Why Ethnicity Matters With Laser, IPL and Photorejuvenation Treatments

As new research comes to light and litigations are constantly on the rise, we believe it is important to regularly review our consultation and consent forms to ensure they are constantly updated to reflect research and scientific updates. Your consultation and consent process is your most powerful tool in providing you with the ultimate protection from treatment misadventures. 

While we are all familiar with the Fitzpatrick Classification Scale for skin types, new research is suggesting we need to extend the review process to include a more thorough investigation of a person’s ethnic background and not just their presented skin colour. 

On a regular basis, we are approached by-law firms to provide expert advice on litigation cases relating to clients who have experienced severe burns from laser or IPL treatments and determine whether the incidents were a result of operator errors or device malfunctions.

As part of this process, we are required to conduct a thorough investigation, starting with the consultation and consent forms and then examine the practitioner’s record-keeping information throughout the treatment process.  If we were to summarise the most common areas that appear to contribute to burns, they would have to be the following:

• The client is of ethnic background, but often their apparent presented Fitzpatrick classification did not provide the full picture.  The setting was established on the perceived colour.
• The consultation process did not require a thorough investigation of the client’s ethnic background to capture this information.
• The client was not patch-tested on all areas they were treated e.g. hair reduction treatment was performed on the lower legs, while the patch test was conducted on the back of the neck where the hair was covering the skin, resulting in a different colour-tone to the area being treated. 

We live in a multi-cultural society where inter-racial marriages are becoming more and more common.  However, often an offspring may appear Caucasian, but have a person of colour in their heritage.  This is often common with New Zealanders, but they are also not uncommon with Australians who may also have aboriginal in their bloodline. Americans, on the other hand, may have an American-Indian ancestor. In fact, we are sure you would agree that some of the most attractive women and men often come from a mixed-racial background. 

However, if our consultation process does not investigate this we may never find out.  The result could be that while our settings reflect the presented skin colour, they will not be taking into consideration the client’s ethnic background that would allow us to take the appropriate precautions when determining the settings.

Please make sure your consultation and consent forms are up-to-date.  If you are not sure you can contact us, we have a range of regulatory and best-practice documents including consultation and consent forms. Find out more about our resources.

It is also advisable to establish Fitzpatrick Classification Charts in your treatment room as a friendly reminder to you and your staff.  Below is a brief, but a concise outline.  Please feel free to copy it and display it where appropriate.

The Fitzpatrick Classification Scale for Skin Types

Type	Features	Characteristics
I	Pale white skin | red or blond hair | blue eyes | freckles	Always burns, never tans
II	White or fair skin | red or blond hair | blue, hazel, or green eyes	Usually burns, tans with difficulty
III	Cream white or fair skin | any eye or hair colour	Gradually tans, sometimes has a mild burn
IV	Light brown skin	Tans with ease, rarely burns
V	Dark brown skin	Tans very easily, very rarely burns
VI	Deeply pigmented dark brown	Tans very easily, never burns