- Fitzpatrick skin type IV is characterized by olive or light-brown skin that tans easily and rarely burns due to sun exposure.
- This type is at a higher risk of vitamin D deficiency than types I–III.
- Harsh exfoliants and abrasive skin resurfacing procedures can trigger hyperpigmentation and should be avoided by this group.
- Type IV is at low risk of developing sun-induced skin cancer, but should still be mindful of its early signs, as they often go unnoticed on darker skin.
The Fitzpatrick skin type classification groups skin into six distinct types based on color and how likely it is to tan or burn in response to sun exposure. Skin type IV is at the lower end of the scale as it is characterized by olive or light brown skin that tans with relative ease and does not burn easily.
However, type IV has a higher risk of vitamin D deficiency compared to types I–III. This group is also at increased risk of developing hyperpigmentation as a result of acne, sun exposure and certain skin resurfacing treatments.
Do You Have Skin Type IV?
Two types of melanin are found in human skin and hair: pheomelanin and eumelanin. Eumelanin is the darker pigment, and may be either brown or black in color; pheomelanin is the lighter of the two, and may be red, pink or yellow. One’s skin color is determined by the ratio between these two types of melanin.
Skin type IV contains a higher amount of eumelanin than types I–III as well as more melanosomes – cellular structures that carry melanin. This accounts for the darker skin color of type IV. However, this type still has a higher ratio of pheomelanin than types V and VI, therefore skin and hair color is usually lighter.
Typical features of type IV include:
- Olive or light-brown skin
- Dark brown eyes
- Dark brown or black hair
Reaction to sun exposure:
- Rarely burns; tans with ease
- Develops a deep bronze color
Skin type IV vs. skin type III
Skin type IV can easily be distinguished from type III. Type IV typically demonstrates the following characteristics:
- Darker color than type III, which ranges from a deep pink to a medium beige, with golden or olive undertones
- Almost always has dark brown eyes; type III may have brown or blue eyes
- Darker range of potential hair color; type III may have dark blond, brown or black hair
- Tans more readily than type III, and is less likely to burn
Skin type IV vs. skin type V
Type IV has similarities to type V, but can be recognized by the following qualities:
- Lighter skin than type V, which typically has medium to dark-brown skin
- More likely to have dark-brown hair, while type V is more prone to have black
- Slightly more vulnerable to sunburn than type V
Skin Type IV Safety
Those within the type IV category are not as susceptible to sun damage as those within types I–III, but are still at risk of developing some forms of skin cancer as a result of sun exposure. They are also at increased risk of a vitamin D deficiency due to the fact that their skin’s higher eumelanin content interferes with vitamin D synthesis.
Type IV is also moderately at risk for developing postinflammatory hyperpigmentation (PIH). This condition is characterized by scattered areas of skin that is darker than the surrounding area.
PIH develops as a result of elevated white blood cells present in inflamed skin tissues; the white blood cells stimulate an increase in melanin production, and the excess melanin accumulate into clusters, causing the skin in that area to appear darker.
Inflammation of any kind can trigger PIH, however the most common causes include acne, eczema, allergic reactions and skin damage that may occur due to some in-office dermatological procedures.
Risks of sun exposure
The two forms of melanin respond differently to sun exposure. Eumelanin absorbs ultraviolet (UV) rays; pheomelanin does not. Instead, pheomelanin responds to UV radiation by generating free radicals, which trigger oxidation and further damage the skin.
Because those in the skin type IV category have more eumelanin in their skin than those in types I–III, they are at a lower risk of developing skin cancer. However, unprotected sun exposure can still have damaging effects for this skin type, leading to undesirable visual skin changes, including the appearance of early signs of skin aging.
Type IV is also vulnerable to the development of certain forms of hyperpigmentation that can be aggravated by unprotected sun exposure. PIH can sometimes be triggered by the inflammation that accompanies sunburn. Melasma, a form of hyperpigmentation that is related to hormonal imbalances, can also be exacerbated by sun exposure.
Vitamin D deficiency
When the skin is exposed to UV radiation, it produces vitamin D. Vitamin D helps to regulate calcium and phosphate levels in the body, and plays a role in supporting the health of muscles, bones and teeth.
However, because those within the skin type IV group have a high ratio of UV-absorbing eumelanin in their skin, they synthesize less vitamin D. As a result, they are at increased risk of developing a vitamin D deficiency, which can in turn lead to a number of other health issues, including low bone density and depression.
To ensure an adequate intake of vitamin D, type IV can spend time in the sun as long as protection measures are taken. Studies suggest that for this type to maintain a healthy level of vitamin D, they should spend about 25 minutes in the sun three times a week.
People of skin type IV who are unable to spend adequate time in the sun can instead take vitamin D supplements, or choose foods high in vitamin D, such as egg yolks, oily fish and red meat. The recommended daily dosage of vitamin D to ensure safety and proper nutrition is around 800–1000 IU per day.
Even though type IV is less affected by UV exposure, the use of tanning beds should still be avoided. Tanning beds present an avoidable risk factor for the development of skin cancer and signs of aging, and are relatively ineffective at increasing vitamin D production.
Skin treatments to avoid
Depending on the level of sensitivity, some treatments may cause the skin to become dry, irritated and inflamed. Those with type IV skin are at risk of developing PIH due to these negative effects.
As such, this group is advised to avoid these procedures, and consult their dermatologist for alternative options.
Protecting Skin Type IV
To avoid the risk of sunburn and the damaging effects of sun exposure, it is recommended that people with skin type IV do not exceed 50 minutes of sun exposure daily. Exposure should ideally be limited to the morning and late afternoon, when UV radiation is relatively low.
Sunscreen with an SPF of 15 or higher should always be applied 15–30 minutes prior to sun exposure. UV protective sunglasses and clothing that covers the arms and legs should be worn during prolonged periods of exposure.
Skin type IV’s skin care routine
As with all skin types, applying sunscreen before going outdoors is an important part of any skin care routine. For proper application, it should always be applied at the end of your skin care routine, but before any makeup is applied.
Because skin type IV is prone to PIH, harsh, exfoliating cleansers and toners that may trigger inflammation should be avoided. Opt for gentle and fragrance-free products that will not irritate skin.
Avoid acne treatment methods that may result in worsened irritation, as these can also trigger PIH. Do not attempt manual comedone or acne papule extraction, as this can damage your skin. If you regularly experience breakouts, use topical medications such as retinoids or azelaic acid.
Signs You Should See a Dermatologist
People with skin type IV are mildly at risk of developing skin cancer compared to skin types I–III, however they should still be mindful of skin irregularities that may signal cancer. Should you notice any of the following abnormalities on your skin, be sure to see a doctor or dermatologist.
- Development of new moles
- Changes in existing moles
- Moles that bleed or become irritated
- Appearance of darker patches of skin
- Flat and scaly patches of skin that feel rough or dry
- Sores that have difficulty healing or won’t heal
Signs of skin cancer in dark skin
There are three primary forms of skin cancer, and each type will show a distinct set of symptoms when it appears on either lighter or darker skin. For this reason, early signs of developing skin cancer often go undetected on darker skin.
Basal cell carcinoma, the most common form of cancer, manifests as raised, translucent, shiny bumps. Squamous cell carcinoma, which develops due to long-term exposure to UV radiation, is marked by wart-like growths and severe inflammation.
While melanoma is rare, it is a more severe form of skin cancer that affects people with darker skin at a disproportionately high rate. Melanoma develops in the melanocytes, the cellular structures responsible for producing melanin, and appears as scattered blotches that resemble ink spills.
|Appearance on Dark Skin
|Basal cell carcinoma
|Translucent, shiny bumps on the face and neck
|Bumps appear dark brown or black in color
|Squamous cell carcinoma
|Scaly red patches, open sores, elevated growths resembling warts
|Bumps appear on the waist, legs and feet
|Dark blotches resembling ink spills that spread quickly and become raised and swollen with time
|Blotches appear dark brown or black in color
Skin type IV is characterized by olive or light brown skin that tans easily and burns infrequently. Although people with this type are mildly resistant to sun damage, they are still at risk of incurring long-term sun damage and developing skin cancer due to sun exposure. For this reason, they should regularly wear sun protection and be mindful of signs of developing skin cancer, which can be difficult to identify on darker skin.
Inflammation caused by acne, sun damage and the use of certain harsh skin care products can trigger hyperpigmentation in type IV. For this reason, people of this skin type will benefit from a skin care routine that incorporates gentle, nonirritating ingredients and regular sun protection.
Laser hair removal and certain professional skin resurfacing procedures can also trigger PIH for type IV. As such, these treatments should be avoided when possible.
Due to the UV-absorbent properties of the eumelanin in their skin, type IV group are at moderate risk of developing a vitamin D deficiency. This risk can be mitigated with a carefully planned diet, supplementation (at a dosage of 800–1000 IU daily), or as little as 25 minutes of protected sun exposure three times per week.
- Matts, J., Fink, B. (2010). Chronic sun damage and the perception of age, health and attractiveness. Photochemical & photobiological sciences, 9(4), 421–31. doi:10.1039/b9pp00166b
- Brenner, M., & Hearing, V. J. (2008). The protective role of melanin against UV damage in human skin. Photochemistry and photobiology, 84(3), 539–549. doi:10.1111/j.1751-1097.2007.00226.x
- Beral, V., Evans, S., Shaw, H., Milton, G. (1983). Cutaneous factors related to the risk of malignant melanoma. The British journal of dermatology, 109(2), 165–72. doi:10.1111/j.1365-2133.1983.tb07077.x
- Woo DK, Eide MJ. Tanning beds, skin cancer, and vitamin D: An examination of the scientific evidence and public health implications. Dermatol Ther. 2010 Jan-Feb;23(1):61-71. doi: 10.1111/j.1529-8019.2009.01291.x
- Kennel, K. A., Drake, M. T., & Hurley, D. L. (2010). Vitamin D deficiency in adults: when to test and how to treat. Mayo Clinic proceedings, 85(8), 752–758. doi:10.4065/mcp.2010.0138
- Munavalli, S., Weiss, A., Halder, M. (2005). Photoaging and nonablative photorejuvenation in ethnic skin. Dermatologic surgery, 31(9 pt. 2) 1250–60. doi:10.1111/j.1524-4725.2005.31935
- Nair, R., & Maseeh, A. (2012). Vitamin D: The “sunshine” vitamin. Journal of pharmacology & pharmacotherapeutics, 3(2), 118–126. doi:10.4103/0976-500X.95506
- Gupta, A. K., Bharadwaj, M., & Mehrotra, R. (2016). Skin Cancer Concerns in People of Color: Risk Factors and Prevention. Asian Pacific journal of cancer prevention, APJCP, 17(12), 5257–5264. doi:10.22034/APJCP.2016.17.12.5257
- Barsh G. S. (2003). What controls variation in human skin color?. PLoS biology, 1(1), E27. doi:10.1371/journal.pbio.0000027
- Nasti, H., Timares, L. (2015). MC1R, eumelanin and pheomelanin: their role in determining the susceptibility to skin cancer. Photochemistry and photobiology, 91(1), 188–200. doi:10.1111/php.12335
- Morgan, A. M., Lo, J., & Fisher, D. E. (2013). How does pheomelanin synthesis contribute to melanomagenesis?: Two distinct mechanisms could explain the carcinogenicity of pheomelanin synthesis. BioEssays : news and reviews in molecular, cellular and developmental biology, 35(8), 672–676. doi:10.1002/bies.201300020
- Handel, A. C., Miot, L. D., & Miot, H. A. (2014). Melasma: a clinical and epidemiological review. Anais brasileiros de dermatologia, 89(5), 771–782. doi:10.1590/abd1806-4841.20143063
- Slominski, A., & Postlethwaite, A. E. (2015). Skin under the sun: when melanin pigment meets vitamin D. Endocrinology, 156(1), 1–4. doi:10.1210/en.2014-1918
- Nimitphong, H., & Holick, M. F. (2013). Vitamin D status and sun exposure in southeast Asia. Dermato-endocrinology, 5(1), 34–37. doi:10.4161/derm.24054
- InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. How much sun is too much? 2011 Jul 22 [Updated 2018 Nov 29]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK321117/
- McDaniel B, Badri T. Basal Cell Carcinoma. [Updated 2019 Dec 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482439/