How to Care for Darker Fitzpatrick Skin Tones

We all have a friend that can spend all day at the pool and never burns, and the one that is outside for only a few minutes and turns bright red from sun exposure.

The difference between these two individuals and their genetic predisposition is especially important when undergoing aesthetic procedures with lasers or light-based devices.

In fact, in the hands of an inexperienced provider, patients with darker skin tones could be at risk for injury to the skin.

That’s why it’s essential to seek a dermatologist with the knowledge and experience to provide safe and effective treatment for patients with darker skin tones.

What Is Skin Tone?

Melanocytes are the cells within the skin that produce pigment known as melanin. These cells also respond to ultraviolet radiation from the sun and induce tanning.

Consequently, the amount, packaging, and distribution of naturally occurring melanin in your skin is responsible for its natural color.

Therefore, individuals with greater amounts of melanin tend to have a darker skin tones, and those with lower levels of melanin often present with lighter complexions.

What Is the Fitzpatrick Scale?

The Fitzpatrick Scale was developed by Dr. Thomas B. Fitzpatrick of the Harvard Medical School in 1975 to help guide the use of lasers and light-based treatments on different skin tones.

The Fitzpatrick scale is categorized into six different phototypes, and a score is calculated based on a patient’s answers about:

• Genetics (eye color, natural hair color, natural skin color, and freckles on unexposed areas of skin)
• Reaction to sun exposure
• Tanning habits

What Are the Six Phototypes of the Fitzpatrick Scale?

Type I – Light or pale white skin color; Always burns and never tans

Type II – Light or fair skin color; Usually burns, tans with difficulty

Type III – Medium white to olive skin color: Sometimes mildly burns and gradually tans to olive

Type IV– Olive or moderate brown skin color; Rarely burns, tans with ease to moderate brown

Type V– Brown or dark brown skin color; Very rarely burns, tans very easily

Type VI – Black or very dark brown or black color; Never burns, tans very easily, deeply pigmented.

How Can Lasers and Light-Based Treatments Affect Darker Skin Tones?

Depending on the wavelength, many lasers and light-based treatments, such as laser hair removal and intense pulsed light (IPL), are absorbed by melanin.

The goal of these procedures is to deliver the energy to specific targets, like hair follicles or areas of hyperpigmentation, while leaving healthy skin unharmed.

However, for patients with darker Fitzpatrick skin tones, necessary precautions must be taken to avoid adverse events including burns, lightening of the skin, darkening of the skin, and scarring.

How to Safely Treat Darker Skin Tones With Lasers and Light-Based Treatments?

A dermatologist with expertise on the effects of lasers and light-based treatments on all skin tones, including Fitzpatrick types V and VI, is able to evaluate the patient’s skin and determine a reasonable treatment plan.

Additionally, knowledge and experience allow providers to select the appropriate laser, wavelength, and energy levels to achieve the desired results while avoiding the negative ones.

A patch test may also be performed to evaluate to actual effects of the treatment on a small area of the patient’s skin.

For additional information about provide safe and effective care for darker Fitzpatrick skin tones, please schedule a consultation at Cultura.

Dr. Eliot Battle

CEO & Founder at Cultura Dermatology & Plastic Surgery

Dr. Eliot Battle, CEO of Cultura Dermatology, is a global leader in cosmetic dermatology and laser innovation. His Harvard research pioneered “color-blind” lasers, making treatments safe for all skin tones. A sought-after expert featured in TIME, Oprah, and The New York Times, he continues to advance inclusive, cutting-edge dermatological care.