Is IPL appropriate for Fitzpatrick Skin Type V or VI?

Many conventional IPL systems are contraindicated or very high risk in Types V and VI due to dense epidermal melanin. Consider non-light-based options such as RF or thermal pulsation for MGD management.

Can I perform IPL on a patient with a recent tan?

Avoid IPL on recently tanned skin. A tan increases epidermal melanin and raises burn and dyspigmentation risk. A common rule is to wait about 4 weeks after significant UV exposure, guided by device recommendations.

How should fluence be adjusted by skin type?

Fluence tolerance generally decreases as Fitzpatrick type increases. Types I and II often tolerate higher fluence, while Types III and IV typically need lower fluence and longer pulses. Start with your device’s nomogram and titrate based on test spots and tissue response.

Fitzpatrick Skin Types for IPL

Skin typing and safety-focused IPL planning

Fitzpatrick Skin Types: IPL Safety for MGD and Rosacea

Why skin type drives IPL risk

The Fitzpatrick classification describes skin Types I to VI based on baseline pigmentation and response to ultraviolet (UV) exposure. In intense pulsed light (IPL) for meibomian gland dysfunction (MGD) and ocular rosacea, Fitzpatrick type is one of the most important factors in determining how aggressively you can treat while protecting the epidermis.

Melanin is a competing chromophore. Lighter skin types (I and II) have less epidermal melanin, which typically allows higher fluence and shorter pulse durations with a wider safety margin. Darker skin types (V and VI) have denser epidermal melanin that absorbs more of the delivered energy, increasing the risk of burns, dyspigmentation, and scarring if standard settings are used.

Selective photothermolysis in MGD treatment

IPL relies on selective photothermolysis. Pulsed broad-spectrum light is absorbed by target chromophores, primarily hemoglobin in telangiectatic vessels and melanin in the epidermis and hair follicles. In MGD and ocular rosacea, the goal is to reduce the inflammatory contribution of abnormal periocular vessels. As skin type increases, more energy is absorbed by epidermal melanin, the therapeutic window narrows, and the margin between effective and injurious fluence becomes smaller.

Practical safety protocols and test spots

For Types III and IV, or for any patient with recent sun exposure, a test spot in a discreet preauricular area can help assess tolerance before completing a full treatment pass. After the test spot, assess for excessive erythema, edema, or early blistering before proceeding.

Use an appropriate coupling gel and confirm that the selected filter (for example, 590 nm versus 615 nm) and fluence range follow the manufacturer's recommendations for that Fitzpatrick type. When in doubt, start more conservatively with lower fluence, longer pulse durations, and staged escalation across sessions rather than aiming for maximal effect in a single visit.

Fitzpatrick Skin Typing: Features and Classification

Type	Skin	Characteristics	Example
I	Light, pale white, freckled	Extremely sensitive skin, always burns, never tans	Light blonde/red hair
II	White, peach, fair	Very sensitive skin, burns easily, tans minimally	Fair haired Caucasians, northern Asians
III	White to light brown, olive	Sensitive skin, sometimes burns, slowly tans to light brown	Darker Caucasians, some Asians
IV	Olive, light to moderate brown	Mildly sensitive, rarely burns, tans easily	Mediterranean and Middle Eastern Caucasians, southern Asians
V	Brown to dark brown	Resistant skin, rarely burns, tans well	Some Hispanics, some Africans
VI	Dark brown to black	Very resistant skin, never burns, deeply pigmented	Darker Africans, Indigenous Australians

IPL and Skin Type FAQs

Is IPL appropriate for Fitzpatrick Skin Type V or VI?: With many conventional broad-spectrum IPL platforms, Fitzpatrick Types V and VI are often considered contraindicated or very high risk because of dense epidermal melanin. Even conservative settings can increase the risk of burns, dyspigmentation, or scarring. For these patients, consider non-light-based options for MGD management such as radiofrequency (RF), thermal pulsation, or lid-based heat and expression, guided by local protocols and device labeling.
Can I perform IPL on a patient with a recent tan?: Avoid IPL on recently tanned skin. A tan from natural sun exposure or a tanning bed increases epidermal melanin and effectively shifts risk toward a higher Fitzpatrick tier, raising the chance of blistering and dyspigmentation. Defer treatment until the skin returns closer to baseline, which is commonly around 4 weeks after the last significant UV exposure, depending on the individual and device guidance.
How should fluence be adjusted by skin type?: In general, fluence (J/cm²) tolerance decreases as Fitzpatrick type increases. Types I and II often tolerate higher fluence and shorter pulses, while Types III and IV usually require lower fluence, longer pulse durations, and meticulous coupling and cooling to protect the epidermis. Start with your device's recommended nomogram for the selected skin type, then adjust in small increments based on test spots and tissue response.