I will be happy to understand that better. i understand that we should treat the client by there ethnic back round and by there skin type.. my client mom is Scottish her dad Jamaican . by the skin type evaluation she is skin type 3 ' by looking at her skin she is 4 and by going genetic she is 5. i"m confuse!!!!! please if any body can give me tip for that. what is the right way to get the right skin type. thank you all!!!!!!!!!!!!!

In my medspa she'd be a 5. Ethnic heritage trumps all other indications if there is any African American or East Indian heritage. test spot each part of the body being treated every visit- don't rely on past test spot information.

Speaking of test spots how long do you normally wait for a result?

Also do i always need to look for adema??? some times there is no adema?

Skin type 5 -we wait 24 hrs.
You're right sometimes there is no edema- but edema is not always the only sign of a thermal injury to the skin.

I'm getting a little concerned by your questions- where is your medical director to help you with this? What are the established protocols for treating a Skin Type 5 in your medspa?

Agree with BetterOffNow. Treat her as a skin type 5 or you are going to get into trouble with this one. We actually wait longer after a test site, usually 3 weeks, because signs of inflammation may be subtle, especially to a non-experienced clinician. Much better to go slow and stay out of trouble than to have to deal with it for months or longer. You need guidance from your medical director, who I hope is experienced, actively involved, and cautious.

Anyone with African American, American Indian or East Indian that close in their blood line should be treated as a 5. And not the laser manufacturer's settings either, those are usually too high. Test spot and have them come back in a month. It would be best to use a yag, never an alexandrite. Even the lowest setting on an alexandrite could cause a burn. You should always look for edema, as well as ask the client how they are feeling through the process. You also need to check for a history of keloids or hypopigmentation, which is prominent in African Americans. My protocol is "If in doubt - 40/40".

We use an IPL and wait 24 hours only after the test spot on skin type 5's. It is at the Medical director's discretion what the protocols are per skin type depending on the laser used.

I hope the OP comes back and lets us know what their medical director is recommending, and that they are in the loop for treating this patient.

RE: Fitz 5 skin type: Agreed that you ALWAYS use the genetic skin typing. Best not to treat these patients with Thermal Energy like IPL. This is too risky. If you wish to treat skin type 5's I would recommend the Laser Genesis or other mild ablative modalities that treat imperfections slow and steady without thermal injury. I don't know where you are located but we have a continuing education program in Arizona that you might benefit from. There is an online version that is interactive with our Dermatologist. This may be helpful to you and/or your Medical Director. If you are interested drop me a line at info.amlasers@gmail.com