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The Fitzpatrick scale classifies skin into six types (I–VI) by how it responds to sun—from very fair, always-burns skin to deeply pigmented skin. It is the single most important tool for predicting laser risk and choosing safe settings.
The Fitzpatrick scale sorts skin into six phototypes based on constitutive pigment and how the skin reacts to UV: Type I (very fair, always burns, never tans) through Type VI (deeply pigmented, never burns). It was devised for dosing UV therapy but has become the universal language of laser and light safety.
The reason is melanin. Energy-based devices that target melanin (hair removal) or that pass melanin-rich epidermis to reach a deeper target are far riskier on higher Fitzpatrick types, where abundant surface pigment competes for the energy and can lead to burns and post-inflammatory hyperpigmentation. This is why a 1064nm Nd:YAG is favoured for Types IV–VI, why fluences are lowered and cooling increased on darker skin, and why some technologies (Alexandrite, IPL) are restricted to lighter types.
Every responsible treatment begins by establishing the client’s Fitzpatrick type—it dictates device choice, settings and consent.
Establish the Fitzpatrick type first—everything from device choice to fluence to consent follows from that single number.
The Fitzpatrick scale classifies skin into six phototypes (I–VI) by sun response and pigment—the key tool for predicting laser burn and hyperpigmentation risk and choosing safe wavelengths and settings, especially for darker skin.
