Updating the Fitzpatrick Classification: The Skin Color and Ethnicity Scale

BACKGROUND There has been a significant increase in submissions to scientific journals addressing a broad spectrum of medical and surgical conditions in subjects grouped under the classification of “Skin of Color.” Authors, reviewers, and editors have struggled with accurate terminology. OBJECTIVE To update the Fitzpatrick scale to make it more accurate in stratifying various shades of skin color. MATERIALS AND METHODS A thorough literature review was performed using PubMed and Embase to assess existing skin color scales, and an extensive internet search was conducted using makeup foundation ranges as a starting point for skin tone matching. RESULTS The research resulted in a consensus that Fitzpatrick types 4 and 5 ratings were the most confusing in that these included a broad range of skin types with different responses to solar radiation, lasers, surgery, and cosmetic products. The authors reached a consensus that subdividing skin types 4 and 5 into “A” and “B” better defined them. The new scale that resulted was labeled the SCE scale (for Skin Color Ethnicity). CONCLUSION This new updated SCE scale should assist authors in better reporting scientific data in skin of color.