blistering and peeling. This group is made up primarily of people of Northern European descent, such as Scandinavians and Celts.
Fitzpatrick skin type II
This group has light skin that is less pale than type I and is slightly more sun-resistant. However, these people are still very susceptible to the damaging effects of UV radiation. They are typically of European or Northeast Asian ancestry.
Fitzpatrick skin type III
Type III is characterized by medium pink or beige skin that is moderately sensitive to UV radiation. Although still more susceptible to sunburn than types IV–VI, those in this category are able to tan with relative ease. They may be of Mediterranean, Latin American, Middle-Eastern, Native American or East Asian origin.
Fitzpatrick skin type IV
This type has olive or light brown skin that is only mildly sensitive to UV radiation and is relatively unlikely to develop sunburn. People with this skin type commonly have East Asian, South Asian, African, Latin American, Middle-Eastern or Native American ancestry.
Fitzpatrick skin type V
People in this category have brown skin that tans readily and profusely, and is strongly resistant to sunburn. They often have African, Latin American, Middle-Eastern, Austronesian, Australian Aboriginal or South Asian ancestry.
Fitzpatrick skin type VI
Skin type VI is characterized by very dark brown skin. This type has little sensitivity to UV radiation and almost never suffers from sunburn, but is still at risk of developing skin cancer. People within this group are typically of African, Austronesian, Australian Aboriginal or South Asian descent.
Fitzpatrick skin type chart
To a certain extent, it’s possible to determine your Fitzpatrick skin type by comparing your skin to a skin tone chart:
However, this method is often inaccurate because it relies strictly on a subjective assessment of skin tone, and doesn’t take skin characteristics and sun exposure reactions into consideration.
To gain a clearer picture of your type, it’s best to use a skin tone chart in conjunction with a chart of physical features associated with each type of skin:
|Skin Type||Typical Features||Reaction to Sun|
|I||Very pale skin|
Light-blue, gray or green eyes
Red or blond hair
|Burns very easily|
Almost never tans
|II||Pale pink or beige skin|
Blue, gray, green or hazel eyes
Blond or brown hair
Tans with difficulty
|III||Pink or medium-beige skin|
Brown or dark-blue eyes
Dark blond, brown or black hair
|IV||Olive or light-brown skin|
Dark brown eyes
Dark-brown or black hair
Tans with ease
|V||Medium to dark-brown skin|
Dark brown eyes
Dark brown or black hair
|Burns very rarely|
|VI||Deep dark-brown skin|
Very dark, almost black eyes
|Almost never burns|
Tans readily and profusely
Fitzpatrick skin type tests
Skin type tests typically include questions regarding physical appearance – such as eye and hair color, skin tone, and how your skin reacts to sun exposure. These tests can be administered by yourself or by a dermatologist.
Tests tend to provide more accurate results carried out by a dermatologist than when they are self-administered. These tests usually predict sun sensitivity more accurately than tanning ability.
A dermatologist can also identify your Fitzpatrick skin type using a reflectance spectrophotometer. This device shines a beam of light on the skin and measures the intensity of the reflected light. This test is quick, noninvasive and accurate – however, it is expensive and may not be offered at all dermatology clinics.
How to Protect Your Skin
The regular application of sunscreen is one of the most effective measures one can take to reduce the risk of sun damage. Other safety measures include staying in the shade, wearing protective clothing and avoiding the use of tanning beds, which carry a similar set of risks to skin health as the UV radiation emitted by the sun.
Protection for Fitzpatrick types I–III
These skin types are much more sensitive to UV radiation than types IV–VI. Because of this, more stringent sun protection measures are needed.
- Apply sunscreen with a sun protection factor (SPF) of 30 or higher, 15–30 minutes before going outdoors; reapply every 2 hours
- Avoid sun exposure between 10 a.m. and 2 p.m., when UV radiation is at its highest
- Remain in the shade when possible
- Wear clothing that covers your arms and legs, and a wide-brimmed hat to protect your head and shoulders
- Wear UV protection sunglasses
Skin care concerns
Those within types I–III tend to have dry or sensitive skin, and can benefit from ingredients that encourage moisture retention and soothe inflammation. These include hyaluronic acid, glycerin, ceramides and aloe. Products with artificial fragrances and preservatives should be avoided, as these can cause irritation and dryness.
Sunscreen should always be applied at the end of a morning skin care routine, but before any makeup. It should have an SPF of at least 30 and be applied 15–30 minutes before going outdoors. Moisturizers and foundations with a high SPF can help protect the skin as well, but should not replace sunscreen.
This group should take extra care to avoid sun exposure following the use of photosensitizing products, as these increase the skin’s sensitivity to UV radiation, leaving it more prone to damage. Products include retinoids, glycolic acid and benzoyl peroxide.
Lighter skin is already more sensitive to sun exposure, therefore these types are advised to avoid photosensitizing skin care products, which can increase their risk of sun damage and premature signs of skin aging. Such products include retinoid creams, harsh exfoliants and ingredients such as benzoyl peroxide and glycolic acid.
Professional skin resurfacing procedures may also have a photosensitizing effect that lasts a short while after treatment. For this reason, sun exposure should be avoided immediately after treatment.
Protection for Fitzpatrick types IV–VI
People within these skin types are much less sensitive to UV radiation than types I–III, but preventative measures should still be taken to protect them from sun damage.
- Apply sunscreen with an SPF of 15 before going outdoors
- Avoid sun exposure between 10 a.m. and 2 p.m., when UV radiation is at its highest
- Wear clothing that covers your arms and legs when in the sun for extended periods
- Wear UV protection sunglasses
Skin care concerns
People within these groups are at an increased risk of hyperpigmentation, which is commonly caused by skin injury and inflammation. As such, they should avoid the use of potentially irritating skin care products, such as harsh scrubs and potent chemical exfoliants. Products containing artificial fragrances and preservatives should also be avoided.
Acne is also a common cause of hyperpigmentation. If your skin type falls within this range and you regularly experience breakouts, address them with spot treatments such as retinoids or azelaic acid. Avoid treatment methods that can worsen inflammation, such as manual extraction.
Those within types IV–VI are at an increased risk of vitamin D deficiency. This is because these skin types contain more UV-blocking eumelanin, and UV radiation is necessary for vitamin D synthesis.
Vitamin D deficiency can lead to health issues such as low bone density and depression. To avoid a deficiency of this nutrient, people within this group should spend more time in the sun, take vitamin D supplements, or eat foods high in vitamin D, such as eggs, fish and red meat.
These skin types are also at an increased risk of developing hyperpigmentation as a result of the inflammation caused by skin resurfacing and laser procedures. If your skin type falls within this range, be sure to discuss with your doctor or dermatologist before undergoing procedures such as these.
When to See a Dermatologist
All forms of skin cancer appear slightly differently on lighter versus darker skin. The most common types of skin cancer are nonmelanoma cancers such as basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), which appear as bumps or discolored patches on the skin that persist over weeks or months.
BCC is characterized by shiny, translucent red, brown or black bumps that appear on the face and neck. SCC presents as scaly red patches, open sores and wart-like growths, which can appear anywhere on the body.
Be mindful and regularly check your skin for abnormalities. If you notice any symptoms suggestive of cancer development, see your dermatologist or doctor. Treatment for skin cancer is usually successful when treated early, and can be administered by means of surgery, freezing, radiotherapy or light therapy.
A word about melanoma
Malignant melanoma is less common than other types of skin cancer, but it is much more aggressive and prone to spreading to other parts of the body. It is often fatal, so it is important to identify and treat it early.
If you notice any potential signs of melanoma developing, you should contact your doctor or dermatologist immediately. Melanoma is usually treated with surgery, and if it is caught early enough, treatment is usually successful.
Melanoma typically appears as dark, inky blotches that quickly spread across the body, and become swollen and bumpy as the cancer advances. They may be deep red, dark brown or black in color.
The Fitzpatrick skin type scale classifies skin into six distinct types based on color and response to UV radiation. Type I is the lightest and most at risk of sunburn; type VI is the darkest and most resistant to sun exposure.
People who fall within skin types I–III are advised to take additional precautions against sun exposure, such as using a higher SPF sunscreen, covering up their skin and avoiding photosensitizing treatments. People within types IV–VI should still protect their skin from the sun, but can take fewer precautions; they should also avoid the use of treatments and products that can trigger hyperpigmentation.
Everyone, regardless of their skin type, should regularly check their skin for potential signs of skin cancer, and be mindful of how different symptoms present on their specific skin type.
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