OBJECTIVE: Fitzpatrick's Skin Type Classification Scale often is used to assess sun sensitivity and skin cancer risk. Because the scale was developed with Whites, its utility and validity with Blacks may be limited by its reliance on the European-cultural terms suntan and sunburn. We tested the hypothesis that most Blacks would be unable to classify their skin into the four Fitzpatrick skin types. DESIGN, SETTING, PARTICIPANTS: A random, statewide sample of 2085 California Black adults were administered a survey to categorize their skin into the Fitzpatrick types of always burn/never tan (I), usually burn/rarely tan (II), rarely burn/usually tan (III), and never burn/always tan (IV). We also added a response option not available in the scale, "none of the above describes me." Questions on sunscreen use and demographics were included. MAIN OUTCOME MEASURE: Self-reported skin type. RESULTS: 1231 (59%) selected none of the above, and only 559 (26.8%) categorized themselves as type IV. When the none option is removed and the 59% who chose it were excluded as non-responders, the 559 who selected type IV constitute 65.5% of the remaining sample. Those who selected none were significantly less likely than all others to use sunscreen, and income and residential segregation were the strongest predictors of type I/II skin. CONCLUSION: Standard administration of the Fitzpatrick Scale excludes the majority of Blacks, yields data that overestimate Black population prevalence of type IV skin, and excludes the Blacks who are least likely to use sunscreen. Suggestions are provided for improving the cultural sensitivity of the skin-type assessment.
OBJECTIVE: Fitzpatrick's Skin Type Classification Scale often is used to assess sun sensitivity and skin cancer risk. Because the scale was developed with Whites, its utility and validity with Blacks may be limited by its reliance on the European-cultural terms suntan and sunburn. We tested the hypothesis that most Blacks would be unable to classify their skin into the four Fitzpatrick skin types. DESIGN, SETTING, PARTICIPANTS: A random, statewide sample of 2085 California Black adults were administered a survey to categorize their skin into the Fitzpatrick types of always burn/never tan (I), usually burn/rarely tan (II), rarely burn/usually tan (III), and never burn/always tan (IV). We also added a response option not available in the scale, "none of the above describes me." Questions on sunscreen use and demographics were included. MAIN OUTCOME MEASURE: Self-reported skin type. RESULTS: 1231 (59%) selected none of the above, and only 559 (26.8%) categorized themselves as type IV. When the none option is removed and the 59% who chose it were excluded as non-responders, the 559 who selected type IV constitute 65.5% of the remaining sample. Those who selected none were significantly less likely than all others to use sunscreen, and income and residential segregation were the strongest predictors of type I/II skin. CONCLUSION: Standard administration of the Fitzpatrick Scale excludes the majority of Blacks, yields data that overestimate Black population prevalence of type IV skin, and excludes the Blacks who are least likely to use sunscreen. Suggestions are provided for improving the cultural sensitivity of the skin-type assessment.
Authors: Marilyn S Sommers; Jamison D Fargo; Yadira Regueira; Kathleen M Brown; Barbara L Beacham; Angela R Perfetti; Janine S Everett; David J Margolis Journal: Ethn Dis Date: 2019-07-18 Impact factor: 1.847
Authors: Mark Lee Willingham; Shane Y P K Spencer; Christopher A Lum; Janira M Navarro Sanchez; Terrilea Burnett; John Shepherd; Kevin Cassel Journal: Melanoma Res Date: 2021-12-01 Impact factor: 3.599
Authors: Jennifer Wang; Samantha Lopez; Amanda M Treviño; Daniel Galvan; Joan Reisch; Rajiv I Nijhawan; Arturo R Dominguez Journal: Arch Dermatol Res Date: 2022-07-23 Impact factor: 3.033
Authors: Hope Landrine; Irma Corral; Denise Adams Simms; Scott C Roesch; Latrice C Pichon; Diane Ake; Feion Villodas Journal: Front Public Health Date: 2013-09-25