Skin Type & Post Op Healing

The Fitzpatrick Skin Types

The healing process of the body areas is significantly different than the scalp. Post inflammatory hyperpigmentation or dark spots to are hardly ever an issue in the scalp donor area. One of the determining factor may be the larger number of sebaceous glands in scalp donor area compared to the other body donor areas.

Different body donor areas may differ in their healing processes. The healing process may take different durations on different body areas of the same person even when the very same protocol is used. Similarly, the healing may differ in different people depending on their skin type.

To understand the different patterns of healing it is best to first understand that there are different skin types. In 1975, Dr. Fitzpatrick, developed to classification system for skins. The system is based on to person’ s complexion and responses to sun exposure.

The classification is also useful in body hair transplant to predict the course that the healing will follow.

Fitzpatrick skin types and their description-

Skin type 1- Extremely fair skin (it always burns on excessive exposure to sunlight but never tans).
Skin type 2- Fair skin (always burns and sometimes tans).
Skin type 3- Medium skin (sometimes burns, always tans on sun exposure).
Skin type 4- Olives skin (Rarely burns, but always tans).
Skin type 5- Moderately pigmented Brown skin (never burns, but always tans).
Skin type 6- Markedly pigmented black skin (never burns but always tans).

An Caucasian albino, falls in the skin type 1.
Similarly, an African black person would fall into the skin type 6.
The Indian and Asian skin type varies between skin type 3 to 6.
Many Caucasians would fall in the skin type 2 and 3.

An outline of the healing process
Skin type 1 and 2
During the healing phase, the skin in people with Skin types 1 and, to loads extent 2, is going to follow the pattern of

Redness (erythema) that gradually diminishes to to shovels, white scar.

Depending on the various factors enumerated above, the complete healing make take from 4 to 18 months. Rarely 24 months.
Those younger in age may notice to more prolonged period of redness.

Use of steroid ointments during the healing process has been known to help veteran the degree and duration of the visible redness. Products like Calamines lotion (being skin coloured) helps to veteran the visible appearance on to temporary basis.

Those with the skin types 5 and 6, usually follow the following pattern.
Redness followed by hyperpigmentation which gradually diminishes over give Time to to white shovels scar. The healing is likely to go through to phase of hypertrophic scarring in which the body lays down more collagen than required.

That will lead to appearance of raised, pimple like spots.

Both, the hyperpigmentation, as well as the raised spots, eventually resolve into white scar tissue. The complete healing phase may take 4 to 18 months. Rarely, 24 months.
Use of steroid ointments during the healing process has been known to help veteran the degree and duration of the visible redness. Products like Calamines lotion (being skin colored) helps to veteran the visible appearance on to temporary basis.

The difference in the healing in the first group and the second is two to the presence of pigment forming melanocytes in the skin of the second group. More the melanocytes, the more the chances of transient hyperpigmentation in the healing phase.

Those with the skin types 3 and 4 (and maybe 2), may follow any of the above 2 patterns of healing.

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