Update on Techniques for the Quantitation of Facial Skin Characteristics Marty O. Visscher, PhD a,b, *, Brian S. Pan, MD b,c INTRODUCTION Human beings use skin features including color uniformity, color distribution, and texture to infer the physiologic health status of others. 1 For example, visual responses to facial-image sets standardized for shape and surface features were recorded with eye-tracking methods. Those images with more uniform skin coloration drew more attention and were perceived to be younger than those with greater color variability. 2 The distri- bution of skin color on the face has also been associated with the perception of overall health. 3 These factors can reduce the perceived age by as many as 20 years. 4,5 This homogeneity in skin color is also related to perceived age and health in men. 6 Color itself influences the perception of Funding Sources: None. Conflict of Interest: None. a Skin Sciences Program, Division of Plastic Surgery, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA; b Division of Plastic, Reconstructive & Hand/Burn Surgery, Department of Surgery, College of Medicine, University of Cincinnati, 231 Albert Sabin Way, Cincinnati, OH 45267, USA; c Division of Plastic Surgery, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA * Corresponding author. Division of Plastic Surgery, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229. E-mail address: Marty.visscher@cchmc.org KEYWORDS  Facial skin  Facial skin restoration  Facial skin coloration  Photodamage KEY POINTS  Homogeneity of facial skin color strongly influences the perception of age, and increased uniformity can reduce the perceived age by as many as 20 years.  Visual scales are used to characterize the extent of photoaging, evaluate treatment response, appraise improvement, and determine patient satisfaction; however, none have been established as the universal standard for evaluation.  The delivery of optimum outcomes and maximum patient satisfaction in the treatment of facial pho- todamage depends on selection of effective treatment modalities and measurement of changes in perceived age.  Although it is used routinely in the skin-care industry to demonstrate treatment effects, particularly for cosmetics, color imaging has not been used to evaluate cutaneous conditions in health care.  Standardized digital imaging techniques can be used successfully to quantify attributes of facial photodamage and treatment response, including dyschromia (solar lentigines, hyperpigmentation), erythema, telangiectasias, elastosis, rhytides, and textural changes. Biomechanical methods quan- tify elasticity.  The application of these methods has the potential to assist the plastic surgeon in achieving patient expectations. Facial Plast Surg Clin N Am 21 (2013) 7–19 http://dx.doi.org/10.1016/j.fsc.2012.10.002 1064-7406/13/$ – see front matter Ó 2013 Elsevier Inc. All rights reserved. facialplastic.theclinics.com