Developed decades ago for UV phototherapy, the Fitzpatrick skin typing system has been adopted and modified for other uses in dermatology, including determining parameters for laser procedures. However, the Fitzpatrick scale measures a person’s baseline, sun-protected skin color and UV reactivity, and ignores pigmentation from recent UV exposure. This knowledge gap can have significant consequences: Treating a patient with a tan based on their baseline paperwork can lead to accidental laser burns.

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In this Next Steps in Derm video interview, in conjunction with the Pigmentary Disorders Exchange Symposium, E. Victor Ross, MD, FAAD, shares why dermatologists should instead measure localized melanin density before laser procedures. A handheld meter can provide real-time, site-specific data that can inform laser settings.

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Dr. Ross, director of the Scripps Clinic Laser and Cosmetic Dermatology Center, reminds dermatologists not to rely on visual assessments: “The meter is always better than your eyeball.” Laser technology that integrates melanin data in determining settings can ensure safer and more effective outcomes.