Gender-related differences in the facial aging of Chinese subjects and their relations with perceived ages.

Objective: To describe the progressing severity of facial signs and their links with perceived age, of Chinese men and women.

Methods: Full-face photographs of 438 Chinese subjects (220 men, 218 women) differently aged (18-80 years) were taken. These photographs afforded a zoom on 5 facial signs of aging: forehead and crow's feet wrinkles, nasolabial fold, marionette lines and ptosis of the lower face. A panel of 15 experts graded each sign, using the Asian skin aging atlas reference. A naïve panel of 80 Chinese women (20-60 years) was asked to attribute an apparent age.

Results: Despite slight differences in severity between genders, men and women share in common a rather regular progression rate, correlated with perceived ages. 15% of men were judged older by more than 10 years, and all 5 signs were found more severe than the means of the other 85%. Forehead and Crow's feet wrinkles appear more pronounced in men. Ptosis is slightly more pronounced in women. Nasolabial fold does not differ. Marionette lines show distinct changes: those of men show a lessened severity and a slower rate of progression. In contrast with changes in facial signs with real ages, the upper face seems privileged in the perception of ages in women whereas the latter seems more focusing on its lower part in men.

Conclusion: The facial skin aging process in Chinese subjects presents an almost linear progression with perceived ages, common to both genders, at the exception of marionette lines that are more marked and more rapidly progressing in women.