Skin classification

• Sun reaction

  Validated scale

  Fitzpatrick type from burn and tan history only.

  I · II · III · IV · V · VI

  ClientNative score 1 to 6

• Skin tone (Monk)

  Validated scale

  Monk scale 1 to 10, judged from a photo with a colour card.

  PhotoConsultantNative score 1 to 10

• Skin tone (ITA°)

  Adapted

  Estimated from the photo. Approximate, never used alone.

  PhotoNative score -90 to 90

• Oil baseline

  Adapted

  How oily the skin is by nature.

  Dry · Balanced · Combination · Oily

  ClientConsultant

• Dehydration tendency

  Consultant judgement

  Tight or dull even when oily. Recorded separately from oil.

  Client

• Constitutional sensitivity

  Validated scale

  Sensitive Scale-10 questionnaire, 0 to 100.

  ClientNative score 0 to 100

• Pigment reactivity

  Adapted

  How easily marks form after spots, bites, friction or treatments.

  Low · Moderate · High

  Client

• Scar tendency

  Adapted

  Personal or family raised scars or keloids.

  None · Raised scars · Keloids

  Client

• Family history

  Consultant judgement

  Melasma, stretch marks or keloids in close family.

  Melasma · Stretch marks · Keloids

  Client

• Undertone

  Consultant judgement

  Cosmetic descriptor only. No validated scale exists.

  Cool · Neutral · Warm · Olive

  Consultant

• Breakouts

  Validated scale

  Overall severity; IGA 0 to 4 stored alongside.

  0 Clear · 1 Minimal · 2 Mild · 3 Moderate · 4 Marked

  PhotoClientBy zoneTrigger trackedNative score 0 to 4

• Breakout types

  Consultant judgement

  What the spots look like.

  Blackheads and whiteheads · Inflamed spots · Nodules · Uniform steroid-type spots

  PhotoBy zone

• Overall acne grade

  Validated scale

  Acne on the face as a whole, judged by what you see rather than by counting. Treatment success: clear or almost clear, and at least two grades better than at the start (US FDA guidance, 2018).

  Clear · Almost clear · Mild · Moderate · Severe

  PhotoConsultantNative score 0 to 4

• Inflamed spots (count)

  Validated scale

  Approximate number of red or pus-filled spots on the face.

  PhotoConsultant

• Blackheads and whiteheads (count)

  Validated scale

  Approximate number on the face.

  PhotoConsultant

• Dominant pillar

  Consultant judgement

  Which of the four acne pillars is driving it.

  Oil · Blockage · Bacteria · Inflammation

  Consultant

• Lower face and jawline pattern

  Consultant judgement

  Location alone is not proof of hormonal acne. Ask about the cycle.

  PhotoClient

• Suspected fungal acne

  Adapted

  Itchy, uniform spots, no blackheads, no response to acne care. Refer to confirm.

  ClientPhotoReferral

• Razor bumps

  Consultant judgement

  By site: beard, bikini, underarms, legs.

  0 Clear · 1 Minimal · 2 Mild · 3 Moderate · 4 Marked

  PhotoBy zone

• Pigmentation

  Adapted

  Severity by zone, with trigger and trigger status.

  0 Clear · 1 Minimal · 2 Mild · 3 Moderate · 4 Marked

  PhotoClientBy zoneTrigger tracked

• Pigmentation type

  Consultant judgement

  What kind of pigmentation is present.

  Marks after acne · Melasma · Sun spots · Friction darkening · Rebound after lightening · Uneven tone

  PhotoClientBy zone

• Pigmentation depth

  Consultant judgement

  Surface or deep, as an estimate.

  Surface · Deep · Mixed · Unsure

  Consultant

• Melasma (mMASI)

  Validated scale

  Modified MASI 0 to 24, tested in dark skin.

  PhotoConsultantNative score 0 to 24

• Small raised dark spots (DPN)

  Consultant judgement

  Approximate count.

  Photo

• Dark circles

  Consultant judgement

  Type only, no severity.

  Pigmented · Vascular · Structural · Mixed

  Photo

• Red or purple marks

  Consultant judgement

  The client describes colour and whether it fades when pressed.

  0 Clear · 1 Minimal · 2 Mild · 3 Moderate · 4 Marked

  ClientBy zoneNot photo-scored on Monk 7 to 10

• Acquired sensitivity

  Adapted

  Stinging, burning or tightness with a likely cause.

  Over-exfoliation · Steroid or lightener damage · Dermatitis · Unknown

  Client

• Barrier and hydration

  Consultant judgement

  Tightness, flaking and stinging plus what you observe.

  0 Clear · 1 Minimal · 2 Mild · 3 Moderate · 4 Marked

  ClientConsultant

• Texture and scars

  Consultant judgement

  Pitted or raised scars, pores, rough texture.

  0 Clear · 1 Minimal · 2 Mild · 3 Moderate · 4 Marked

  PhotoBy zone

• Visible ageing

  Validated scale

  Chien scale 0 to 8, validated in African American faces.

  PhotoNative score 0 to 8

• Stretch marks

  Consultant judgement

  By colour.

  Red · Dark · White · Blue-purple

  PhotoClientBy zone

• Pregnancy

  Consultant judgement

  Pregnant, breastfeeding or planning.

  Pregnant · Breastfeeding · Planning pregnancy · None

  Client

• Medication

  Consultant judgement

  Anything that changes what the skin can tolerate.

  Isotretinoin · Other oral acne treatment · Antibiotics · Light-sensitising medicine · Prescription skin cream · Blood thinners · Hormonal contraception · None

  Client

• Diagnosed conditions

  Consultant judgement

  Conditions a doctor has diagnosed.

  Eczema · Rosacea · Psoriasis · Autoimmune condition · Thyroid condition · PMOS (formerly PCOS) · None

  Client

• Recent procedures

  Consultant judgement

  Peels, lasers, needling or injections in recent weeks.

  Client

• Allergies

  Consultant judgement

  Including fragrance.

  Client

• Skin-lightening history

  Consultant judgement

  Asked without judgement. Ask to see the product.

  Cream · Pills · Injections · Soap · None

  Client

• Still using a lightener

  Consultant judgement

  Stopping steroid creams needs medical support.

  Client

• Changing mole

  Validated scale

  NICE 7-point checklist; refer at 3 or more. Check palms, soles and nails.

  ClientPhotoNative score 0 to 10Referral

• Signs of infection

  Validated scale

  Fever, spreading redness, or infection near the eyes or nose.

  ClientPhotoReferral

• Severe acne

  Validated scale

  Nodules or cysts, or sudden severe acne with feeling unwell.

  PhotoClientReferral

• Suspected mercury exposure

  Validated scale

  Unlabelled lightener, swelling or foamy urine. Refer first.

  ClientReferral

• Steroid damage

  Adapted

  Thin skin, visible vessels, dependency.

  ClientPhotoReferral

• Suspected ochronosis

  Adapted

  Blue-grey or sooty darkening after lightener use.

  PhotoClientReferral

• Hormonal signs

  Validated scale

  Point to a medical check for PMOS.

  Irregular periods · Excess hair growth · Velvety dark patches · None

  ClientReferral

• Main goal

  Consultant judgement

  The one thing that bothers the client most.

  Client

• Event or deadline

  Consultant judgement

  Any date the client is working towards.

  Client

• Climate

  Consultant judgement

  Where the client lives and works.

  Hot and humid · Hot and dry · Temperate · Cold · Changes with the season

  Client

• Sun and light exposure

  Consultant judgement

  Time spent outdoors on a normal day.

  Mostly indoors · Mixed · Mostly outdoors

  Client

• Heat exposure

  Consultant judgement

  Heat can drive melasma.

  Cooking over open flame · Very hot showers · Hot workplace · None

  Client

• Sweat, sport and swimming

  Consultant judgement

  How often.

  Daily · Weekly · Rarely

  Client

• Friction and clothing

  Consultant judgement

  Tight clothing, straps, rubbing.

  Client

• Hair removal

  Consultant judgement

  Method used.

  Razor · Wax · Cream · Laser · None

  Client

• Sleep and stress

  Consultant judgement

  Self-reported.

  Good · Fair · Poor

  Client

• Sunscreen habit

  Consultant judgement

  How often, honestly.

  Daily · Sometimes · Rarely · Never

  Client

• Monthly budget

  Consultant judgement

  For products.

  Client

• Routine steps

  Consultant judgement

  How many steps the client will really follow.

  2 to 3 · 4 to 5 · 6 or more

  Client

• Where they shop

  Consultant judgement

  And what is hard to find locally.

  Client

Triggers

• Sun and visible light
• Acne
• Friction
• Hormonal
• Heat
• Chemical irritation
• Aggressive treatment
• Infection or dermatitis
• Wound healing

Zones

Scales and sources

These scales and guidelines belong to their authors. The platform applies them; it did not create them.

• Fitzpatrick skin phototypeFitzpatrick TB, 1975. Validity of self-report: Eilers S et al., JAMA Dermatology 2013.
• Monk Skin Tone ScaleEllis Monk, Harvard University; released publicly with Google in 2022. Clinical comparison: Lipnick et al., British Journal of Dermatology 2026.
• Individual Typology Angle (ITA°)Chardon A, Cretois I, Hourseau C, International Journal of Cosmetic Science 1991. Image-based estimation: Ulrich et al., npj Digital Medicine 2025.
• Roberts Skin Type Classification SystemRoberts WE, Journal of Drugs in Dermatology 2008. Used in adapted form.
• Sensitive Scale-10Misery L et al., Acta Dermato-Venereologica 2014.
• Definition of sensitive skinInternational Forum for the Study of Itch (IFSI), Misery L et al., 2017.
• Investigator's Global Assessment (acne)US FDA, Acne Vulgaris: Establishing Effectiveness of Drugs Intended for Treatment (guidance for industry, 2018). Photo versus in-person agreement: Singer S et al., JAMA Dermatology 2018.
• Global Acne Grading SystemDoshi A, Zaheer A, Stiller MJ, International Journal of Dermatology 1997. Limited evidence of validity and reliability: Agnew T et al., Journal of Clinical and Aesthetic Dermatology 2016.
• Acne severity and referral (NICE NG198)National Institute for Health and Care Excellence, 2021.
• Modified Melasma Area and Severity Index (mMASI)Pandya AG et al., Journal of the American Academy of Dermatology 2011.
• Photonumeric facial ageing scale for African American skinChien AL et al., Journal of the National Medical Association 2018.
• Weighted 7-point checklist for changing skin lesions (NICE NG12)National Institute for Health and Care Excellence, NG12.
• Skin infection referral signs (NICE NG141)National Institute for Health and Care Excellence, NG141.