How to use the Fitzpatrick scale questionnaire

According to Wikipedia; the Fitzpatrick skin type scale was developed in 1975 by Thomas Fitzpatrick as a way to estimate the response of different types of skin to ultraviolet (UV) light. It was initially developed on the basis of skin colour to measure the correct dose of UVA for PUVA therapy, and when the initial testing based only on hair and eye colour resulted in too high UVA doses for some, it was altered to include the patient’s reports of how their skin responds to the sun; it was also extended to a wider range of skin types.

Nowadays the Fitzpatrick scale is the standard instrument to evaluate a client’s skin before laser or light-based therapy. However, it seems that a lot of therapists have a problem with interpreting the Fitzpatrick scale. The main reason for this is that the terms used to describe the skin are subjective and with that the fact that we do not remain constant on the scale throughout our lives. It is possible to move a level up or down for the majority of people falling between type 2 and 4.

The Fitzpatrick scale questionnaire is recommended as one of the best ways to determine the skin type of client. It remains still recommended combining it with a second verification, especially for therapists with less experience.

How to use the Fitzpatrick scale questionnaire:
The questionnaire consists of two sets of questions; genetic disposition and reaction to sun. For each question you have to allocate a value between 0 and 4 for that question. At the end of the questionnaire you add up the various values to get a grand total.

The Fitzpatrick scale questionnaire.

Generic disposition

Score 0 1 2 3 4
Your eye colour? Light blue, grey, green Blue, grey or green Hazel or light brown Dark brown Brownish black
Natural colour of hair? Sandy, red Blond Chestnut / Dark blond Dark brown Black
Colour of non-exposed skin? Reddish Very pale Pale with beige tint Light brown Dark brown
Do you have freckles on unexposed areas? Many Several Few Incidental None

Reaction to sun exposure

Score 0 1 2 3 4
What happens when you stay in the sun too long? Painful redness, blistering, peeling Blistering, followed by peeling Burn sometimes, followed by peeling Rarely burns Never burns
To what degree de you turn brown? Hardly or not at all Light colour tan Reasonable tan Tans easily Turns dark brown quickly
Do you turn brown within several hours after sun exposure? Never Seldom Sometimes Often Always
How does your face react to the sun? Very sensitive Sensitive Normal Very resistant Never had a problem

Add up the total scores for each section for your skin type score to give you a better evaluation of your skin type.

Genetic disposition ____

Reaction to sun exposure ____

Total skin type score ____

Total skin type score Fitzpatrick Skin type
0 to 6 Type 1
7 to 13 Type 2
14 to 20 Type 3
21 to 27 Type 4
28 to 34 Type 5
35 and over Type 6

Verification question: Which of the following best describes your skin type?

Description Type
Always burn, never tan 1
Always burn, sometimes tan 2
Sometimes burn, tan somewhat 3
Rarely burn, tan with ease 4
Moderately pigmented, tans very easily 5
Deeply pigmented, never burn 6

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