Fitzpatrick Skin Type Calculator

The Fitzpatrick scale classifies constitutional skin by how it behaves under ultraviolet light rather than by how dark it looks. Type I always burns and never tans; Type II burns easily and tans minimally; Type III sometimes burns and tans gradually; Type IV rarely burns and tans readily; Type V very rarely burns; Type VI never burns and is deeply pigmented. The original question asked what happened during the first 30 to 45 minutes of unprotected midday sun after a winter without exposure, so the classification is fundamentally a burning and tanning history. This tool reaches the same endpoint through proxy items - eye colour, natural hair colour, unexposed skin colour and recalled sun reaction - which correlate with phototype but less reliably than the direct question. The practical value lies in dose selection. Minimal erythema dose rises with phototype, so narrowband UVB phototherapy at 311 to 313 nm sets starting fluence by type. In laser and intense pulsed light work, epidermal melanin competes with the intended chromophore, so types IV to VI require reduced fluence, longer pulse durations and longer wavelengths such as 1064 nm Nd:YAG to avoid burns and lasting dyspigmentation. Types I and II carry the highest melanoma and keratinocyte carcinoma risk. The scale's weakness is that it is frequently used as a stand-in for race or ethnicity, which it was never meant to be, and self-reported burning history is poorly reproducible, particularly among people with type IV to VI skin.

Thomas B. Fitzpatrick, chairman of dermatology at Harvard Medical School and Massachusetts General Hospital, introduced the classification in 1975 to solve a narrow and urgent dosing problem. PUVA therapy, combining oral psoralen with ultraviolet A, had just been introduced for psoriasis, and clinicians had no reliable way to choose an initial UVA dose. Guessing too high caused severe phototoxic burns. Fitzpatrick's answer was to ask patients how their skin reacted to sun and use that answer to set the starting dose. The original scheme ran only from I to IV and described white skin. Types V and VI, covering brown and black skin, were added later, and Fitzpatrick set out the extended six-type scale in a 1988 article in the Archives of Dermatology on the validity and practicality of sun-reactive skin types I through VI. From there the scale escaped its clinical origin, becoming embedded in sunscreen labelling, laser safety protocols, cosmetic dermatology consent forms and epidemiological studies of skin cancer, uses far broader than a phototherapy dosing aid was designed to support. That expansion drew criticism, since the scale discriminates poorly among darker skin and conflates pigmentation with ancestry. Proposed successors include objective colorimetry, particularly the individual typology angle derived from L, a and b reflectance readings, and the Taylor Hyperpigmentation Scale developed for pigmentary disorders in skin of colour.