Fitzpatrick Skin Type Assessment

Fitzpatrick Skin Type Assessment
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
BENEFITS OF KNOWING YOUR FITZPATRICK

By assessing Fitzpatrick skin type, beauty and medical professionals are able to determine what treatments are best as well as what to be cautious of. Knowing what Fitzpatrick Skin Type you have can more accurately predict your response to different cosmetic procedures and treatments.

Skin types IV-VI run a higher risk for pigmentary change with treatments such as chemical peels, dermabrasion, and topical bleaching agents.

Knowing your Fitzpatrick is also important in evaluating your risk for skin cancer. Melanin in the skin absorbs and scatters energy from UV light to protect skin cells from damage. Skin types with less pigmentation have less melanin and therefore less protection against harmful sun rays. Type I - III have the highest risk of melanoma and nonmelanoma skin cancers and sun damage.
Part I: Genetic Disposition
What color are your eyes?*

Light blue, light gray, light green (0)Blue, green (1)Hazel, light brown (2)Dark brown (3)Brownish-black (4)
Score = {Eyecolor}
What is the natural color of your hair?*

Red or light blonde (0)Blonde (1)Dark blonde, light brown (2)Dark brown (3)Black (4)
Score = {Haircolor}
How many freckles do you have on unexposed areas of your skin?*

Many (0)Several (1)A few (2)Very few (3)None (4)
Score = {Freckles}
What is the natural skin color before sun exposure?*

Ivory white (0)Fair or pale (1)Fair to beige w/ a gold undertone (2)Olive or dark brown (3)Dark brown or black (4)
Score = {NatSkincolor}
Total Score for Genetic Disposition = {GeneticTotal}
GeneticTotal:
Part II: Reaction to Sun Exposure
What happens if you stay too long in the sun?*

Sunburn, blistering, peeling (0)Blistering followed by peeling (1)Burns sometimes followed by peeling (2)Rarely burns (3)Never burns (4)
Score = {TooMuchSun}
To what degree does your skin tan?*

Hardly or not at all (0)Light color tan (1)Moderately tan (2)Tans very easily (3)My skin is naturally dark (4)
Score = {TanDegree}
Do you turn brown within several hours of sun exposure?*

Hardly or not at all (0)Light color tan (1)Moderately tan (2)Tans very easily (3)My skin is naturally dark (4)
Score = {FastTan}
How does your face react to the sun?*

Very sensitive (0)Sensitive (1)Normal (2)Resistant (3)Very resistant, never had a problem (4)
Score = {FaceSun}
Total Score for Reaction to Sun Exposure = {SunTotal}
SunTotal:
Part III: Tanning Habits
When did you last expose your body to sun or artificial tanning or tanning cream?*

More than 3 months ago (0)2-3 months ago (1)1-2 months ago (2)Less than a month ago (3)Less than 2 weeks ago (4)
Score = {LastTan}
How often do you expose the area to be treated to the sun?*

Never (0)Hardly ever (1)Sometimes (2)Often (3)Always (4)
Score = {TanFreq}
Total Score for Tanning Habits= {TanTotal}
TanTotal:
Part IV: What is your Ethnic Background?
How would you best describe your ethnic heritage?*

Celtic, Caucasian (0)Caucasian, light-skinned European (1)Caucasian, dark-skinned European (2)Caucasian, Mediterranean (3)Middle Eastern, Indian, Asian, Hispanic (4)Aborigine, African, African-American (5)
Score = {Heritage}
Total Score for Ethnic Background = {EthnicTotal}
EthnicTotal:
Total Fitzpatrick Score = {TotalFitzScore}
TotalFitzScore:
FITZPATRICK SCALE QUIZ SCORE
0-7 = Type I

8-16 = Type II

17-25 = Type III

25-30 = Type IV

Over 30 = Type V-VI
COMMON CHARACTERISTICS OF FITZPATRICK SKIN TYPES

Type I - White skin color, blonde hair, and green eyes, always burns in the sun, has freckles. Common ethnic background: English, Scottish.

Type II - White skin color, blonde hair, and green/blue eyes, always burns, has freckles and is difficult to tan. Common ethnic background: Northern European.

Type III - White skin color, blonde/brown hair, blue/brown eyes, tans after several burns, and may freckle. Common ethnic background: German.

Type IV - Brown skin color, brown hair, and brown eyes, tans more than average, rarely burns, and rarely freckles. Common ethnic background: Mediterranean, Southern European, Hispanic.

Type V - Dark brown skin color, brown/black hair with brown eyes. Tans with ease, rarely burns, and no freckles. Common ethnic background: Asian, Indian, some African.

Type VI - Black skin color, black hair, and brown/black eyes. Tans, never burns, deeply pigmented, and never freckles. Common ethnic background: African.
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Fitzpatrick Skin Type Assessment

Part I: Genetic Disposition

Part II: Reaction to Sun Exposure

Part III: Tanning Habits

Part IV: What is your Ethnic Background?