How Was the Skin Type Quiz Validated?

Only STS and STS Approved Medical Providers have the legal right to use the Baumann Skin Type Indicator Quiz1 to diagnose the Baumann Skin Type®.  Skin Type Solutions is the only skin care routine builder that is based on a scientifically validated quiz that is used by over 100 dermatologists and 280 doctors. The Baumann Skin Typing System is included in many textbooks, including Fitzpatrick’s Dermatology in General Medicine, Neligan’s Plastic Surgery, Nahai’s The Art of Aesthetic Surgery, and Baumann’s Cosmetic Dermatology.  The STS quiz is used in cosmeceutical research studies by doctors and skin care companies to categorize patients into 16 Baumann Skin Types.  Only Skin Type Solutions has the right to use the latest version of the Baumann Skin Type Quiz that has been updated with data from over 100,000 patients.

The Baumann Skin Type Quiz Is A Scientifically Validated Questionnaire Used By Dermatologists To Diagnose The Baumann Skin Type®.  

Why Does a Skin Type Test Need to Be Validated?

A questionnaire must be validated to show that it measures what it is supposed to measure. For example, if the quiz says you have oily skin, you should have an increased amount of sebum production when it is measured with a sebometer.  Many studies have shown that people incorrectly guess if they make excess sebum, and when asked “Is your skin oily,” their answer often does not correspond with the amount of sebum produced.2  For this reason, a series of validated questions is needed to accurately diagnose oily skin. The skin care routine quiz that is used by Skin Type Solutions to diagnose the Baumann Skin Type has been shown to accurately identify skin types with increased sebum production.3

In order for a skin type quiz to be a scientific skin care routine builder, it must identify any underlying barriers to skin health and lifestyle habits that may be affecting skin health. The questions must be proven to correlate with skin issues. See below to read what needs to correlate with the skin type quiz questions to prove scientific validity.

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1Baumann L. Understanding and treating various skin types: the Baumann Skin Type Indicator. Dermatol Clin. 2008;26(3):359-73, vi.

2Youn SW, Kim SJ, Hwang IA, Park KC. Evaluation of facial skin type by sebum secretion: discrepancies between subjective descriptions and sebum secretion. Skin Res Technol. 2002;8(3):168-72.

3Baumann LS, Penfield RD, Clarke JL, Duque DK. A validated questionnaire for quantifying skin oiliness. J Cosmet Dermatol Sci App. 2014;4:78-84.

 

Which Skincare Routine Quiz Is Used by Dermatologists?

Only STS has licensed the rights to use the Baumann Skin Type Indicator skin type quiz used by dermatologists in their offices.  The only way one can take the quiz is at SkinTypeSolutions.com or by making a telemedicine or office visit to one of our approved doctors.  This is the most tested skin typing system. It is discussed in the major dermatology and plastic surgery textbooks and is used by dermatologists around the world.  

  • The Skin Type Quiz used by STS has been shown to make the correct diagnosis when self-administered.

  • The Skin Type Quiz used by STS has been shown to make the correct diagnosis regardless of gender. 4 5 6

  • The Skin Type Quiz used by STS has been tested on multiple ethnicities.7

  •  The Skin Type Quiz used by STS has been tested on ages 13 and up.8

  • The Skin Type Quiz used by STS is used by over 250 doctors in the USA to diagnose the skin type. 

  • Over 100 dermatologists use the STS skin type test in their dermatology offices.

  • The quiz is constantly validated, adjusted, and updated based on this data.

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4Lee YB, Ahn SK, Ahn GY, Bak H, Hong SP, Go EJ, et al. Baumann Skin Type in the Korean Male Population. Ann Dermatol. 2019;31(6):621-30.

5Ahn SK, Jun M, Bak H, Park BD, Hong SP, Lee SH, et al. Baumann skin type in the Korean female population. Ann Dermatol. 2017;29(5):586-96.

6Choi JY, Choi YJ, Nam JH, Jung HJ, Lee GY, Kim WS. Identifying skin type using the Baumann skin type questionnaire in Korean women who visited a dermatologic clinic. Kor J Dermatol. 2016;54(6):422-37.

7Baumann L. Validation of a questionnaire to diagnose the Baumann skin type in all ethnicities and in various geographic locations. J Cosmet Dermatol Sci App. 2016;6(1):34-40.

8Lee YB, Park SM, Bae JM, Yu DS, Kim HJ, Kim JW. Which Skin Type Is Prevalent in Korean Post-Adolescent Acne Patients?: A Pilot Study Using the Baumann Skin Type Indicator. Ann Dermatol. 2017;29(6):817-9.

 

What Needs to Correlate With the Skin Type Quiz Questions to Prove Scientific Validity?

These are the most important issues that need to be treated to have the healthiest skin possible. After each skin issue are the names of the tests that are used in clinical research to identify skin type. These were the tests used to validate the skin type quiz questions used by Skin Type Solutions.

    • TEWAmeter measures transepidermal water loss which is water evaporation off the skin.

    • Corneometer measures the conductance of electricity in the skin which is affected by the presence of water.

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    • Sebometer measures the amount of sebum produced in a discrete area of the skin and gives a quantitative value.

      • Sebutape collects lipids that can be analyzed using various methods, such as a chemical assay or spectroscopy.9

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    • Inflammation manifests as redness in the skin. It can be measured using a camera system such as the Canfield Visia which measures redness.

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 9Ashraf, Z., Pasha, U., Greenstone, V., Akbar, J., Apenbrinck, E., Foulks, G. N., & Borchman, D. (2011). Quantification of human sebum on skin and human meibum on the eye lid margin using Sebutape®, spectroscopy and chemical analysis. Current eye research36(6), 553-562.

 

  • Skin color including redness is measured with a spectrophotometer10 that measures skin color and gives results as L*, a*,b*.

  • Pigmentation

    • The darkness or lightness of dark spots is measured using a Mexometer.

    • Skin color is measured using a spectrophotometer.

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  • Aging

    • Skin aging is measured by evaluating wrinkles.  This can be done with silicone casts11, a camera system such as the Canfield Visia discussed above, live investigators or the use of light cast across the skin and measuring the shadows.12

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10Pershing, L. K., Tirumala, V. P., Nelson, J. L., Corlett, J. L., Lin, A. G., Meyer, L. J., & Leachman, S. A. (2008). Reflectance spectrophotometer: the dermatologists' sphygmomanometer for skin phototyping?. Journal of investigative Dermatology128(7), 1633-1640.

11Berardesca, E., Farinelli, N., Rabbiosi, G. A. N. D., & Maibach, H. I. (1991). Skin bioengineering in the noninvasive assessment of cutaneous aging. Dermatology182(1), 1-6.

12Bielfeldt, S., Böhling, A., & Wilhelm, P. K. (2011). Bioengineering methods to assess aging parameters in the depth of the skin. SOFW J3, 1-8.

 

How Was the Skin Type Solutions Quiz Validated?

2005 at The University of Miami

The original testing took place from July- November 2005 at the University of Miami Department of Dermatology under IRB supervision.  400 participants were patients at the Dermatology Clinic at the Edelman Building of the University of Miami medical campus. Two trained interviewers were assigned to intercept all clinic patients as they entered the waiting room of the clinic. Participation in the survey was entirely voluntary.  Informed consent was obtained before the survey was given to the respondents. Once enrolled, demographic information and a dermatological history were obtained by the two interviewers. Next, the study participants were given the survey and asked to complete the Baumann Skin Type Indicator (BSTI) questionnaire, version 1.13 This table shows the demographics of the initial 400 participants.

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The Baumann Skin Type (BST) result of each of these patients was compared to the CPT diagnosis code (this is the official skin disease diagnosis code used by insurances to reimburse for the office visit) of the dermatologist who saw them in the University of Miami clinic.  This dermatologist was unaware of the participant's BSTI quiz result to eliminate bias. This preliminary study showed that the BSTI questionnaire could accurately diagnose the underlying skin problems of the participant prior to seeing a dermatologist.

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13Baumann L. The Skin Type Solution. Bantam Del NY 2005, pages

 

2006 at the University of Miami

The questionnaire known as the Baumann Skin Type Indicator was tested on patients around the world and shortened to contain only the most pertinent questions. It was tested when administered by a dermatologist, a staff member and the patients themselves.  Questions were adapted until the accurate skin type result was obtained even when the test was self-administered (as determined by the investigating dermatologists)

In 2006, data was compared from participants who took the quiz online versus patients in dermatology practices around the world to see if there was a difference in the incidence of skin types from those who chose to see a dermatologist versus those who did not have a dermatologist.  52,862 participants took the skin type quiz. The data showed that there was no significant difference in skin types between patients who took the quiz online versus those who saw a dermatologist in their office. 14

2009 to 2013 at Baumann Cosmetic and Research Institute Miami FL

The skin type quiz was tested in dermatology clinics around the world including Korea, China and India. In the US, various geographic areas tested the quiz such as the department of dermatology at the University of Colorado with Dr. Pachecho. Colorado has a very dry climate, and the results were compared to results in Miami FL- a humid climate.  The skin type quiz was found to be valid in both dry and humid climates.  Comparing worldwide data15 revealed that there was not a significant difference in skin types in the US vs China and Korea.  The study showed that worldwide oily skin types (which include what others call normal types) were more common than dry skin types.

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14Baumann, Leslie. “Validation of a Questionnaire to Diagnose the Baumann Skin Type in All Ethnicities and in Various Geographic Locations” Journal of Cosmetics, Dermatological Sciences and Applications 6 (2016): 34-40.

15Baumann, Leslie. “Validation of a Questionnaire to Diagnose the Baumann Skin Type in All Ethnicities and in Various Geographic Locations” Journal of Cosmetics, Dermatological Sciences and Applications 6 (2016): 34-40.

 

2015

The Skin Type Solutions Franchise Systems LLC was created to allow physicians to license the use of the Baumann Skin Typing System.  This was tested on dermatologists, plastic surgeons, facial plastic surgeons and medi-spas and found to be valid in all of these settings.  Software was developed to streamline the process and allow the inclusion of all brands that meet the stringent criteria. The skin type quiz was only available in a doctor’s office.

2021

After COVID, it was decided that the skin type quiz would be made available online. The data gathered online is constantly begin compared with the data in doctors’ offices.  This allows the processes of deep learning to occur and will one day allow accurate artificial intelligence based on a validated skin type quiz.

What Skin Type Test Do Dermatologists Use?

The same skin type quiz used here on our website is used by dermatologists around the world using our patented software. From 2014- 2020 many studies have used the Baumann Skin Typing System to categorize patients scientifically into skin types.  In 2016, a Korean study showed that the BSTI questionnaire was as accurate as a dermatologist’s evaluation in determining skin type. In 2017 the skin typing system was shown to be valid to evaluate post-adolescent acne and valid in Korean females, and in 2019 was shown to be valid when used on males. In 2020 this study showed that the Baumann Skin Typing System can be used to prescribe skin care. The skin typing system is described in many dermatology and physician textbooks.

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16Choi, J. Y., Choi, Y. J., Nam, J. H., Jung, H. J., Lee, G. Y., & Kim, W. S. (2016). Identifying skin type using the Baumann skin type questionnaire in Korean women who visited a dermatologic clinic. Korean Journal of Dermatology54(6), 422-437.

17Lee, Y. B., Park, S. M., Bae, J. M., Yu, D. S., Kim, H. J., & Kim, J. W. (2017). Which Skin Type Is Prevalent in Korean Post-Adolescent Acne Patients?: A Pilot Study Using the Baumann Skin Type Indicator. Annals of Dermatology29(6), 817.

18Ahn, S. K., Jun, M., Bak, H., Park, B. D., Hong, S. P., Lee, S. H., ... & Goo, J. W. (2017). Baumann skin type in the Korean female population. Annals of dermatology29(5), 586-596.

19Lee, Young Bin, Sung Ku Ahn, Gun Young Ahn, Hana Bak, Seung Phil Hong, Eun Jung Go, Chang Ook Park et al. "Baumann Skin Type in the Korean Male Population." Annals of Dermatology 31, no. 6 (2019): 621-630.

20Hong, J. Y., Park, S. J., Seo, S. J., & Park, K. Y. (2020). Oily sensitive skin: A review of management options. Journal of Cosmetic Dermatology19(5), 1016-1020.

 

Does the Skin Type Quiz Have Different Versions?

In 2005, Leslie Baumann MD’s New York Times Bestselling Book The Skin Type Solution contained an early paper version of the questionnaire.  It was then converted to a digital platform, with new questions added and some others reworded.  The quiz was shortened in 2014, and new questions were added in 2020.  The most recent version of the Baumann Skin Type Quiz is available only here at Skintypesolutions.com and in STS-approved doctors that can be found here. It is constantly updated as new data is gathered.

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