Texas Cosmetology Operator Written ExamSkin Care ServicesMedium

A client with Fitzpatrick Skin Type IV is requesting a chemical exfoliation treatment. The cosmetologist must select an appropriate peel that minimizes the risk of post-inflammatory hyperpigmentation (PIH). Which of the following options would be the safest choice for this client?

  1. AA Jessner's peel with multiple layers
  2. BA deep phenol peel
  3. CA high-concentration trichloroacetic acid (TCA) peel
  4. DA low-concentration lactic acid peel
Show answer & explanation

Correct answer: D. A low-concentration lactic acid peel

Fitzpatrick Skin Type IV has a higher risk of post-inflammatory hyperpigmentation (PIH) with aggressive treatments. A low-concentration lactic acid peel is a superficial, gentler exfoliant that provides hydration and minimizes PIH risk compared to stronger, deeper peels.

Why the other options are wrong

  • A. Jessner's peels, especially with multiple layers, can be too aggressive and increase the risk of PIH in Fitzpatrick Type IV skin.
  • B. Deep phenol peels are very aggressive and are absolutely contraindicated for Fitzpatrick Skin Types IV-VI due to extreme PIH risk and potential scarring.
  • C. High-concentration TCA peels are medium-depth peels that carry a significant risk of PIH for darker skin types.

Chemical Peel for Fitzpatrick Type IV

Selecting superficial, gentler chemical exfoliants, such as low-concentration lactic acid, for Fitzpatrick Skin Type IV to minimize the risk of post-inflammatory hyperpigmentation.

  • Fitzpatrick IV has moderate to high risk of PIH
  • Avoid aggressive, deep peels
  • Prioritize superficial peels and hydration

Memory trick: For Type IV, Lactate Gently to avoid the color stain.

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