Everybody has individual differences in their skin based on the interaction of genetic and environmental factors.

Skin analysis involves the use of clinical assessment (history and examination) as well as diagnostic tools including magnification, polarised light, black light illumination and dermoscopy.

Skin analysis can assess levels of hydration, luminosity, texture, tone and colour. Skin analysis can identify skin problems such as acne, blackheads, rosacea, pigmentation, oily skin, sensitive skin, wrinkles, pores and sun damage.

In skin analysis one diagnostic tool often used is the Woods lamp. In a totally dark room the deep violet light of the Woods lamp is applied to the skin.

Different substances on the skins surface become luminous under the Woods lamp helping distinguish normal healthy skin which appears blue-white in colour from damaged skin such as with pigmentation acne and dehydration.

An individual’s skin can be classified into a particular skin type based on various classifications depending on what is being assessed. For example, when assessing skin type in terms of suitability for laser treatment and to help determine the proper laser machine settings, we use the Fitzpatrick Skin typing. The Fitzpatrick classification for Sun Reactive Skin Type takes into account the amount of melanin content in the skin and on the capacity of the skin to produce melanocytes in response to sunlight. It is important to factor in the effect of an individuals skin type when treating with lasers. Many lasers especially hair removal and pigmentation lasers can interact with the melanin in an individuals skin.

Fitzpatrick Skin Classification

Skin TypeColourReaction to SunReaction to UVA
Type IScandinavian, blonde or red hair, freckles, fair skin, blue eyesVery sensitiveAlways burns easily, never tans: Very fair skin tone
Type IINorthern European (Caucasian); blonde or red hair, freckles, fair skin, blue or green eyesVery sensitiveUsually burns easily, tans with difficulty:Fair skin tone
Type IIIDarker Caucasian, light AsianSensitiveBurns moderately, tans gradually:Fair to moderate skin tone
Type IVMediterranean, Asian, HispanicModerately sensitiveRarely burns, tans very easily:Medium skin tone
Type VMiddle eastern, Latin, light-skinned African-American, IndianMinimally sensitiveVery rarely burns, tans very easily: Olive or dark skin tone
Type VIDark-skinned African AmericanLeast sensitiveNever burns, deeply pigmented: Very dark skin tone

Another classification we use is the Glogau Photoaging Skin type which grades an individual’s skin based on the degree of skin damage and wrinkling. This helps determine the optimal choice between antiwrinkle injections, dermal fillers, laser treatment and surgery.

Glogau Photoaging Classification

Type I - Mild - Early Photoageing (usually 20-30 years)
  • No keratoses
  • Little wrinkling
  • No scarring
  • Little or no make-up
Type II - Moderate - Early to Moderate Photoageing (usually 35-50 years old)
  • Early solar keratoses - slight yellow skin discolouration
  • Early wrinkling
  • Parallel smile lines
  • Little makeup
Type III - Advanced - Advanced Photoageing (usually 50 ??? 60 years old)
  • Solar keratoses, obvious yellow skin discolouration with facial capillaries
  • Wrinkles present at rest
  • Moderate acne scarring
  • Wears makeup always
Type IV - Severe - Severe Photoageing (usually 60 ??? 75 years old)
  • Solar keratoses and skin cancers have occurred
  • Wrinkled throughout
  • Wears makeup that is caked on

Classifications are also used when analysing skin in terms of specific skin conditions; for example in Acne we often use a classification called the BURTON ACNE SCALE. This helps both initially assess and help determine appropriate management protocol as well as monitor response to treatment.

Burtons Acne Scale

Grade 0Total absence of lesions
Grade ISub clinical Acne
Few comedons visible only in close examination
Grade IIComedonal Acne
Comedons with slight inflammation
Grade IIIMild Acne
Inflamed papules with erythema
Grade IVModerate Acne
Many inflamed papules and pustules
Grade VSevere Nodular Acne
Inflamed papules and pustules with several deep nodular lesions
Grade VISevere Cystic Acne
Many nodular cystic lesions with scarring

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