Fitzpatrick Skin Type Classification
Skin Classification System
A numerical classification system (Types I-VI) for human skin based on its response to ultraviolet radiation. Widely used for phototherapy dosing, laser parameter selection, and skin cancer risk estimation.
About the Fitzpatrick
Severity Bands
| Score Range | Classification | Interpretation |
|---|---|---|
| 1 | Type I | Very fair / pale white; always burns, never tans |
| 2 | Type II | Fair / white; burns easily, tans minimally |
| 3 | Type III | Medium / light brown; burns moderately, tans uniformly |
| 4 | Type IV | Olive / moderate brown; burns minimally, tans well |
| 5 | Type V | Brown / dark brown; rarely burns, tans very easily |
| 6 | Type VI | Very dark brown / black; never burns, deeply pigmented |
Clinical Background
The Fitzpatrick Skin Phototype (FST) scale, developed in 1975 by Thomas B. Fitzpatrick at Harvard Medical School, is a numerical classification system (Types I-VI) for human skin based on its response to ultraviolet radiation. It was originally created to predict safe initial UVA doses for PUVA photochemotherapy in psoriasis. Types I-IV were described in 1975 based on patients with lighter skin; Types V and VI were added in 1988 to include individuals of Asian, Indian, and African ancestry.
The scale is widely used for estimating initial doses of UVB and PUVA phototherapy, calibrating laser and energy-based devices (wavelength, fluence, pulse duration, cooling parameters), predicting skin cancer risk, and guiding sun protection advice.
Limitations include subjectivity of self-reported tanning and burning history, poor reliability in skin of color (particularly mixed-ancestry individuals), and lack of granularity for highly diverse populations. Modern practice increasingly pairs FST with objective colorimetric measurements.
References
- Fitzpatrick TB. Soleil et peau. J Med Esthet. 1975;2:33-34.
- Fitzpatrick TB. The validity and practicality of sun-reactive skin types I through VI. Arch Dermatol. 1988;124(6):869-871. doi:10.1001/archderm.124.6.869
- Sachdeva S. Fitzpatrick skin typing: applications in dermatology. Indian J Dermatol Venereol Leprol. 2009;75(1):93-96. doi:10.4103/0378-6323.45238
- Ware OR, Dawson JE, Shinohara MM, et al.. Racial limitations of Fitzpatrick skin type. Cutis. 2020;105(2):77-80.
Getting Started
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