Most energy-based device settings are built around one number: the patient's Fitzpatrick type. In this episode of 10 Minutes with Tracey, Tracey Mancuso explains why that scale was never designed for lasers, how relying on it alone leads to PIH, burns and undertreatment, and the fuller assessment she uses instead.

In this episode:

Why the Fitzpatrick scale was created in 1975 to predict sunburn and skin cancer risk, not laser response

Eumelanin versus pheomelanin, and what each means for photoprotection

Why you never hand a patient the skin-typing form, and the questions they almost always answer wrong

How the aesthetic industry adopted Fitzpatrick for devices, and why fluence charts still lean on it

Why a tan doesn't change a patient's type, and what fluence should depend on instead

The Roberts Skin Type Classification System: phototype, hyperpigmentation, Glogau photoaging and scarring, combined into one code

The palmar assessment and the Lancer scale, and the gaps they fill

Building a full risk profile before you choose a treatment

As Tracey puts it: "Energy-based medicine requires risk-based stratification, not just some visual assumption." And on the intake form: "Unless they live in a cave, they are going out in the sun."

Free download: The DermaRoom Collective's skin typing and patient assessment forms are in the Downloads section at thedermaroomcollective.com.

About the host: Tracey Mancuso, BScHS, CMLSO, is the founder and course director of The DermaRoom Collective. A Certified Medical Laser Safety Officer with more than 30 years in aesthetic medicine, she teaches laser, light and RF treatment to practitioners.