(1026) Eye Tracking to Determine Noticeability of Pediatric Facial Scar Characteristics to Adult Observers

Introduction: Current scar assessment tools are highly subjective and do not account for patient specific characteristics such as skin tone and scar type. This study examines objectively noticeable features of pediatric facial scars using eye-tracking software and explores how patient specific factors impact the scar perception.

Methods: This was a cross-sectional study performed at Children’s Minnesota between October 2023 and November 2023. A total of 97 naïve adult participants viewed 12 randomized photos on a laptop equipped with the Tobii Pro Nano eye-tracking device. Photos of 4 children with different Fitzpatrick (FP) types were used to digitally create 3 images each: a scarless control, an image with a hypertrophic scar, and one with dyspigmentation. The scar size and location were kept consistent. Gaze metrics were compared between skin types and between scar types.

Results: Hypertrophic and dyspigmented scars had greater total fixation duration and fixation count than controls across all skin types (p < 0.01). When comparing scar types for each child, the only difference was noted in the FP2 child where the dyspigmented scar had greater total fixation duration (p = 0.01) and fixation count (p = 0.04) than the hypertrophic scar. When comparing scar types across children, the dyspigmented scar of the FP2 child had greater total fixation duration and fixation count than the dyspigmented scars of the FP6 and FP4 children (p < 0.01). The hypertrophic scar on the FP1 child had a longer fixation duration than the hypertrophic scar of the FP6 child (p = 0.04). There were lower times to first fixation for both hypertrophic and dyspigmented scars in the FP6, FP4, and FP1 children (p < 0.04), and the dyspigmented scar in the FP2 child (p = 0.049).

Conclusions: Dyspigmented scars were more noticeable than hypertrophic scars in FP2 tones, but equally noticeable in other skin tones. Dyspigmented scars on FP2 tones were more noticeable than those on darker skin tones. Hypertrophic scarring was more noticeable in FP1 compared to FP6 tones. These results provide context in evaluating scars on patients of various skin tones and can help guide treatment counseling.