Fitzpatrick Scale

The Fitzpatrick scale is a six-point classification of how skin responds to ultraviolet light, running from type I, which burns and does not tan, to type VI, which rarely burns and is deeply pigmented. It was developed in the 1970s to help decide dosing for light-based treatment, and it describes a reaction to UV rather than a skin colour.

It remains widely used because it is quick and because clinical protocols reference it, particularly for lasers, chemical peels and phototherapy, where the risk of pigment change after treatment differs sharply across the range.

• Higher types are more prone to post-inflammatory hyperpigmentation after inflammation, injury or aggressive treatment.
• Lower types carry a higher risk of sunburn and of UV-related skin damage.
• Everyone benefits from sun protection; the scale changes the emphasis, not the advice.

Its limitations are well documented. It was built around light skin and extended afterwards, it conflates ethnicity with UV response in ways practitioners have criticised, and many people do not recognise themselves in any single category. Treat it as a rough clinical shorthand — useful for anticipating how skin may react to a procedure, and not a description of who someone is.