A Picture of Health?: unmasking the role of appearance in health

Evaluating health requires visual assessment. From the meticulous self-scrutiny of a worried woman in front of the looking glass to the doctor's reaction at the sight of a patient in the examining room, external appearance plays an important role in appraising health above and beyond clinical assessment. However, this dominance of the visual in our image-driven culture has assumed a disproportionately prominent position. Media, businesses, and health care commonly misrepresent appearance as the reality of health. Industry mongers beauty-promoting wares and services as health-protecting products, and physical appearance contributes to clinicians' imperfect heuristics. An explanation for this focus on appearance is persistence of the ancient belief that looks indicate inner character. In this article we unmask the historical origin of this belief and reveal how it contaminates contemporary approaches to health assessment and maintenance.