Visual scales are superior to questionnaires in skin phototype self-assessment by children

There are no suitable methods for skin phototype self-assessment by children. Our study investigated several skin phototype self-assessment methods in children to identify the best correlation to objectively measure skin phototype.

Danish schoolchildren (ages 6-19) participated in a nation-wide study that assessed skin, eye, hair colour and sun behaviour. Skin phototype self-assessment was performed by children using two visual colour scales (cartoon faces and colour cards), question-based colour scale and questions about tendency to burn and ability to tan. For objective skin phototype measurements, 483 children from all age groups were selected and their pigment protection factor (PPF) was measured at three skin sites using a skin reflectance spectrophotometer.

Cartoon faces (r²  = 0.654) and colour cards (r²  = 0.659) were better at predicting PPF on the inner forearm than the question-based colour method (r²  = 0.520). PPF prediction from questions on skin reaction to sun exposure was markedly inferior (r²  ≤ 0.142) to both visual colour scales and question-based colour method.

Both visual colour scales proved to be superior to question-based skin phototype self-assessment in schoolchildren. In contrast, questions on skin reaction to sun exposure were shown to be an unsuitable tool for self-assessment of skin phototype in children.