Development of a Photonumeric Lip Health Scale

Abstract

Background:The lips are important facial anatomic features with particular vulnerability to environmental damage, yet they have received little attention in the dermatologic literature. A photonumeric rating scale for clinically assessing lip heath is needed to advance lip research. Objective: To develop a photonumeric lip health assessment scale for clinical use that can evaluate the efficacy of products for improving lip health. Methods: The VISIA ® -CR 4.3 system was used to photograph the frontal face of 103 subjects with Fitzpatrick skin types I-III exhibiting a range of lip health status based on the key characteristics of lip shine, texture, and vermilion border. An expert panel comprising 3 dermatologists independently rated the images based on the proposed rating scale. Images with ≥75% rater agreement were redistributed to the panel for selecting the final images and verification of the final scale. Results: The panel selected 15 images for the final scale: 5 for each of the key characteristics (lip shine, texture, and vermilion border) and 1 for each ordinal rating of 0-5 within a characteristic (eg, 0=very shiny, 5=very dull). All of these images achieved 100% agreement among the raters. Conclusion:This scale provides healthcare professionals and researchers a way to evaluate current lip health, track improvement, and evaluate the efficacy of treatments. It can be used to communicate with patients during discussions about lip conditions, recommending treatments, and setting goals. The scale also provides a research tool to evaluate different formulations for developing lip care products.