Skin Care Classification Systems

3 Jan
Dry/Oily/Combination is not a skin type classification system!
Sorry Obaji and Proactive.  But you suck.

Skin Type classification is important to evaluate in order to form a cosmetic plan.  In order to identify optimal outcomes for any skin treatment the following are crucial to identify: 

  • Hyper/hypo-pigmentation risk
  • Scarring risk
  • Skin Phenotoype
  • Photo-age

Skin Typing is important for an aesthetician/doctor/nurse to perform before undergoing any medical aesthetic procedure including:

  • chemical peels
  • laser hair removal
  • laser skin resurfacing
  • IPL (intense pulse light)

Fitzpatrick Type Scale

The Fitzpatrick Type Scale is the gold standard of skin typing.  It is described below as it is a part of the Roberts Skin Type Classification System. Used by Aestheticians prior to chemical peels, laser treatments, and IPL.

1. Fitzpatrick skin type I –extremely fair skin (less melanin at basal layer under the epidermis), Skin always burns (note: melanin acts to block UV rays and its potential damage). Skin never tans with ease.
2. Fitzpatrick skin type II –Fair skin (a bit more melanin at basal layer compare to type I) Skin always burns, sometimes tans).
3. Fitzpatrick skin type III –medium skin color, sometimes burns, always tans.
4. Fitzpatrick skin type IV –Olive skin, rarely burns, always tans (since it rarely burns we could conclude that has lots more melanin at basal layer than types I, II, III and that during aggressive inflammation either by acne or a skin stimulating treatments the excess release of melanin pigments could cause skin discoloration, darkening or brown spots into the surrounding tissues.
5. Fitzpatrick skin type V – moderately pigmented skin, never burns, always tans.
6. Fitzpatrick skin type VI – markedly pigmented black skin, never burns, always tans.

Glogau Scale

The Glogau Scale is also described below as it is part of the Roberts Skin Type Classification System.  Used by Aestheticians to determine Skin Care Product need. If your a stage 4, you might want to consider  A Wrinkle In Time–My Botox Lines or  That’s NOT Botox..

You can be a pup and still be a Glogau 4. Stay away from Tanning! See link below.

Glogau 1– No Wrinkles, early photoaging
Glogau 2– Wrinkles in motion, early to moderate photoaging
Glogau 3– Wrinkles at rest, advanced photoaging
Glogau 4– Only wrinkles, severe photoaging

There’s a fine line between tan and looking like you rolled in a bag of doritos..

Acne Rating

1. Grade 1– has open comedones (black heads); mild red spots and is easiest to treat. May be labeled acne cosmetica if due from make-up use or poor home care of skin.
2. Grade II-has closed comedones with no inflammation.
3. Grade III-has papules, pustules, inflammation, open and closed comedones
4. Grade IV-Is the most severe with a combination of all of the above, however with lots more large closed comedones and bumps of many sizes. Grade IV will most often be referred to a dermatologist. These clients respond well to Jessner peel solutions since they have a soothing effect on the skin from the anti-inflammatory ingredients salicylic acid.

The Roberts Skin Type Classification System

This system predicts the skin response to injury and insult from cosmetic procedures and identify the propensity of sequelae from inflammatory skin disorders. It is used by more advanced medical personal and includes 4 elements:

1.  Fitzpatrick Scale: to measure skin phototyping

1. Fitzpatrick skin type I –extremely fair skin (less melanin at basal layer under the epidermis), Skin always burns (note: melanin acts to block UV rays and its potential damage). Skin never tans with ease.
2. Fitzpatrick skin type II –Fair skin (a bit more melanin at basal layer compare to type I) Skin always burns, sometimes tans).
3. Fitzpatrick skin type III –medium skin color, sometimes burns, always tans.
4. Fitzpatrick skin type IV –Olive skin, rarely burns, always tans (since it rarely burns we could conclude that has lots more melanin at basal layer than types I, II, III and that during aggressive inflammation either by acne or a skin stimulating treatments the excess release of melanin pigments could cause skin discoloration, darkening or brown spots into the surrounding tissues.
5. Fitzpatrick skin type V – moderately pigmented skin, never burns, always tans.
6. Fitzpatrick skin type VI – markedly pigmented black skin, never burns, always tans.

2.  Glogau Scale: describes photo-aging

Glogau 1– No Wrinkles, early photoaging
Glogau 2– Wrinkles in motion, early to moderate photoaging
Glogau 3– Wrinkles at rest, advanced photoaging
Glogau 4– Only wrinkles, severe photoaging

3.  Roberts Scarring Scale: describes scar morphology.  Helps to determine short and long term affects of treatments and procedures.

None

Atrophy 

Nodule

I couldn’t find any pics of Roberts 3 and 4. So here’s some more cute puppies. They’re kissing. Awwwww

Macule
Plaque within scar boundaries
Keloid
Keloidal nodule

4.  Roberts Hyper-pigmentation Scale:  Propensity for hyper-pigmentation based on the natural history of post-inflammatory pigmentation in an individual.  This value is based on past medical history, clinical exam, and ancestral background.

– Hypo-pigmentation
– Minimal and Transient Hyper-pigmentation
– Minimal and permanent Hyper-pigmentation
– Moderate and transient Hyper-pigmentation
– Moderate and permanent  Hyper-pigmentation
– Severe and permanent Hyper-pigmentation

**My good friend John Fournier, MD, a prestigious Derm in Miami is going to help me out with this post, so it will be revised in time!  Sorry!  He’s just really busy being awesome.

Also, my next post will be a glossary.  I think it’s time for one of those!
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