Skin typing system streamlines dermatologic care

National report - A classification system featuring 16 skin types empowers patients while saving them and their dermatologists time, says Leslie S. Baumann, M.D., professor of dermatology, University of Miami Miller School of Medicine, Miami, and originator of the system.

The Baumann Skin Typing System uses a 64-point questionnaire to classify skin types depending on where the skin falls in terms of the following sets of variables:

Oily (O) or dry (D)

The stratum corneum, natural moisturizing factor (NMF), hyaluronic acid (HA) and sebum production all factor into the skin's hydration level, Dr. Baumann tells Dermatology Times.

To treat dry skin, Dr. Baumann says that topical products focus on repairing the stratum corneum's three key components - ceramides, cholesterol and fatty acids. Additionally, she says patients can repair or replenish cholesterol and fatty acids through a healthy diet.

Sensitive (S) or resistant (R)

"By sensitive," she explains, "I mean that one gets either acne or rosacea, or burning and stinging or allergies from skincare products."

More specifically, she says that sensitive skin is best described as hyperreactive skin characterized by a weaker stratum corneum, which leaves it more vulnerable to exogenous factors such as cold, heat, temperature and wind, as well as pollution and excessive use of topical agents.

Patients with resistant skin possess a solid stratum corneum that seals out allergens and potential irritants, Dr. Baumann says. However, such patients may fail to derive benefits from skincare products not potent enough to penetrate a resistant stratum corneum.

Conversely, she says, "One must take great care in selecting appropriate products for sensitive skin."

In particular, she says that treatment must address the underlying nature of a patient's particular sensitive skin subtype, whether it's the acne, rosacea, stinging or allergic subtype.

Pigmented (P) or nonpigmented (N)

Dr. Baumann explains, "These variables have nothing to do with race - rather, does one get pigmented disorders such as melasma or not?"

A white person with freckles and red hair would be categorized as type P, as would a person of color with melasma, she adds. In fair-skinned individuals, Dr. Baumann says, type P is most often correlated with type W due to a causal link between sun exposure and rhytides and solar lentigos.

To treat patients with type P skin, she recommends formulations containing hydroquinone, kojic acid, arbutin, Tyrostat (Fytokem Products) and mulberry extract. Patients with ORPW or DRPW skin furthermore benefit from vitamin C and retinoids, while products containing soy or niacinamide can prevent hyperpigmentation from occurring, Dr. Baumann adds. As for sunscreen, she says that, while it's important for fighting photoaging and skin cancer, it's less effective than sun avoidance for preventing avoidable forms of skin pigmentation.

Wrinkled (W) or tight (T)

"The W/T parameter is the only skin parameter somewhat within an individual's control," Dr. Baumann says.

While one cannot change one's genetic predisposition toward pigmentation problems, one can alter one's lifestyle to eliminate or reduce behaviors - such as poor nutrition, smoking and sun exposure - that contribute to extrinsic aging, she explains.