Skin health, the Fitzpatrick Scale and the importance of understanding skin tone

Every person’s skin is different and understanding these differences is an essential part of choosing the right skincare routine – and the most suitable aesthetic treatments.

Your skin type, tone, sensitivity and how it responds to sunlight, all influence the way you’ll react to a specific treatment.

This is particularly important when considering laser or light-based treatments, where the amount of melanin in your skin can influence how the treatment is tailored for you, helping to protect your individual skin tone while achieving the best possible results.

At Hannah London, you will always have a personalised skin assessment to ensure that any treatments are selected and adapted to suit you as an individual

Understanding skin type vs skin tone

It’s important to distinguish skin type from skin tone.

Skin type describes characteristics such as whether your skin is dry, oily or combination, and can also include specific skin concerns such as sensitivity, acne, rosacea or dehydration.

Skin tone refers to the colour of your skin, which is determined by the amount of the natural pigment, melanin, that is present.

Both skin type and tone are important considerations when assessing your skin and determining the most appropriate skincare or treatment approach.

What is the Fitzpatrick Scale?

One tool commonly used by dermatologists and aesthetics practitioners is the Fitzpatrick Scale.

This skin classification system was first developed in 1975 by Harvard dermatologist, Thomas Fitzpatrick.

The scale categorises skin into six phototypes, based on its pigmentation and its reaction to ultraviolet (UV) radiation – in particular whether it tends to burn or tan.

The six Fitzpatrick skin types are:

• Type I – Very pale skin that burns easily and does not tan
• Type II – Fair skin that burns easily and tans only slightly
• Type III – Fair to beige skin that can burn but usually tans gradually
• Type IV – Olive or light brown skin that rarely burns and tans easily
• Type V – Brown or dark brown skin that rarely burns and tans readily
• Type VI – Very dark brown or black skin that generally does not burn and tans very easily

Whilst the Fitzpatrick scale is a useful clinical tool, it is not a complete description of an individual’s skin.

Skin colour spans a broad spectrum and two people with the same Fitzpatrick classification may have quite different skin tones, characteristics and treatment needs.

Recognising the limitations of the Fitzpatrick Scale

Whilst the Fitzpatrick Scale remains widely used, research has highlighted that it does have certain limitations.

The Fitzpatrick Scale was originally developed to classify how skin responds to UV exposure, rather than to provide a detailed classification of skin colour. It relies partly on an individual’s perception of how their skin burns or tans, which can make classification subjective and may not accurately reflect the wide diversity of skin tones, particularly darker skin.

According to the British Association of Dermatologists, a new approach to skin classification has been proposed for use, alongside the Fitzpatrick Scale.

The Eumelanin Human Skin Colour Scale (named after the most common pigment found in skin) has been proposed by researchers including members of the British Association of Dermatologists’ Lexicon Group.

Based on measurements of melanin in the skin, this five-point scale is designed to describe the full spectrum of human skin colours more objectively.

Read more from the British Association of Dermatologists.

Why skin tone matters for aesthetic treatments

We will always carefully assess and consider your skin tone when recommending a personalised treatment plan.

For example, your skin tone is an important factor when considering laser and light-based treatments such as laser hair removal and Pro-Yellow Laser treatment. Because melanin absorbs light energy, in darker skin, there can be an increased risk of pigment changes following certain treatments.

This does not mean that people with darker skin cannot have laser or other energy-based treatments. Modern technologies and treatment techniques mean that most procedures can be performed safely across a wide range of skin tones.

Your practitioner will select the appropriate device settings and follow treatment protocol to ensure your skin is well cared for. This might include choosing a particular wavelength, adjusting the energy settings or allowing appropriate time between treatments.

Aesthetic treatments and skin tone – your questions answered

Are aesthetic treatments safe for very pale skin?

Very pale skin can be treated safely, but its sensitivity to UV exposure and tendency to burn should be taken into consideration. The suitability of a treatment depends on the skin concern, the technology being used and the condition of the patient’s skin.

At Hannah London, an initial consultation enables your practitioner to assess your skin and determine the optimum approach to your treatment, to ensure the safety of your skin and the best possible outcome.

Does laser treatment work differently on darker skin tones?

Because melanin absorbs certain wavelengths of light, some laser and light-based treatments require particular care when used on darker skin.

The choice of technology and treatment settings, such as wavelength, may need to be adapted to reduce the risk of unwanted pigment changes while still achieving the desired result.

Can people with darker skin have laser treatments?

Yes. Laser treatments and techniques can be used safely on darker skin. Your practitioner should assess your skin and recommend the most suitable technology and settings for your individual needs.

Why is pigmentation a particular consideration for darker skin?

Darker skin contains more melanin, therefore inflammation or skin trauma can sometimes trigger increased pigment production. This can lead to post-inflammatory hyperpigmentation, which causes darker patches or marks that can appear after the skin has been irritated or injured.

This risk is therefore an important consideration when planning some laser, light-based or resurfacing treatments.

Do aesthetic clinics take skin tone into consideration?

Skin tone is an important consideration when assessing the suitability of certain treatments. However, it is only one part of the overall assessment that should take place.

An experienced practitioner will also consider the overall condition of your skin, your medical history and the outcome you want to achieve.

Is the Fitzpatrick Scale the only way to assess skin?

The Fitzpatrick Scale is a useful clinical tool, but it has some limitations. A thorough skin assessment should consider the individual as a whole, including the characteristics and condition of their skin and the treatment being considered.

Your skin deserves a personalised approach

At Hannah London, our experienced practitioners understand that every person’s skin is unique.

We take into consideration your skin type, tone, condition and individual concerns when recommending treatments, so that we can ensure safe, natural-looking results for both women and men.

If you would like to address a particular skin concern but are unsure which treatments are best for your skin tone, we will assess your skin, discuss your needs and recommend an appropriate, personalised treatment plan.

To book your consultation, please contact us.