Glogau Classification Scale – Photoaging groups

Skin type	Age (years)	Findings
1, Mild	Early 20s or 30s	Early photoaging: early pigmentary changes, no keratoses, fine wrinkles
2, Mod.	30s to 40s	Early to moderate photoaging: early senile lentigines, no visible keratoses.
3, Adv.	50 plus	Advanced photoaging: dyschromia and telangiectasia, visible keratoses, wrinkles at rest
4, Sev.	60s or 70s	Severe photoaging: dynamic and gravitational wrinkling, multiple actinic keratoses.

Recommended therapies based on the Glogau wrinkle scale

Type 1 skin

Education, sunscreen, and topical antioxidants
Tretinoin
Alpha hydroxyl acid (AHA) lotions and superficial (glycolic acid) peels
Microdermabrasion (monthly)
Botulinum toxin neuromodulation
Photorejuvenation treatments (intense pulsed light)

Type 2 skin

Education, sunscreen, and topical antioxidants
Tretinoin
AHA lotions, superficial peels (glycolic acid)
Medium depth peels (trichloroacetic acid [TCA])
Botulinum toxin neuromodulation
Soft tissue augmentation
Photorejuvenation treatments (intense pulsed light)
Combination procedures (Botox plus fillers, Thermage)
Nonsurgical (radiofrequency-mediated Thermage); face, neck, and eye- brow lifts

Type 3 skin

Education, sunscreen, topical antioxidants
Medium depth peels (TCA)
Photodynamic skin rejuvenation (intense pulsed light plus Levulan)
Soft tissue augmentation
Botulinum toxin neuromodulation
Combination procedures (Botox plus fillers, Thermage)
Nonsurgical radiofrequency-mediated (Thermage); face, neck, and eye- brow lifts
Minimally invasive face lifts (Pointe lifts)

Type 4 skin

Education, sunscreen, and topical antioxidants
Botulinum toxin neuromodulation
Photodynamic skin rejuvenation (intense pulsed light plus Levulan)
Soft tissue augmentation
Combination treatments (Thermage, Pointe lifts, Botox, and Fillers)
Surgical face-lift, brow-lift, blepharoplasty