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 Type||Colour||Reaction to Sun||Reaction to UVA|
|Type I||Scandinavian, blonde or red hair, freckles, fair skin, blue eyes||Very sensitive||Always burns easily, never tans: Very fair skin tone|
|Type II||Northern European (Caucasian); blonde or red hair, freckles, fair skin, blue or green eyes||Very sensitive||Usually burns easily, tans with difficulty:Fair skin tone|
|Type III||Darker Caucasian, light Asian||Sensitive||Burns moderately, tans gradually:Fair to moderate skin tone|
|Type IV||Mediterranean, Asian, Hispanic||Moderately sensitive||Rarely burns, tans very easily:Medium skin tone|
|Type V||Middle eastern, Latin, light-skinned African-American, Indian||Minimally sensitive||Very rarely burns, tans very easily: Olive or dark skin tone|
|Type VI||Dark-skinned African American||Least sensitive||Never 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)|
|Type II - Moderate - Early to Moderate Photoageing (usually 35-50 years old)|
|Type III - Advanced - Advanced Photoageing (usually 50 ??? 60 years old)|
|Type IV - Severe - Severe Photoageing (usually 60 ??? 75 years old)|
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 0||Total absence of lesions|
|Grade I||Sub clinical Acne|
Few comedons visible only in close examination
|Grade II||Comedonal Acne|
Comedons with slight inflammation
|Grade III||Mild Acne|
Inflamed papules with erythema
|Grade IV||Moderate Acne|
Many inflamed papules and pustules
|Grade V||Severe Nodular Acne|
Inflamed papules and pustules with several deep nodular lesions
|Grade VI||Severe Cystic Acne|
Many nodular cystic lesions with scarring