Fig. 1.1
Different shades of brown among Filipinos
Brown skin people, as a category, may be considered a racial or ethnic classification, based on human skin color. As discussed by many learned authors as early as the eighteenth century, included in this category are populations from Africa (North), America (Latin and South) and Asia (Western, South, and Southeast).
Several classification schemes exist designating how a particular skin color reacts to several stimuli. For long, researches have followed the Fitzpatrick Phototyping Scale developed in 1975 by Dr. Thomas B. Fitzpatrick, based on the typical response of the different skin types to ultraviolet light. The majority of brown skin people are categorically placed in the skin phototypes IV–V. The skin burns minimally to rarely but tans uniformly or more easily [3–5].
The Lancer Ethnicity Scale (LES), introduced in 1998 by Dr. Harold A. Lancer, added ancestry to the existing Fitzpatrick skin type. With ethnicity background included, it aids in defining potential risks for patients undergoing cosmetic procedures. Higher risks abound a higher rate/score on this ethnicity scale. Moderate, significant, and considerable risks are seen in the LES types 3, 4, and 5, respectively. Asians (Chinese, Koreans, Japanese, Thai, Vietnamese, Filipinos), Polynesians, Americans (Latin, Central, South) and American Indians (Central and South) have skin type IV and LES type 4. Africans (Central, North, East, and West), Eritreans and Ethiopians, Middle East Arabic and Indians have skin type V and LES type 4 [6].
The Roberts Skin Type Classification System, proposed by Dr. Wendy Roberts in 2006, deals with identifying a patient’s skin type characteristics. It further went on to predict the response of the skin to insult, injury and inflammation, detecting the susceptibility of sequelae for individuals of global skin types. Using four indices (phototype, hyperpigmentation, photoaging and scarring), optimal outcomes may then be identified for each patient [5, 7].