PEER-REVIEW | DERMATOLOGY | presented by Fanous et al., highlights the importance
Table 1 The six genetico-racial categories
CATEGORY DESCRIPTION The Nordics
Individuals originating from Northern Europe
Eg: Scandinavians, Irish or Scottish roots
of incorporating the genetic and racial origin of the patient during assessment1–3
. The authors’ observation on The Europeans
Individuals originating from mid Europe
Eg: German, English, Northern Spanish, Northern Italian, Polish or French roots
The Mediterraneans Individuals originating from southern Europe, most northern Africa and western middle Asia
Eg: Southern Italians, southern Spanish, Portuguese, Greek, Lebanese, Iranians
The Indo-Pakistanis
Individuals originating from upper middle Africa, western lower Asia
Eg: Indian, Pakistani, Thai, Egyptians or Saudi roots
The Africans
Individuals originating from middle and lower Africa
Eg: Sudanese, Ethiopians, South Africans
the ‘north to south’ phenomenon that depicts the change in skin colour and features across the globe formed the base for this classification. The important variables that were taken into account were the colour of the skin, thickness of the skin, and facial characteristics. Accordingly, six genetico-racial subtypes were described from the three founding races (Table 1). The authors highlighted the importance of the role of genetics in determining a patient’s response to medical and cosmetic treatment1–3
. The most popular classification system is the
Fitzpatrick classification, which is based on genetic background and skin reaction to UV light exposure (Table 2). The classification is considered as the gold standard and a simple guide to predict outcome of therapies and risk of skin cancers4
. Later, many similar classifications
were developed based on the complexion and characteristics of the skin. The Robert’s skin type classification system evaluates four important elements: phototype, hyperpigmentation, photoageing and scarring. This system helps to predict the skin’s response to injury and insult from cosmetic procedures and helps to predict impending complications5
. The Obagi skin
classification considers five important variables to classify the skin. These include the skin colour, oiliness, thickness, laxity, and fragility6
. The Kawada skin The most popular
classification system is the Fitzpatrick
classification, which is based on genetic
The Asians
Individuals originating from central and eastern Asia
Eg: Koreans, Chinese, Japanese, Filipinos
background and skin reaction to UV light exposure.
classification system analyses Japanese skin types based on personal history of sun reactivity. The Glogau scale considers the degree of photoageing, wrinkling, and discolouration of the patient’s skin7,8
. The system is not
applicable for mixed race individuals. Other classifications include the Lancer ethnicity scale, the Goldman world classification of skin types, the Willis and Earles scale, the Taylor hyperpigmentation scale, and the Baumann skin type solution9–12
. The
Willis and Earles classification is especially designed for people of
African origin. Most of the systems consider the genetic and racial origin as an important factor in the classification. In the clinical practice, the skin types are correlated to post- procedure outcomes after diverse dermatological and surgical procedures.
Facial differences in skin The properties of the skin and its response to external stimuli are largely
determined by its genetic origin,
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