A validated grading scale for forehead lines.
BACKGROUND
As with other facial wrinkles, the gradual loss and disorganization of collagen fibers and elastin, connective tissues that provide underlying support for skin, cause horizontal forehead rhytides in large part.


OBJECTIVE
To develop the Forehead Lines Grading Scale for objective quantification of horizontal forehead rhytides at rest and with expression and to establish the reliability of this photonumeric scale for clinical research and practice.


METHODS
The Forehead Lines Grading Scale is a 5-point photonumeric rating scale that was developed to objectively quantify resting (static) and hyperkinetic (dynamic) forehead lines. Inter- and intrarater variability was assessed by computing intraclass correlation coefficients.


RESULTS
The agreement between the experts was highly significant. Bubble plots (bivariate scatter plots) demonstrated linearity in judgment by the experts.


CONCLUSIONS
The 5-point photonumeric scale generated spans the severity of forehead lines for which patients commonly seek correction. The scale is well stratified for consistent rating.
Carruthers
Alastair
A
Department of Dermatology and Skin Sciences, University of British Columbia, Vancouver, British Columbia, Canada. alastair@carruthers.net
Carruthers
Jean
J
Hardas
Bhushan
B
Kaur
Mandeep
M
Goertelmeyer
Roman
R
Jones
Derek
D
Rzany
Berthold
B
Cohen
Joel
J
Kerscher
Martina
M
Flynn
Timothy Corcoran
TC
Maas
Corey
C
Sattler
Gerhard
G
Gebauer
Alexander
A
Pooth
Rainer
R
McClure
Kathleen
K
Simone-Korbel
Ulli
U
Buchner
Larry
L
D004954:Esthetics / Q000145:classification*; D005260:Female; D005546:Forehead / Q000033:anatomy & histology*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008297:Male; D010781:Photography / Q000379:methods*; D015203:Reproducibility of Results; D015595:Skin Aging