Risk factors associated with higher skin age relative to chronological age in community-dwelling middle-aged Japanese adults

Skin condition reflects both chronological aging and overall health, yet few studies have examined its links to lifestyle or cardiovascular risk factors in Asian populations. In 2023, 527 Japanese adults aged 40–64 years underwent facial imaging with the VISIA Evolution, which estimated skin age and quantified eight skin parameters. The difference between skin and chronological age, derived from linear regression residuals, was analyzed for associations with lifestyle and cardiovascular factors using multiple regression. A greater skin–chronological age difference was significantly associated with higher scores on all eight skin parameters. In multivariable-adjusted models, male sex, higher systolic blood pressure, elevated γ-GTP, smoking, reduced grip strength, and frequent occupational sun exposure were associated with greater skin–chronological age difference. Sex-specific multiple regression identified systolic blood pressure, blood glucose, smoking, reduced grip strength, and sun exposure in women, and systolic blood pressure, serum γ-GTP, alcohol intake, reduced grip strength, and sun exposure in men. The present cross-sectional analysis showed that cardiovascular and metabolic health, as well as smoking and sunlight exposure, were associated with skin aging objectively assessed by facial imaging. Although causality cannot be inferred, improving systemic health may help promote healthier skin aging.