Knowing Your Fitzpatrick Skin Type Can Help Prevent Skin Cancer

Skin Types
  • The Fitzpatrick skin type system is used to categorize skin to indicate susceptibility to sun damage.
  • You can determine your own Fitzpatrick skin type using your physical characteristics as well as your reactions to sun exposure.
  • The correct categorization can help you choose the best strategies to protect your skin from damage and skin cancer.

If you are unsure of what strategies will work best for you to protect your skin from the sun, the Fitzpatrick skin type (or phototype) system can help. This system helps people identify how sensitive their skin is to sunburn and how likely they are to develop a tan. It also allows doctors to identify patients who may be at the greatest risk for skin cancer and make recommendations for sun protection strategies.

It’s a common fallacy that hair and eye color are the best determinants of susceptibility to sunburn and skin cancer. Physical traits play a role but are less important than your history of sun exposure and your skin’s response to it.

There are many quizzes available online that may help you identify your Fitzpatrick skin type but the process can be distilled to a few indicators of skin complexion and your reaction to sun exposure.

Ultimately, knowing your Fitzpatrick skin type will give you an indication of your skin cancer risk and help you choose the best approach to protect yourself from the sun.

What is the Fitzpatrick Skin Type System?

In the mid-1970s, Dr. Thomas Fitzpatrick, a dermatologist at Harvard Medical School and Massachusetts General Hospital, was working on a new treatment for patients with psoriasis that involved exposing patients to UVA rays. Using a skin typing system based on a patient’s hair and eye color, Dr. Fitzgerald and his colleagues found that some patients were unexpectedly sensitive to the sun.

Dr. Fitzpatrick decided that a new system of classifying a patient’s skin type was needed. He developed a process that involved brief interviews with patients that took into account their history of sunburn and suntan as well.

This new system, subsequently referred to as the Fitzpatrick phototype or skin type, proved to be a more accurate predictor of a patient’s reaction to UVA rays. The initial scale was developed for Caucasian patients but was subsequently expanded to include patients with darker skin tones.

In the many years since the development of this system, it has proven invaluable to dermatologists. The scale has been validated many times over. The Fitzpatrick skin type system is now most commonly used as a predictor of skin cancer risk and can help patients decide on the best methods to protect their skin from the sun.

There have also been additional studies that effectively utilize the Fitzpatrick skin type classification system to evaluate a patient’s risk of skin cancer in more specific settings, such as those who have received solid organ transplants.

How to Determine Your Fitzpatrick Skin Type

The Fitzpatrick scale is broken down into six groups designated using Roman numerals. The following table outlines the general descriptions of each group. However, these categories are not set in stone. For instance, although most patients with Type I skin have light hair and eyes, it is possible for a person with Type I skin to have brown hair and eyes.

Although you can certainly take one of many online quizzes to determine your Fitzpatrick skin type, the original method described by Dr. Fitzpatrick is much simpler. The original interviews performed by Dr. Fitzpatrick and his colleagues asked patients about their history of sunburn and suntan.

Consult the following tables to find your skin type.

Skin TypePhysical CharacteristicsReaction to Sun Exposure
Type I
  • Skin is ivory prior to sun exposure
  • Hair is naturally red or blonde
  • Eyes are light blue, green or gray
  • Always burns and peels
  • Never tans
  • Freckles usually appear
Type II
  • Skin is fair prior to sun exposure
  • Hair is naturally blonde
  • Eyes are blue, green or gray
  • Often burns and peels
  • Tans infrequently and with difficulty
  • Freckles often appear
Type III
  • Skin is light with golden undertone prior to sun exposure
  • Hair is naturally dark blonde or light brown
  • Eyes are hazel or brown
  • Burns occasionally and mildly
  • Tans occasionally
  • Freckles sometimes appear
Type IV
  • Skin is olive or light brown prior to sun exposure
  • Hair and eyes are dark brown
  • Burns rarely
  • Tans often and easily
  • Freckles infrequently appear
Type V
  • Skin is brown or dark brown prior to sun exposure
  • Hair is naturally dark brown or black
  • Eyes are dark brown
  • Almost never burns
  • Always tans
  • Freckles rarely appear
Type VI
  • Skin is dark brown or black prior to sun exposure
  • Hair is naturally black
  • Eyes are brownish black
  • Never burns
  • Always tans darkly
  • Freckles never appear

What’s the Best Sun Protection Strategy for You?

Skin Types I and II

People with Fitzpatrick skin types I and II are at the highest risk for sun-related skin damage, which includes wrinkles and skin cancers (basal cell carcinoma, squamous cell carcinoma and melanoma). To protect their skin, people with skin types I and II should adhere to the following sun protection strategies:

  • Avoid sun exposure whenever possible and seek shelter in the shade.
  • Cover skin by wearing protective clothing and wide-brimmed hats whenever out in the sun.
  • Wear sunscreen with an SPF of 30 or higher.

Skin Types III to VI

Those with Fitzpatrick skin types III through VI are at a lower risk of sun damage but precautions should still be taken. Consider the following sun protection strategies:

  • Limit sun exposure.
  • Cover skin using protective clothing and wide-brimmed hats whenever in the sun for extended periods of time.
  • Wear sunscreen with an SPF of 15 of higher.

Patients with darker skin types should also be on the lookout for the development of dark spots on the palms of the hands or the soles of the feet, which could be indicative of acral lentiginous melanoma.

General Recommendations

All patients should wear sunglasses that offer UV protection. Not all sunglasses offer this protection, so it’s important to check the packaging or ask the salesperson at the point of purchase. Another risk factor for skin cancer is the use of artificial tanning beds and tanning machines. Tanning machines are potentially harmful to all skin types and should be avoided.

Everyone, regardless of skin type, should perform a head-to-toe check of their skin every month. You should look out for any new growths or moles as well as changes in the size, shape, color, texture or sensitivity of any existing moles. If you notice anything out of the ordinary, consult your physician.

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