Evaluation and Comparison of Dermoscopic Features of Facial Aging between Males and Females in the Indian Population: A Prospective, Cross-sectional, Observational Study

Background: Facial aging is a multifactorial process influenced by intrinsic and extrinsic factors, with esthetic implications that drive the pursuit of objective assessment tools. Traditional methods for evaluating facial aging often lack holistic clinical relevance, particularly when anti-aging treatments are applied globally rather than regionally. This study aimed to assess facial photoaging using a validated dermoscopic tool, the Dermoscopic Photoaging Scale (DPAS), and compare it with clinical grading through Glogau’s scale. Aims and Objectives: To evaluate and compare the dermoscopic features of facial aging in males and females in the Indian population. Materials and Methods: A cross-sectional study was conducted on 172 Indian patients aged 30–80 years attending a dermatology outpatient department in South India. A detailed history, including sun exposure, occupation, smoking, sleep patterns, and skincare practices, was documented. Standardized facial photographs were taken, and clinical aging was graded using Glogau’s classification. Dermoscopic evaluation was performed across three facial regions (forehead, malar areas, and chin) using the Medicam 1000 Fotofinder device. DPAS scores were calculated based on 11 specific dermoscopic features, with a maximum possible score of 33. Results: Males had significantly higher mean DPAS scores (8.33) than females (7.3), indicating more severe photoaging ( P = 0.003). DPAS scores increased progressively with age in both genders. Common findings included hyper/hypopigmented macules, yellow papules, and superficial wrinkles. Deep wrinkles and yellowish discoloration were more prevalent in older males, while telangiectasias were more common in younger females. A positive correlation was observed between Glogau grades and DPAS scores. Significant associations were also found between DPAS and smoking (in males), sun exposure, and sleep duration. Limitations: The single-centered study design and small participant size, the absence of female smokers, and the exclusion of external factors such as stress, pollution, dietary habits, body mass index, associated comorbidities, hormonal influences, and long-term drug intake, which could contribute to skin aging, were the main limitations of our study. Conclusion: DPAS provided a comprehensive and objective assessment of facial photoaging. It effectively captured age- and gender-related dermoscopic changes and reflected lifestyle influences, suggesting its utility in evaluating and guiding timely anti-aging interventions.