Introduction: The Fitzpatrick skin scale has long been used as a proxy for skin tone categorization. However, its initial creation was to classify reactivity of white skin to ultraviolet A radiation. A reported one-third of dermatologists conflate the Fitzpatrick skin scale for race and ethnicity. Approximately half of the dermatologists also reported utilizing the Fitzpatrick scale to describe skin color. The goal of this study was to compare the Fitzpatrick scale to skin color and ethnicity in a larger, cohort including the full spectrum of skin tones. Methods: Subjects completed a standardized questionnaire. The questionnaire encompassed subjective classification methods: self-reported skin color descriptors (very fair, fair, olive, light brown, dark brown, and very dark), self-assessed Fitzpatrick skin type (I-VI) and ethnicity. The questionnaire included the following ethnicities: White, Asian, African American or Black, Hispanic or Latino, Native Hawaiian or Pacific Islander, Multiple Ethnicities, and Other. If more than one ethnicity was chosen, the subject was reported as “multiple ethnicities.” Chi-squared tests were performed comparing skin color and ethnicity to Fitzpatrick skin type. Results: 440 subjects completed the questionnaire. Chi squared test revealed that each Fitzpatrick type was composed of significantly different proportions of skin colors (p