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

Anna L. Chien, Ji Qi, Nancy Cheng, Thy Thy Do, Missale Mesfin, Robert Egbers, Wenfei Xie, Conroy Chow, Heather Chubb, Dana Sachs, John Voorhees, Sewon Kang

Research output: Contribution to journalArticle


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.

Original languageEnglish (US)
Pages (from-to)924-930
Number of pages7
JournalJournal of the American Academy of Dermatology
Issue number5
StatePublished - May 1 2016



  • crows feet
  • gender differences
  • perioral wrinkling
  • photoaging
  • photonumeric scale
  • smoking

ASJC Scopus subject areas

  • Dermatology

Cite this