Is the human face a biomarker of health? - a scoping review

There is a widespread opinion that facial features could provide an important cue to individuals health and are a biomarker of a human developmental stability. Taking evolutionary lens, they are interpreted to be a signal physical and cognitive health. However, research to date does not clearly support this assumption. This is the first review that explores the association between various aspects of health and facial features, namely symmetry, averageness or sexual dimorphism in adults. We searched electronic databases including Web of Science, MEDLINE PubMed, Scopus and Embase. We followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines for reporting of our results. Of the 702 screened articles, 17 were eligible for inclusion. Studies presented a varied outcomes between facial features and cardiovascular health; immunocompetence; oxidative stress level; cortisol level; reproductive health, cognitive health and general physical health. This review presents mixed and inconclusive answer for the question whether facial features can serve as indicators of health. The results deepen our knowledge of the relationship between facial features and health outcomes and warrant caution when interpreting face as a biomarker of health. Protocol: Open Science Framework, https://osf.io/dv9pu/.