Aging in the Male Face: Intrinsic and Extrinsic Factors.

BACKGROUND Gender is one of the most significant factors that influence facial anatomy and behavior, both key factors in the aging process. OBJECTIVE To review male facial anatomy, physiology, and behavior and how it contributes to sexual dimorphism in facial aging. METHODS A MEDLINE search was performed for publications on gender differences in facial anatomy, aging, cutaneous physiology, and behavior. RESULTS There are differences in both intrinsic and extrinsic aging factors in men. Men have a thicker epidermis and dermis with more active cutaneous appendages including hair growth. Male skin has a reduced antioxidant capacity and increased ultraviolet-induced immunosuppression. The male face is larger and has a unique square shape with less subcutaneous soft tissue, especially at the medial cheek. Men are also more prone to smoking and exhibiting poor sun-protective behavior. The differences in intrinsic and extrinsic aging factors contribute to poor facial aging in men. Men develop more severe rhytides in a unique pattern, show increased periocular aging changes, and are more prone to hair loss. CONCLUSION This review provides insight into the factors contributing to accelerated male facial aging. Understanding gender differences in aging will help physicians tailor cosmetic treatments for men and minimize extrinsic aging factors.