The Fitzpatrick Scale: What Determines Your Skin Type Score?

The Fitzpatrick scale (aka the Fitzpatrick skin phototype scale) is commonly used to describe a person’s skin type and tone, particularly in terms of how it responds to light. Developed in 1975 by Dr. Thomas B. Fitzpatrick, a dermatologist at Harvard Medical School, the scale originally included skin types I–IV; types V and VI were added in 1988.

Dr. Fitzpatrick’s intent in devising the scale was to anticipate patients’ propensity to burn when receiving phototherapy treatments. Now it’s widely used by dermatologists and plastic surgeons to predict the response of different skin tones to certain cosmetic procedures, like lasers and chemical peels. It also helps predict people’s risk of skin cancer from sun exposure.

Where you fall on the scale depends on your eye, hair, and skin color as well as the way your skin reacts to sun exposure. Melanin, the pigment that gives skin its color, also determines how deeply it tans in response to the sun’s UV rays. People with dark skin tend to have more active melanocytes, cells that produce melanin, and dark skin absorbs much less UV light than pale skin—up to 70% less, according to The New York Times. That’s why people with more melanin in their skin usually tan or get darker rather than burn. They’re also at a lower risk of skin cancer due to sun exposure (though skin cancer is still a concern).

Knowing your Fitzpatrick skin type can help when you’re considering cosmetic treatments, especially laser hair removal, laser resurfacing, and chemical peels (commonly used to treat sun damage). It’s especially critical for people with Fitzpatrick skin types V and VI, who are at higher risk of postinflammatory hyperpigmentation and even scarring from laser treatments or deep chemical peels. A dermatologist or plastic surgeon with extensive experience treating brown skin will understand and know how to avoid these risks.

While the Fitzpatrick skin typing system is still the most widely used in dermatology, Harvard dermatologist Dr. Karen Kagha says that there’s currently a push in the field to expand the scale to more accurately reflect the vast variety of skin tones dermatologists treat in practice today.

Fitzpatrick skin types are usually represented in Roman numerals from I to VI, with I being the fairest and VI the darkest, though many doctors on RealSelf also use numbers 1 to 6.