The large majority of research in the field of aesthetics and cognitive psychology focuses
on morphological features such as the nose, eyes, lips and facial shapes with symmetry
and dimorphism.
These are inherently salient aspects of the face that we notice, whether they’re proportionate
or disproportionate, attractive or unattractive.
However there’s one aspect we fail to pickup on, the skin.
Much like an unstealthy ninja, you only notice it when it’s bad but as preliminary studies
by Morris 1967 and Symons 1979 have found, healthy looking skin is an important determinant
of human physical attractiveness.
Well kept skin is taken as a ‘perceived health trait’ (Grammar and Thornhill 1994)
although whether it’s a good indicator of actual physical health, remains to be tested.
In one 2002 experiment by Jones Et al [a] different patches of male skin were shown
to female participants, with each patch varying by complexion, tone, evenness and blemishes
to find a correlation for attractiveness.
Likewise, a full face morph was created with deliberately adjusted skin tones, with the
paler, uneven skin on the right being found to be unhealthier than that of the left.
Healthier looking skin did significantly correlate with attractiveness.
More importantly, it shows that changing just one aspect of the face, something that for
most people, doesn’t require surgical intervention, can have a large impact.
So how can we define healthy skin?
In a 2014 study by Cruz and Mullet[b], there was a notable correlation with preferred skin
tone and attractiveness for both Mozambican and French participants.
This study is from a strictly biological perspective that compared different combinations of attractive
African and European features on different skin tones.
In other words, Koinophillic or genetically average faces for that particular race were
more attractive.
Having pale skin on African features becomes incredibly polarizing and vice versa.
White Kanye just doesn’t feel the same.
One interesting point from this study is that it equates the social benefits of darker skinned
Africans bleaching their skin to be a few shades lighter to be as equally as unfruitful
as Europeans tanning their skin to be a few shades darker.
Having an even complexion is more important than trying to artificially change the colour
of your skin otherwise your facial features won’t match.
Fink Et al[c] showed that in 2001 with greater skin homogeneity, i.e. the colour correlation
of neighbouring pixels as being perceived as more attractive.
The study also found smoother skin texture to be more attractive on women as an indicator
of immune health but did not support the theory that men find women with paler skin to be
more attractive as initially proposed by Van den Berghe and Frost 1986[d].
Lastly, slightly reddish skin was perceived as healthier and bluish as unhealthier although
this particular study is limited to only Caucasian faces unlike the previous.
To achieve a more homogeneous skin, it’s important to talk about blemishes and their
impact.
From Jaeger Et Al’s 2018[e] study on blemishes, cosmetic skin flaws are more closely linked
to trait perceptions rather than simply attraction.
In fact, the presence of blemishes may be a more salient indicator of health than smoothness
due to humans evolving with a host of skin diseases from the malignant smallpox to benign
acne.
Even the slightest skin blemishes can be a hit to facial attractiveness as Nesse 2005[f]
and Zebrowitz [g]and Rhodes 2004 found because the cost of a false positive (failing to identify
sickness) outweighs the cost of a false negative (avoiding a healthy person).
This heightened sensitivity to diseases causes acne to be such a troubling condition for
young adolescents when their self esteem is at its most vulnerable.
From the 2018 Jaegar Et al study, the negative effect of blemished skin outweighs the positive
benefits of smooth skin.
From that same paper, the benefits of smooth skin are halved when paired with skin blemishes.
Lastly, people with high pathogen disgust, we all know someone like that, perceived unattractive
participants as even more unattractive compared to those with low pathogen disgust (Park Et
al 2012).
This is because of what I mentioned at the beginning on blemishes being linked with trait
perception, essentially making it out to be worse than it is.
These are very important nuances to skin blemishes, because if you’re in the large majority
of this channel’s demographic of young adults, chances are you’ve dealt with or are dealing
with skin blemishes at some point in your life.
The most common blemish would likely be acne vulgaris.
Although its common to have the occasional singular breakout here and there, which isn’t
acne, a larger systematic breakout most likely would be.
Propionibacterium Acnes is an anaerobic bacteria that resides on everyone’s skin.
It has the role of being a powerful immunostimulant for the skin but only ever grows uncontrollably
if certain skin terrain conditions are met, most commonly during puberty.
Being a skin disease, I see a lot of people with severe acne refuse to visit a dermatologist
because they’ve been taught that it’s from a lack of cleanliness.
Obsessively cleansing your skin to get rid of excess oil only makes your body produce
more which in turn creates more comedones that disrupt your skin’s microstructure.
Acne is problematic, not because it looks and feels bad for the time being, but because
it can leave serious scarring in the long term.
This scarring reduces your skin smoothness and acts as a notable blemish, which as we’ve
just learnt is a double no-no.
Acne, much like most skin diseases are treatable with modern medicine.
r/skincareaddiction is great for establishing a routine, but like with most bacterial infections,
antibiotics are the more permanent fix.
For those that don’t respond to broad spectrum antibiotics such as Doxycycline, dermatologists
in certain countries can prescribe Accutane (isotretinoin) which is the only prescribed
medication that targets the root cause of acne, excess oil production, by shutting it
off completely.
It’s about as heavy duty as acne medication gets and you can imagine how turning off an
entire feature of the body can result in a very long potential side effect list for legal
reasons.
Accutane itself is the brand name which was taken off the shelves by Roche, the major
producer, due to being hit with many personal injury lawsuits over the course of its product
cycle.
The most concerning side effect being depression but a 2017 meta analysis by the American Academy
of Dermatology[h] found that its use is not linked with depression and that curing acne
actually helped with reducing it.
The drug faced highly publicised cases too where in the 2000s a US congressman blamed
Accutane for the death of his 17 year old son[i], but again another 2016 study found[j]
weak to no links between Accutane and depression.
It could be that the people suffering from acne serious enough to take Accutane are already
at their weakest mental state and a lack of improvement or response to the drug may be
enough to cause them to lose hope.
There are definitely more confounding effects at play surrounding Accutane that makes it
so controversial and difficult to study.
For instance, all of these studies have a low sample size because it would be unethical
to give it to moderately healthy participants due to its severity.
Another main concern of the drug is the increased risk of bowel disease, but this was refuted
by a 2016 meta analysis by the European Journal of Gastroenterology finding no increased risk.
So how does this relate to aesthetics?
This part is purely my own opinion and while the previous was backed by scientific fact
and research, this is anecdotal.
Many years ago, I asked my dermatologist for accutane when antibiotics weren't working.
My acne was moderate at worst, I don’t have any pictures, but it was resilient and physically
painful.
The bigger concern was the presence of acne scarring if I left it untreated and let nature
take its course.
It started working very quickly and the most serious side effect I ever got was extreme
dryness on my forearms.
My experience with it was very positive and it completely cleared it up with no scars
and smooth, even skin.
From what we know about the importance of healthy skin, if you’re suffering from acne,
it is worth seeing your dermatologist on ways to clear it up, rather than buying L’oreal’s
new $2000 face cleansing cream.
In terms of aesthetic gain, I’d argue that its one of the highest, if not the highest
because it’s non surgical and strongly correlated with trait perception.
Some people completely don’t respond to medication while others find its side effects
too strong and there are alternatives to medication such as microdermabrasion, but with 80% of
the population relating to the struggle, it should be a top aesthetic priority.
And with that, we bring this video to a close.
While the idea was to fit in wrinkles and fine lines in the same video, that’s a large
topic that deserves its own episode so do subscribe to catch that next week.
As always, leave your suggestions down below and if you would like for us to analyze your
face and give you the rundown on your own features, order an aesthetics report at the
QOVES site.