A Case for Reframing ‘Skin of Color’

The term that transformed dermatology is now blurring the very distinctions it was meant to sharpen.

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The Fitzpatrick scale inadequately represents darker skin, as types V and VI were added based on ethnicity rather than biological measurement.
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The term 'skin of color' has evolved to promote equity in education and research but can obscure important clinical differences.
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'Skin of color' serves as both an equity framework and a clinical shorthand, which may not align with individualized dermatological care.
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The authors propose a granular approach to 'skin of color' that includes pigment phenotype, ancestry, sociocultural context, and clinical risk modifiers.
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Clinicians should specify which aspect of 'skin of color' is relevant in clinical or research contexts to enhance clarity and precision.

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