Skin Typing Worksheet Name ___________________________________________ Date ____________________ Skin 0 1 2 3 4 Score Light Blue or Blue or Hazel or Brownish What is your eye color? Dark Brown Grey Green Light Brown Black Dark Blonde What is your natural Red or Blonde or Chestnut Dark Brown Black hair color? Sandy Red Brown What is the of Pale with Dark your skin (unexposed Reddish Very Pale Light Brown Beige Tint Brown areas)? Do you have freckles Many Several Few Incidental None on exposed areas? Painful, Burns, What happens when Blistering sometimes- you stay in the sun too followed by Rarely burn Never burn followed by long? peeling and peeling peeling Turn dark To what degree do you Hardly ever Reasonable Tan very Light tan brown turn brown? or not at all tan easily quickly How does your face Very Very Sensitive Normal Resistant respond to the sun? sensitive resistant When did you last expose yourself to the More than 3 2-3 months 1-2 months Less than 1 Less than 2 sun, tanning beds, or months ago ago ago month ago weeks ago self-tanning creams? How is the area that you want treated Hardly ever Sometimes Often Always exposed to the sun? __________ Skin Score (total number) Skin Score Skin Type 0-7 I 8-16 II 17-25 III 26-30 IV Over 30 V - VI Signature ______________________________________
Skin Typing Worksheet Name ___________________________________________ Date ____________________ Skin Score 0 1 2 3 4 What is your eye color? Light Blue or Grey Blue or Green Hazel or Light Brown Dark Brown Brownish Black What is your natural hair color? Red or Sandy Red Blonde Dark Blonde or Chestnut Brown Dark Brown Black What is the of your skin (unexposed areas)? Reddish Very Pale Pale with Beige Tint Light Brown Dark Brown Do you have freckles on exposed areas? Many Several Few Incidental None What happens when you stay in the sun too long? Painful, and peeling Blistering followed by peeling Burns, sometimes- followed by peeling Rarely burn Never burn To what degree do you turn brown? Hardly ever or not at all Light tan Reasonable tan Tan very easily Turn dark brown quickly How does your face respond to the sun? Very sensitive Sensitive Normal Resistant Very resistant When did you last expose yourself to the sun, tanning beds, or self-tanning creams? More than 3 months ago 2-3 months ago 1-2 months ago Less than 1 month ago Less than 2 weeks ago How is the area that you want treated exposed to the sun? Hardly ever Sometimes Often Always Skin Score Skin Type 0-7 I 8-16 II 17-25 III 26-30 IV Over 30 V - VI __________ Skin Score (total number) Signature ______________________________________
Skin-Typing-Worksheet.docx