Skin Classifications

Glogau Classification

Mild – type I
“no wrinkles”
Moderate – type II
“wrinkles in motion”
Advanced – type III
“wrinkles at rest”
Severe – type IV
“only wrinkles”
Early mild photoaging:

  • mild pigmentary changes
  • no keratoses (small rough spots on chronically sun-damaged skin; precancerous)
  • minimal wrinkles

Patient age – 20s or 30s

Minimal or no makeup

Moderate photoaging:

  • early visible solar lentigines (sun-induced hyperpigmentation
  • keratoses palpable but not visible
  • parallel smile lines beginning to appear

Patient age – late 30s or 40s

Usually wears some foundation

Advanced photoaging:

  • obvious dyschromia (discoloration) and telangiectasia
  • visible keratoses
  • wrinkles even when not moving

Patient age – 50s

Always wears heavy foundation

Severe photoaging:

  • yellow-gray color of skin
  • keratosis and skin malignancies (cancers)
  • wrinkled throughout, little normal skin

Patient age – 60s or 70s

Can’t wear makeup – “cakes and cracks”

Fitzpatrick scale

Skin Skin color Reaction to sun
I Very white or freckled Usually burns Face of woman with very white or freckled skin color
II White Usually burns Face of man with white skin color
III White to olive Sometimes burns Face of woman with white to olive skin color
IV Brown Rarely burns Face of woman with brown skin color
V Dark brown Very rarely burns Face of woman with dark brown skin color
VI Black Never burns* Face of man with black skin color

*Although it was once thought that Fitzpatrick VI skin types do not burn because they may not show visible redness, this is not the case.

Global heritage model

What is your ancestry?

Globe illustration of climate regions

Treatment guidelines:

Polar region ancestry

  • typically tolerate more inflammation
  • less prone to hyperpigmentation
  • mild to moderate edema and erythema may be present

Equator region ancestry

  • cannot typically tolerate inflammation
  • more prone to hyperpigmentation

Fitzpatrick’s classification

Skin type & correlating sensitivity

Fitzpatrick skin type Skin color Common hereditary backgrounds Visual reaction to sun Typical sensitivity to chemical peels Common adverse responses to UV rays
I Pale white Nordic, Scandinavian (Swedish, Danish) Always burns, never tans Very resilient Skin cancer & hypopigmentation
II White Irish, English, Welsh Usually burns Resilient Skin cancer & telangiectasia
III Light brown (naturally tan) Asian, Mediterranean (Italian, Greek) Mildly burns, tans relatively well Moderately responsive Skin cancer, telangiectasia & hyperpigmentation
IV Moderate brown Hispanic, Middle Eastern, African American, Native American Rarely burns, tans well Sensitive Hyperpigmentation
V Dark brown Hispanic, Middle Eastern, African American, Native American, Southeast Asian Very rarely burns, tans easily Moderately sensitive Hyperpigmentation
VI Black African American, Southeast Asian Least likely to burn, tans very darkly Very sensitive Hyperpigmentation