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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)	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 – Sever 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 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

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