Perioral wrinkles are associated with female gender, aging, and smoking: Development of a gender-specific photonumeric scale

Background: Perioral wrinkling is commonly reported among older adults, but its objective evaluation and causes remain poorly understood. Objective: We sought to develop a photonumeric scale for perioral wrinkling and to elucidate contributory lifestyle factors. Methods: In this cross-sectional study, we recruited participants for facial photographs and a survey. A gender-specific photonumeric scale for perioral wrinkling was developed and used by 3 graders to evaluate participant photographs. Scores and survey responses were used to create a multiple regression model to predict perioral wrinkling. Results: In all, 143 participants aged 21 to 91 years were enrolled. Intraclass correlation coefficient values for interrater and intrarater reliability were high ([0.8) across 2 trials and 3 graders. A multiple regression model for prediction of perioral wrinkling severity included age, gender, and years of smoking as variables. Limitations: The study was limited by sample size and a predominantly Caucasian study population. Conclusion: We created a photonumeric scale that accounts for gender differences in perioral wrinkling and highlighted contributory variables to photoaging in this anatomical location.