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  • The Fitzpatrick Scale in PMU

    How to truly read skin phototypes

The Fitzpatrick scale often appears during trainings as a table to memorize.
Type I, II, III… checked, let’s move on.

But in real PMU practice, the Fitzpatrick scale is not knowledge “for a test”.
It is a tool for predicting problems before they happen.

It helps answer one essential question:
“What might this skin react poorly to if I’m not careful?”

 

What the Fitzpatrick Scale Is in PMU – and What It Is Not

In dermatology, the Fitzpatrick scale focuses mainly on skin reaction to sun exposure.
In PMU, we care about something different:

-how the skin reacts to trauma,
- how quickly redness appears,
- how intensely pigment shows in the skin,
- what the healed result may look like.

That’s why in PMU, the Fitzpatrick scale provides context, not instructions.

 

Phototype I – Skin That Shows Everything

How it looks in practice:

- very fair, porcelain-like skin,
- often thin,
- visible blood vessels,
- redness appears quickly and fades slowly.

This is skin that does not forgive mistakes.
Every error becomes visible faster and lasts longer.

What this means for you:

- pigment will appear more visible than on other skin types,
- warm tones can intensify redness,
- too much intensity creates a heavy result.

How to think:

Always work with the assumption:
“Less than I think.”

If you hesitate between two intensities, choose the lighter one.
If you’re wondering whether it’s already enough – it probably is.

Phototype II – Fair, but With Character

How it looks:

- fair skin, but not paper-thin,
- redness appears but fades faster,
- blood vessels may still be active.

This type often seems “safe”, but still requires caution.

What it means in PMU:

- warm pigments should still be used carefully,
- it’s easy to overdo intensity,
- pigment may look beautiful immediately but too strong after healing.

Studio reality:

This is the skin type where, a month later, you often hear:
“Maybe it’s just a bit too strong.”

Phototype III – The Biggest Comfort Illusion

How it looks:

- medium skin tone,
- less reactive,
- better tolerance of procedures.

This is the most common phototype in PMU studios.
And at the same time, the one where it’s easiest to relax too much.

What can be misleading:

- pigment “settles nicely”, tempting you to add more,
- skin tolerates the procedure well, so it’s easy to go too far,
- undertone is often ignored because “everything looks fine”.

The most common mistake:

Choosing pigment based only on Fitzpatrick, without analyzing:

- redness,
- skin temperature,
- natural facial contrast,
- the specific treatment area.

The result?
Beautiful when fresh. Questionable after healing.

Phototype IV – More Melanin, More Planning

How it looks:

- warm, olive-toned skin,
- lower tendency to redness,
- clear undertone.

This skin accepts pigment well, but can also change it over time.

What this means:

- warm pigments may heal too warm,
- lack of neutralization can lead to unwanted tones,

intensity must be planned ahead.

The key question here is:
“How will this pigment look in 2–3 months?”

Phototype V – Pigment and Melanin in Dialogue

How it looks:

- darker skin tone,
- high melanin content,
- different trauma response.

On this skin type, pigment:

- may appear very intense right after the procedure,
- but stabilize very differently over time.

What matters most:

- color purity,
- predictability,
- avoiding “muddy” mixes.

This is not about darkness.
It’s about clarity and stability.

Phototype VI – No Room for Guesswork

How it looks:

- very dark skin tone,
- high melanin concentration,
- the least predictable pigment response.

In PMU:

- pigment selection requires high awareness,
- intensity does not always equal visibility,
- experience and testing are essential.

Here, the Fitzpatrick scale truly tells you:
“Slow down and think two steps ahead.”

Fitzpatrick vs. Redness, Vascularity, and Undertone – Where the Table Ends

The Fitzpatrick scale does not tell you:

- whether the skin is vascular,
- whether active redness is present,
- whether the undertone is warm or cool.

That’s why after determining the phototype, you should always analyze these factors separately.
In PMU, they make the biggest difference.

How to Use the Fitzpatrick Scale in Daily PMU Practice

The most effective approach:

  1. Determine the Fitzpatrick phototype.

  2. Assess skin reactivity and redness.

  3. Evaluate the undertone.

  4. Only then choose the pigment.

If something doesn’t align at any stage – stop and reassess.

Summary

The Fitzpatrick scale is not the answer.
It is a warning, a context, and a guide.

You make the decision.
Fitzpatrick simply tells you how cautious you need to be when making it.

FAQ

  • What is the Fitzpatrick scale in permanent makeup (PMU)?

    The Fitzpatrick scale in PMU is a classification system used to assess how the skin may react to pigmentation. It helps predict redness, pigment visibility, healing behavior, and potential risks during permanent makeup procedures.

  • Is the Fitzpatrick scale enough to choose a PMU pigment?

    No. The Fitzpatrick scale is only a starting point. In PMU, pigment selection must also consider skin undertone, vascularity, redness, and overall skin condition to achieve predictable healed results.

  • How should PMU artists work with Fitzpatrick skin types I and II?

    For Fitzpatrick types I and II, PMU artists should work with lower intensity and avoid overly warm pigments. These skin types are highly reactive and show mistakes quickly, especially redness and heaviness after healing.

  • Why is Fitzpatrick type III considered misleading in PMU?

    Fitzpatrick type III skin often tolerates procedures well, which can lead to overworking the skin. Because it looks good immediately after treatment, undertone and long-term healing are often underestimated.

  • How does pigment behave on Fitzpatrick type IV skin?

    On Fitzpatrick type IV skin, pigment usually implants easily but can shift in tone over time. Warm pigments may heal too warm, so neutralization and long-term planning are essential.

  • What should be considered when working on Fitzpatrick type V skin in PMU?

    With Fitzpatrick type V skin, pigment may appear very strong initially but stabilize differently during healing. Clean color selection and predictable pigment behavior are crucial.

  • Why does Fitzpatrick type VI require the most experience in PMU?

    Fitzpatrick type VI skin has high melanin content and the least predictable pigment response. PMU on this skin type requires advanced knowledge, careful testing, and conservative intensity planning.

  • Does the Fitzpatrick scale include skin redness and vascularity?

    No. The Fitzpatrick scale does not assess redness, vascularity, or skin undertone. These factors must always be evaluated separately in PMU practice.

  • What is more important in PMU: Fitzpatrick type or skin undertone?

    Skin undertone often has a greater impact on healed PMU results than the Fitzpatrick type alone. Two clients with the same phototype may require very different pigment choices.

  • How should PMU artists use the Fitzpatrick scale in daily practice?

    PMU artists should use the Fitzpatrick scale as a contextual tool, not a rule. It should be combined with observation of redness, undertone, skin thickness, and treatment area before selecting pigment.