Type I

Always burns, never tans

Type II

Usually burns , rarely tans

Type III

Sometimes burns, gradually tans

Type IV

Rarely burns, tans well

Type V

Rarely burns, almost always tans

Type VI

Never burns, always tans

Class

Wrinkling

Score

Degree of Elastosis

I

Fine wrinkles (rhytides)

1-3

Mild (fine textural changes with subtly accentuated skin lines)

II

Fine-to-moderate-depth winkles, moderate number of lines

4-6

Moderate (distinct popular elastosis-individual papules with yellow translucency under direct lighting-and dyschromia)

III

Fine to deep wrinkles and numerous lines with or without redundant skin folds

7-9

Severe (multipapular and confluent elastosis-thickened, yellow, and pallid-approaching or consistent with cutis rhomboidalis nuchae)

Type

Typical Attributes

Age, y

Need for Cosmetics

I

Minimal to no wrinkle or photoaging (very mild freckling); no lentigines or solar keratoses

20s or

30s

Generally no need for foundation or makeup

II

The skin is smooth at rest, but wrinkling appears as the skin moves during smiling, frowning, etc; lentigines and telangiectases begin appearing but no visible keratoses.

Late 30s

or 40s

May wear a little bit of foundation or makeup

III

Visible wrinkles even when face is at rest; obvious lentigines, telangiectases, and even capillary matting; visible solar keratoses.

>50

A constant need for heavy foundation

IV

Wrinkles throughout face and thin epidermis; yellow or gray skin color (due to increased thickness of stratum corneum); possible/prior skin carcinomas

>60

Makeup usually no longer worn, because it cakes and cracks