Are You a Face Reader?

We see a lot of patients in each clinic. And in derm, you have to be observant, because you don't want to miss something that may be a clue to the medical problem.

One of the observations that have come about, unintentionally, is that people's personalities affect what they look like. Now that may be obvious - someone who's extremely depressed may look unkempt, but I'm talking about more subtle changes. Like changes in their face.

I'm not talking about physiognomy, which may or may not have its merits - I don't know enough about the field to comment on that. But when you see many elderly patients, you realize that there's a group that is very happy, a group that is very unhappy, and then many people in between these two extremes. And the surprising thing is that you can often sense what kind of person they are when you walk in the room - some have a kind, open face. Others have this peaceful, happy expression. Still others have the years of pain and anguish etched into the lines on their face. Talking with them helps confirm the initial impression.

I'm not saying that first impressions are always correct, or that facial features always accurately represent the bearer's personality - we've all seen psychopaths with trusting faces (think Scott Peterson). And I think a person's "active" personality (the side they show to the public) is very different (and often looks different) than their "passive" face when they are deep in thought, or not aware that others are looking. I just think that the latter is interesting because it seems to correlate somewhat with the person's views on life and living...

All this sounds a little hokey. But it makes some sense - if you're always worried, it's normal to have worry lines form. Or if you smile a lot, the wrinkles around the eyes often curve up. And then there are the microexpressions, which have actually been studied in depth by Paul Ekman. What do you think?