Fitzpatrick typing is the starting point of a plasma risk assessment, not the whole of it — but it is where the most serious avoidable complications originate.
The pigmentation risk
Post-inflammatory hyperpigmentation is the complication that most often turns a satisfied client into a complaint. Risk rises through the scale, and types IV to VI need genuinely different handling rather than the same treatment performed more carefully.
Adjusting rather than declining
Lower density, fewer passes, longer intervals, and a considered approach to pre-treatment. A patch test in a discreet area, reviewed at four weeks, tells you more than any chart.
History matters more than type
A client of any type who has pigmented after a previous injury, burn or treatment is telling you how their skin behaves. That history outranks their Fitzpatrick number.
Documenting the decision
Record the assessment and the adjustment you made. If a complication occurs, contemporaneous notes showing you identified and mitigated the risk are what defend the treatment.
