Chronological Aging in African-American Skin: A Reliable Photonumeric Scale Demonstrates Age and Body Mass Index as Contributing Factors

Anna L. Chien, Ji Qi, Radhika Grandhi, Tamia Harris-Tryon, Noori Kim, Min Soo Jang, Omolara Olowoyeye, Diane Kuhn, Sherry Leung, Barbara M. Rainer, Flora Poon, Sabrina Sisto Alessi César, Jean Suh, Nancy Cheng, Ginette A. Okoye, Sewon Kang

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background: Increased photoprotection by natural melanin allows for African-Americans to be less impacted by photoaging than Caucasians. However, less is known about chronological aging in this population. Objective: To create a photonumeric scale for African-Americans to evaluate chronological skin aging and to explore contributing elements to intrinsic aging. Methods: Standardized photographs of the upper inner arm were taken from 75 African-American participants. Five participants were chosen as standards to create a 9-point photonumeric scale (0 = none, 8 = most severe). The scale was utilized by three blinded dermatologists to independently rate participants’ photographs. Results: The interrater agreements were 0.768 (95% CI: 0.671–0.834) for trial 1 and 0.725 (0.608–0.794) for trial 2. The intrarater agreements were 0.757 (0.596–0.875), 0.850 (0.771–0.903), and 0.790 (0.686–0.855) for the three raters. Averaged chronological aging scores were correlated with participants’ survey responses, which revealed age as a significant predictor (r = 0.72, p < 0.001). Limitation: Our study was limited by the sample size, although the number of study participants was similar on a investigation in Caucasians. Conclusion: This study created the first reliable photonumeric scale for chronologic skin aging in African-Americans and found increased age and greater BMI as contributors to intrinsic skin aging phenotype in this population.

Original languageEnglish (US)
Pages (from-to)534-539
Number of pages6
JournalJournal of the National Medical Association
Issue number6
StatePublished - Dec 2018


  • African Americans
  • Aging
  • Caucasians
  • Ethnic skin
  • Sun-exposed skin
  • Sun-protected skin

ASJC Scopus subject areas

  • General Medicine


Dive into the research topics of 'Chronological Aging in African-American Skin: A Reliable Photonumeric Scale Demonstrates Age and Body Mass Index as Contributing Factors'. Together they form a unique fingerprint.

Cite this