A Holistic Approach to Assessing and Enhancing Skin Quality

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Skin quality plays a pivotal role in facial attractiveness, influencing perceptions of age, health, and overall well-being.¹ This phenomenon extends across demographics and cultures, with individuals striving for healthy, youthful, and flawless skin; a desire intensified by the omnipresence of social media and virtual interactions.² The emotional and psychological impacts of skin quality on self-perception, mental health, and social interactions cannot be overstated. Despite this, a recent study noted dermatology clinicians have historically lacked a standardized, holistic assessment tool to evaluate and address various skin conditions comprehensively.³

Existing evaluation scales typically focus on isolated aspects such as acne scars, rosacea, or pigmentation.¹ However, these researchers noted these approaches fail to capture the multifaceted nature of skin quality. Recent surveys of clinicians have revealed a strong consensus on the need for a comprehensive assessment tool, with 81% expressing dissatisfaction with the current options.³

Development of the Skin Quality Scale (SQS)

To address this gap, researchers developed a dynamic Skin Quality Scale (SQS)through the collaboration of 10 global experts in dermatology and aesthetic medicine. This multidisciplinary panel, representing diverse geographic backgrounds, aimed to create a holistic and accessible tool for clinicians.

The SQS categorizes skin quality into 4 primary domains:

• Texture: This domain evaluates pore size, lines, and scars, assessing the overall surface quality.
• Discoloration: This aspect includes skin tone evenness, redness (erythema), dyspigmentation, and dullness.
• Firmness: Assessing the skin's structural integrity and resistance to sagging or laxity.
• Hydro-Lipid Balance: Evaluating the skin's moisture levels, distinguishing between dryness and oiliness.

Each domain contains measurable aspects that can be assessed visually, through tactile evaluation, or via self-assessment. The SQS employs a 4-point severity evaluation scale, ranging from 0 (none) to 3 (severe), allowing clinicians to create a personalized profile for each patient. The results are visually represented on a radar chart, facilitating clear communication about treatment priorities and progress.

Real-World Application of the SQS

According to the study, the SQS was validated through an online survey completed by over 40 aesthetic medicine clinicians, primarily dermatologists, who reported positive experiences with its usability and effectiveness. Clinicians indicated that the SQS enhanced the collaborative approach to patient assessment, improving treatment planning and follow-up. In clinical trials, the SQS demonstrated its practical applicability, with case studies showcasing its effectiveness in identifying and addressing patient concerns, leading to measurable improvements in skin quality over time.

For example, 1 case study highlighted the SQS's role in identifying specific issues in a 54-year-old female patient. Researchers said initial assessments pinpointed concerns regarding skin lines and dryness, while follow-up evaluations after treatment revealed significant improvements in these areas. Similar positive outcomes were noted in other patients across various skin concerns, illustrating the SQS's utility in guiding effective treatment strategies.

Conclusion

Researchers said the introduction of the Skin Quality Scale marks an advancement in the assessment of skin quality in clinical practice. By offering a holistic approach that encompasses multiple dimensions of skin health, the SQS allows dermatologists and clinicians to provide more personalized and effective care. The overwhelming approval from surveyed clinicians underscored to researchersthe SQS's potential to transform how skin quality is assessed, prioritized, and treated, ultimately leading to enhanced patient satisfaction and outcomes.

As dermatologists increasingly confront the complexities of skin quality and its impact on patients' lives, the study stated tools like the SQS will become important in achieving holistic, patient-centered care. Researchers noted that continued use and refinement of the SQS in clinical settings will further enhance its effectiveness, ensuring that clinicians are well-equipped to meet their patients' diverse needs and expectations.

Reference

1. Fink B, Grammer K, Thornhill R. Human (Homo sapiens) facial attractiveness in relation to skin texture and color. J Comp Psychol. 2001;115(1):92-99. doi:10.1037/0735-7036.115.1.92
2. Fink B, Matts PJ, Brauckmann C, Gundlach S. The effect of skin surface topography and skin colouration cues on perception of male facial age, health and attractiveness. Int J Cosmet Sci. 2018;40(2):193-198. doi:10.1111/ics.12451
3. Martschin C, Bahhady R, Li J, et al. Development and validation of a novel holistic skin quality assessment scale. J Cosmet Dermatol. Published online October 9, 2024. doi:10.1111/jocd.16615