Fitzpatrick scale

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The Fitzpatrick scale and the risk of skin cancer Influence of pigmentation on skin cancer risk.png
The Fitzpatrick scale and the risk of skin cancer

The Fitzpatrick scale (also Fitzpatrick skin typing test; or Fitzpatrick phototyping scale) is a numerical classification schema for human skin color. It was developed in 1975 by American dermatologist Thomas B. Fitzpatrick as a way to estimate the response of different types of skin to ultraviolet (UV) light. [2] It was initially developed on the basis of skin color to measure the correct dose of UVA for PUVA therapy, and when the initial testing based only on hair and eye color resulted in too high UVA doses for some, it was altered to be based on the patient's reports of how their skin responds to the sun; it was also extended to a wider range of skin types. [3] [4] [5] The Fitzpatrick scale remains a recognized tool for dermatological research into human skin pigmentation.

Contents

The following list shows the six categories of the Fitzpatrick scale in relation to the 36 categories of the older von Luschan scale (in parentheses): [6] [7] [8]

Emoji modifiers

The Fitzpatrick scale is also the basis of skin color in emoji, with five modifiers according to the Fitzpatrick scale (types I and II merged).

Eurocentric bias

The Fitzpatrick scale has been criticized for its Eurocentric bias and insufficient representation of global skin color diversity. [9] The scale originally was developed for classifying "white skin" in response to solar radiation, [2] and initially included only four categories focused on white skin, with "brown" and "black" skin types (V and VI) added as an afterthought. [3]

The scale's methodology, relying on self-reporting of skin color, sunburn, and sun tanning response, fails to capture the broad spectrum of skin reflectance. Studies demonstrate that European populations have the narrowest skin color variation, whereas groups categorized as 'brown' or 'black' exhibit a much wider range. [10] [11]

The efficacy of the Fitzpatrick scale even among white-skinned individuals has been argued to be questionable, [9] since studies such as that on a Dutch student population [12] have found it inadequate for categorizing, challenging its appropriateness for investigating the relationship between sunburn tendency and tanning ability. [9]

The Fitzpatrick scale's Eurocentric orientation and its limitations in accurately representing global skin color diversity, along with similar biases in classifying other phenotypic traits, have been argued to require more inclusive and scientifically valid categorizations in dermatological and genetic research. [9]

See also

Related Research Articles

<span class="mw-page-title-main">Human skin color</span>

Human skin color ranges from the darkest brown to the lightest hues. Differences in skin color among individuals is caused by variation in pigmentation, which is the result of genetics, exposure to the sun, disorders, or some combination thereof. Differences across populations evolved through natural selection or sexual selection, because of social norms and differences in environment, as well as regulations of the biochemical effects of ultraviolet radiation penetrating the skin.

<span class="mw-page-title-main">Melanin</span> Group of natural pigments found in most organisms

Melanin consist of oligomers or polymers arranged in a disordered manner which among other functions provide the pigments of many organisms. Melanin pigments are produced in a specialized group of cells known as melanocytes. They have been described as "among the last remaining biological frontiers with the unknown".

<span class="mw-page-title-main">Melanocyte</span> Melanin-producing cells of the skin

Melanocytes are melanin-producing neural crest-derived cells located in the bottom layer of the skin's epidermis, the middle layer of the eye, the inner ear, vaginal epithelium, meninges, bones, and heart. Melanin is a dark pigment primarily responsible for skin color. Once synthesized, melanin is contained in special organelles called melanosomes which can be transported to nearby keratinocytes to induce pigmentation. Thus darker skin tones have more melanosomes present than lighter skin tones. Functionally, melanin serves as protection against UV radiation. Melanocytes also have a role in the immune system.

<span class="mw-page-title-main">Skin cancer</span> Medical condition involving uncontrolled growth of skin cells

Skin cancers are cancers that arise from the skin. They are due to the development of abnormal cells that have the ability to invade or spread to other parts of the body. Skin cancer is the most commonly diagnosed form of cancer in humans. There are three main types of skin cancers: basal-cell skin cancer (BCC), squamous-cell skin cancer (SCC) and melanoma. The first two, along with a number of less common skin cancers, are known as nonmelanoma skin cancer (NMSC). Basal-cell cancer grows slowly and can damage the tissue around it but is unlikely to spread to distant areas or result in death. It often appears as a painless raised area of skin that may be shiny with small blood vessels running over it or may present as a raised area with an ulcer. Squamous-cell skin cancer is more likely to spread. It usually presents as a hard lump with a scaly top but may also form an ulcer. Melanomas are the most aggressive. Signs include a mole that has changed in size, shape, color, has irregular edges, has more than one color, is itchy or bleeds.

<span class="mw-page-title-main">Vitiligo</span> Skin condition where patches lose pigment

Vitiligo is a chronic autoimmune disorder that causes patches of skin to lose pigment or color. The cause of vitiligo is unknown, but it may be related to immune system changes, genetic factors, stress, or sun exposure. Treatment options include topical medications, light therapy, surgery and cosmetics.

<span class="mw-page-title-main">Sunscreen</span> Topical skin product that helps protect against sunburn

Sunscreen, also known as sunblock or sun cream, is a photoprotective topical product for the skin that helps protect against sunburn and most importantly prevent skin cancer. Sunscreens come as lotions, sprays, gels, foams, sticks, powders and other topical products. Sunscreens are common supplements to clothing, particularly sunglasses, sunhats and special sun protective clothing, and other forms of photoprotection.

<span class="mw-page-title-main">Sun tanning</span> Darkening of skin in response to ultraviolet light

Sun tanning or tanning is the process whereby skin color is darkened or tanned. It is most often a result of exposure to ultraviolet (UV) radiation from sunlight or from artificial sources, such as a tanning lamp found in indoor tanning beds. People who deliberately tan their skin by exposure to the sun engage in a passive recreational activity of sun bathing. Some people use chemical products which can produce a tanning effect without exposure to ultraviolet radiation, known as sunless tanning.

<span class="mw-page-title-main">Indoor tanning</span> Tanning using an artificial source of ultraviolet light

Indoor tanning involves using a device that emits ultraviolet radiation to produce a cosmetic tan. Typically found in tanning salons, gyms, spas, hotels, and sporting facilities, and less often in private residences, the most common device is a horizontal tanning bed, also known as a sunbed or solarium. Vertical devices are known as tanning booths or stand-up sunbeds.

<span class="mw-page-title-main">Dihydroxyacetone</span> Chemical compound

Dihydroxyacetone, also known as glycerone, is a simple saccharide with formula C
3
H
6
O
3
.

<span class="mw-page-title-main">Ultraviolet light therapy</span> Form of treatment for skin disorders

Ultraviolet light therapy or ultraviolet phototherapy is a treatment for psoriasis, atopic skin disorder, vitiligo and other skin diseases.

<span class="mw-page-title-main">Sunless tanning</span> Indoor tanning lotion

Sunless tanning, also known as UV filled tanning, self tanning, spray tanning, or fake tanning, refers to the effect of a suntan without exposure to the Sun. Sunless tanning involves the use of oral agents (carotenids), or creams, lotions or sprays applied to the skin. Skin-applied products may be skin-reactive agents or temporary bronzers (colorants).

<span class="mw-page-title-main">Ultraviolet index</span> Measurement of strength of sunburn-producing ultraviolet (UV) radiation

The ultraviolet index, or UV index, is an international standard measurement of the strength of the sunburn-producing ultraviolet (UV) radiation at a particular place and time. It is primarily used in daily and hourly forecasts aimed at the general public. The UV index is designed as an open-ended linear scale, directly proportional to the intensity of UV radiation, and adjusting for wavelength based on what causes human skin to sunburn. The purpose of the UV index is to help people effectively protect themselves from UV radiation, which has health benefits in moderation but in excess causes sunburn, skin aging, DNA damage, skin cancer, immunosuppression, and eye damage, such as cataracts.

<span class="mw-page-title-main">Von Luschan's chromatic scale</span> Method of classifying skin color

Von Luschan's chromatic scale (VLS) is a method of classifying skin color. It is also called the von Luschan scale or von Luschan's scale. It is named after its inventor, Felix von Luschan. The equipment consisted of 36 opaque glass tiles which were compared to the subject's skin, ideally in a place which would not be exposed to the sun. The von Luschan scale was used to establish racial classifications of populations according to skin color; in this respect it is in contrast to the Fitzpatrick scale intended for the classification of the skin type of individuals introduced in 1975 by Harvard dermatologist Thomas B. Fitzpatrick to describe sun tanning behavior.

<span class="mw-page-title-main">Tanning dependence</span> Physical or psychological dependence on tanning or sunbathing

Tanning dependence or tanorexia is a syndrome where an individual appears to have a physical or psychological dependence on sunbathing or the use of ultraviolet (UV) tanning beds to darken the complexion of the skin. Compulsive tanning may satisfy the definition of a behavioral addiction as well.

<span class="mw-page-title-main">Light skin</span> Human skin color

Light skin is a human skin color that has a low level of eumelanin pigmentation as an adaptation to environments of low UV radiation. Light skin is most commonly found amongst the native populations of Europe, West Asia, Central Asia, and Northeast Asia as measured through skin reflectance. People with light skin pigmentation are often referred to as "white" although these usages can be ambiguous in some countries where they are used to refer specifically to certain ethnic groups or populations.

<span class="mw-page-title-main">Olive skin</span> Human skin colour spectrum

Olive skin is a human skin colour spectrum. It is often associated with pigmentation in the Type III to Type IV and Type V ranges of the Fitzpatrick scale. It generally refers to moderate or lighter tan or brownish skin, and it is often described as having tan, brown, cream, greenish, yellowish, or golden undertones.

<span class="mw-page-title-main">Phytophotodermatitis</span> Medical condition

Phytophotodermatitis, also known as berloque dermatitis, margarita photodermatitis, lime disease or lime phytodermatitis is a cutaneous phototoxic inflammatory reaction resulting from contact with a light-sensitizing botanical agent followed by exposure to ultraviolet A (UV-A) light. Symptoms include erythema, edema, blisters, and delayed hyperpigmentation. Heat and moisture tend to exacerbate the reaction.

<span class="mw-page-title-main">Sunburn</span> Burning of the skin by the suns radiation

Sunburn is a form of radiation burn that affects living tissue, such as skin, that results from an overexposure to ultraviolet (UV) radiation, usually from the Sun. Common symptoms in humans and other animals include red or reddish skin that is hot to the touch or painful, general fatigue, and mild dizziness. Other symptoms include blistering, peeling skin, swelling, itching, and nausea. Excessive UV radiation is the leading cause of (primarily) non-malignant skin tumors, which in extreme cases can be life-threatening. Sunburn is an inflammatory response in the tissue triggered by direct DNA damage by UV radiation. When the cells' DNA is overly damaged by UV radiation, type I cell-death is triggered and the tissue is replaced.

<span class="mw-page-title-main">Health effects of sunlight exposure</span>

Exposing skin to the ultraviolet radiation in sunlight has both positive and negative health effects. On the positive side, exposure allows for the synthesis of vitamin D3. Vitamin D has been suggested as having a wide range of positive health effects, which include strengthening bones and possibly inhibiting the growth of some cancers. A dietary supplement can also supply vitamin D, but there are also benefits to exposure not obtainable through Vitamin D supplementation. Long-term sun exposure is associated with reduced all-cause mortality and reduced mortality risk from cardiovascular disease (CVD), some forms of cancer, and non-CVD/noncancer related disease, with indications in these studies that Vitamin D is not the mediator. Supplementation offers limited bioavailability and no synthesis of subdermal nitric oxide. UV exposure also has positive effects for endorphin levels, and possibly for protection against multiple sclerosis. Abundant visible light to the eyes gives health benefits through its association with the timing of melatonin synthesis, maintenance of normal and robust circadian rhythms, and reduced risk of seasonal affective disorder.

<span class="mw-page-title-main">Dark skin</span> Human skin color

Dark skin is a type of human skin color that is rich in melanin pigments. People with dark skin are often referred to as "black people", although this usage can be ambiguous in some countries where it is also used to specifically refer to different ethnic groups or populations.

References

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  2. 1 2 Fitzpatrick, T. B. (1975). "Soleil et peau" [Sun and skin]. Journal de Médecine Esthétique (in French) (2): 33–34
  3. 1 2 Fitzpatrick, T.B. (1988), "The validity and practicality of sun-reactive skin types i through vi", Archives of Dermatology, 124 (6): 869–71, doi:10.1001/archderm.1988.01670060015008, PMID   3377516
  4. Pathak, M. A.; Jimbow, K.; Szabo, G.; Fitzpatrick, T. B. (1976). "Sunlight and melanin pigmentation". In Smith, K. C. (ed.): Photochemical and photobiological reviews, Plenum Press, New York. pp. 211–39[ ISBN missing ]
  5. Fitzpatrick, T. B. (1986). "Ultraviolet-induced pigmentary changes: Benefits and hazards", Therapeutic Photomedicine, Karger, vol. 15 of "Current Problems in Dermatology", pp. 25–38
  6. "The Fitzpatrick Skin Type Classification Scale". Skin Inc. (November 2007). 13 May 2008. Retrieved 7 January 2014.
  7. "Fitzpatrick Skin Type" (PDF). Australian Radiation Protection and Nuclear Safety Agency. Retrieved 30 November 2017.
  8. "What Is Golden Skin Tone? (With Pictures)". 9 March 2020.
  9. 1 2 3 4 Lasisi, Tina (2021-03-05). "The constraints of racialization: How classification and valuation hinder scientific research on human variation". American Journal of Physical Anthropology. Wiley. 175 (2): 376–386. doi:10.1002/ajpa.24264. ISSN   0002-9483. PMID   33675042.
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