How does Fitzpatrick skin type influence treatment parameters such as fluence and pulse duration?

• A. Higher Fitzpatrick types require higher fluence and shorter pulse durations to minimize pigmentary changes and burns.
• B. Higher Fitzpatrick types require lower fluence and longer pulse durations to minimize pigmentary changes and burns.
• C. Skin type has no influence on fluence or pulse duration.
• D. Lower Fitzpatrick types require higher fluence and shorter pulse durations.

Answer: (B)

Melanin in the epidermis determines how much laser energy is absorbed by the skin, so darker skin (higher Fitzpatrick type) is more prone to pigment changes and burns when treated with standard settings. To protect the skin while still effectively targeting the hair follicle, the fluence is lowered and the pulse duration is lengthened. This reduces the peak energy reaching the epidermis and allows heat to build more gradually in the follicle, balancing safety with effectiveness. In lighter skin, less epidermal melanin means higher fluence and shorter pulses can be used safely.