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Skin type classifications are not only important in patient evaluation and treatment, but also play a key role in the assessment of patients in clinical trials. Some classifications such as Fitzpatrick skin phototyping are mostly used for treatment plans and response. Others, on the other hand, are primarily used in clinical studies to assess the severity of the cosmetic disorder and evaluate and follow-up the treatment response. In order to understand and assess the treatment response, physicians greatly benefit from the use of structural measurement scales. Both types of classifications will be discussed in this chapter.


Fitzpatrick skin classification became the initial skin typing system when it was introduced in 1975 by Dr. Thomas B. Fitzpatrick to measure skin sensitivity to ultraviolet (UV) light (Table 39-1). It was originally designed to classify patients in order to determine the correct dose of UV light for treating psoriasis. Notably, this classification was not intended to define skin color; rather, it is based on patients’ skin responses to UV light. Although not an indicator of patients’ ethnicity, it provides an idea of subjects’ skin color and complexion. For many years, Fitzpatrick’s skin classification was the predominant skin typing system used in the literature. Currently, dermatologists use this classification approach for planning treatments with UV light in addition to predicting skin response to different laser treatments.

TABLE 39-1Fitzpatrick’s Skin Phototyping System


The Baumann Skin Typing System was introduced in 2005 in the book The Skin Type Solution (New York, Bantam 2005). This approach to classifying skin type and tailoring corresponding treatments is discussed at length in Chapter 9 and can be used for patients regardless of their age, gender, or ethnicity. It is based on evaluating the skin according to four major parameters: oily versus dry (O/D), sensitive versus resistant (S/R), pigmented versus nonpigmented (P/N), and wrinkled versus tight (W/T). To obtain one’s four-letter skin type code, patients take a self-administered questionnaire known as the Baumann Skin Type Indicator (BSTI), which provides a score correlating with an individual’s prevailing cutaneous tendencies along the four descriptive spectra. The various permutations of the four parameters yield 16 different skin types (Table 39-2). The questionnaire to determine Baumann Skin Type can be found at

TABLE 39-2Baumann Skin ...

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