Double Board Certified
Plastic Surgeon

Sun Damage, Fractional Lasers, and the Fitzpatrick Scale

Solar keratosis (sun damage) results in wrinkly skin and discoloration. Fractional lasers (like a Fraxel or a Fractionated CO2 laser) are used for skin resurfacing to treat fine lines and wrinkles and can help with discoloration by burning off a very thin layer of skin so that new skin is encouraged to grow. Fractional lasers cannot be used anywhere but on the face, neck, and decolletage because the skin elsewhere is too thick (such as hands) and will not heal properly.

Fotofacial/532 wavelength lasers are for red and brown spots. This wavelength laser CAN be used on other parts of the body because they are not resurfacing the skin-they are only targeting pigment.

Before you undergo either of these lasers, we decide which “Fitzpatrick” you are.

The Fitzpatrick Scale (a numerical classification for human skin tone)

is as follows:

  1. You always burn, cannot tan at all

  2. You burn easily but also can tan if you really work at it

  3. You tan easily, rarely burn

  4. Asian, Mediterranean, Latino, olive-toned skin

  5. Light African American

  6. Dark African American

Why is this the one time when it’s okay to give someone a label? Actually, it’s mandatory when using the two lasers mentioned above.

Both fractionated lasers and fotofacial/532 wavelength lasers can cause hyper- (too dark) and hypo- (too light) pigmentation to patients with Fitzpatrick classifications of III-VI. We usually do a small test area on these patients, even when just lasering scars. While these lasers can almost always be used on Ones and Twos, the good news is that the Threes and up generally have better, thicker skin (literally, the dermis is thicker) and they rarely need laser treatment for skin rejuvenation.

In my experience, you So Cal Fitzpatrick Threes are the ones who have to watch out. You may be able to effortlessly keep a glowy, natural tan (yes I’m envious) but just remember to always pile on the sunscreen--the sun damage will creep up on you, and on the body, it is pretty much irreversible. Only Fitzpatrick Fours and up can afford to be carefree in the sun all day with no wrinkle consequences

Check out our video to learn more about solar keratosis! Contact us to schedule a consultation with us to see where you land on the Fitzpatrick scale (you’d be surprised!) and which lasers are right for you.

* All information subject to change. Images may contain models. Individual results are not guaranteed and may vary.