Objective Skin Color Measurement May Improve Laser Safety and Treatment Precision

Objective assessment of skin pigmentation may improve parameter selection and reduce complications in visible light–based dermatologic procedures, according to E. Victor Ross, MD, during his Music City SCALE 2026 session, “Objective Skin Color Assessment and Its Role for Parameter Selection for Visible Light Technologies.”​ The session focused on limitations of visual skin typing and the growing role of instrumental melanin measurement in laser and light therapies.

Fitzpatrick skin typing (FST), developed in 1975, remains widely used in clinical practice. Originally designed to guide methoxsalen dosing in photochemotherapy for psoriasis, FST continues to influence treatment selection for lasers and other energy-based devices. However, Dr Ross emphasized that visual assessment alone is often unreliable.

“Visual assessment of background epidermal melanin content is often inconsistent and inaccurate,” he noted. Inaccurate estimation can affect both safety and efficacy. Overestimating melanin content may lead to conservative settings and undertreatment, whereas underestimating pigmentation can result in excessive fluence, increasing the risk of vesiculation, dyspigmentation, and scarring.

The session explored whether instrumental measurement of melanin content could support more precise parameter selection. Melanin optical density (MOD) was presented as a marker of epidermal risk, with higher MOD associated with lower fluence thresholds for injury.

The melanin index, a quantitative measure proportional to MOD, can be obtained using objective assessment devices. One example discussed was the Skintel device, which measures diffuse reflectance at 680 nm, a wavelength selected because melanin absorption predominates while hemoglobin interference is minimized.

The presentation highlighted advantages of instrumental systems, including “superior accuracy and reproducibility,” simplified calibration, and reduced sensitivity to ambient environmental conditions. These measurements may provide more standardized evaluation than subjective visual typing alone.

Dr Ross emphasized that objective tools should complement—not replace—clinical judgment. “Instrumental meters, combined with clinical judgment, can help clinicians avoid both undertreatment and overtreatment,” he stated.

The implications are particularly relevant in patients with darker skin phototypes or variable baseline pigmentation, where treatment selection carries increased risk. More accurate assessment may allow clinicians to optimize fluence while minimizing complications.

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Reference
Ross EV. Objective skin color assessment and its role for parameter selection for visible light technologies. Presented at: Music City SCALE Symposium; May 13–17, 2026; Nashville, TN.