Fitzpatrick Skin Types and Who Is at Risk for Melanoma

Scientists developed Fitzpatrick skin types in 1975 by asking people how their skin reacted to the sun. There are six Fitzpatrick skin types (see chart below), and these categories are used today to aid in stratifying skin cancer risk. Skin cancer remains one of the most common types of cancer in America, affecting 1 in 5 people. We know that those patients whose skin tends to burn or are prone to frequent sunburns are also more likely to get skin cancer.

Melanin is a dark brown pigment in our hair, skin, and nails. It is what protects our skin from sunburns. The Fitzpatrick skin type system categorizes patients based on how much melanin is present in their skin. While not everyone will neatly fall into one of these categories, it is a good guideline and can help dermatologists determine one’s risk of skin cancer.

People with Fitzpatrick skin type 1 or 2 will have fair skin, lighter hair, and freckles. These people have a higher risk of melanoma and non-melanoma skin cancers and should take extra precautions to protect their skin from the sun. Those with skin types 3 or 4 usually tan well, but their skin can still burn. While the risk of skin cancer is lower in these skin types compared to those with skin types 1 or 2, sun protection measures should be taken as the possibility of getting skin cancer remains. Those with skin types 5 and 6 typically do not burn but can still get sun damage, leading to skin cancer and early signs of aging. In general, the risk of skin cancer is lower in higher Fitzpatrick skin types. Nevertheless, awareness must be raised when skin cancer does arise in these skin types, as it is often found later and at more advanced stages.

We encourage patients of all skin types to perform skin self-exams monthly. Skin cancer can have variable presentations, such as a new mole, an existing mole that is changing, or a non-healing lesion. It is also essential to get an annual skin exam from a dermatologist who is trained in identifying skin cancer in all types of skin. Lastly, daily sun-protective practices are important for everyone!

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