I'm Older Than I Look

Summary and Comment |
May 28, 2014

I'm Older Than I Look

  1. Mark V. Dahl, MD

Among features that influence an individual's perceived age, length of the nasolabial fold has the most impact.

  1. Mark V. Dahl, MD

Perceived age and biological age often differ from chronological age. Intrinsic and extrinsic factors contribute to changes in facial skin, such as wrinkling, color abnormalities, and sag. Efficacy of cosmetic treatments is often gauged by the amount of “youthful change.” The cosmetic industry needs an objective, fast, and cheap method to determine perceived age.

Investigators developed an algorithm that uses objective measures of phenotypic features to estimate perceived age. The algorithm employed artificial intelligence, supervised mathematical learning, and error retropropagation. The artificial neural network was trained 10 times using standard k-fold cross-validation methods.

Participants were 120 female volunteers aged 41 to 49. Women with medical and cosmetic skin disorders, recent smokers, and skin tanners were excluded. Twenty-two biophysical features, including eyebrow position, perioral and frontal wrinkles, labiomental groove, pigmentation, vascular elements, and roughness, were analyzed. Perceived age was also assessed by an expert panel of six dermatologists, who assigned an age to each subject based on experience and the validated Carruthers grading scale.

The contributions made by each of the 22 variables to perceived age were tabulated. Length of the nasolabial groove was the most relevant, followed by the variation/heterogeneity index of hemoglobin, depth of the nasogenian groove, eyebrow position, method of distribution of hemoglobin, hemoglobin concentration, distribution of melanin, and roughness, in that order. Left and right periorbital wrinkles were at the bottom of the list. The algorithm correctly classified age with 92% accuracy compared against the expert panel.


Although crow's feet wrinkles are often pictured in cosmetic ads, the appearance of fine lines and wrinkles is not a powerful determinant of perceived age. Degree and distribution of redness and depth of grooves were much more significant determinants. Objective measurement of these aging signs is not only useful for gauging the effectiveness of cosmetics and cosmetic procedures but may also help personalize cosmetic treatments to optimize youthful change.

Editor Disclosures at Time of Publication

  • Disclosures for Mark V. Dahl, MD at time of publication Consultant / Advisory board Makucell, Inc.; Castle Diagnostics, Inc.; Up To Date; Ulthera, Inc.; Biohealth, Inc. Equity Elorac, Inc.; Makucell, Inc. Editorial boards UpToDate


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