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Treatment based, multi-specialty skin classification system: Guidelines for assessing skin response to cosmetic treatments

Laurence A. Kirwan

Fitzpatrick Skin Typing (FST) is the most utilized skin classification system and was described in 1975 by Thomas Fitzpatrick, MD. The classification types skin in relation to its sensitivity to ultraviolet radiation and the resultant risk of developing skin cancer. It is a tool familiar to dermatologists, plastic surgeons and all practitioners treating the skin with light-based technology and skin peels. The von Luschan scale was used to establish racial classifications of populations according to skin color; in contrast to the Fitzpatrick scale which was intended for the classification of the skin type of individuals to describe sun exposure. The primary use of the Fitzpatrick System today is in the ever-expanding and ubiquitous field of cosmetic skin treatments. These treatments are performed by a spectrum of operators ranging from specialist and non-specialist physicians to ancillary medical staff and spa employees with no formal medical training. Furthermore, medical lasers and other skin treatments such as Chemical Peels, Intense Pulse Light (IPL) and Light Emitting Diode (LED), are used in many different settings and for a multitude of therapeutic indications from hair removal to skin resurfacing. They all have, as a common denominator, the risk of injury to the skin with potential sequelae such as burns, scarring, hyper-pigmentation and hypo-pigmentation. In this paper, a new skin classification system is proposed in which patients fall into one of three groups

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