HIS hair is grayer, and the creases around his mouth have deepened. The bags under his eyes make him look a bit weary. But his brow is mostly smooth, his chin firm, his neck taut.

If it’s true, as George Orwell said, that by 50 people have the faces they deserve, then President Obama — whose birthday is Thursday — has fared well. But what’s in the face at 50? As the tail end of the baby boom reaches that milestone and looks in the mirror, the collective sigh may well be, what happened?

Time, heredity, sunlight, illness, smoking, good fortune and bad — all leave their marks on the face. People make instant judgments about one another’s age, health, mood, personality and character based on facial features, and yet we often judge unconsciously, not fully aware of the cues we’re reading. There’s more — and sometimes less — to aging than jowls, wattles and crow’s-feet.

Across time and cultures, the idea that there are secrets to be deduced from a person’s features has been irresistible. Efforts to predict character and personality — even criminal tendencies — by analyzing people’s faces and the shape and size of their skulls date back centuries and have swung through cycles, being in vogue and being denounced as fakery. In China, face-reading was an ancient art that mapped out more than 100 distinct regions and linked them to certain traits, illnesses and even fate. Today, self-described face-reading experts turn up periodically on TV shows with flakily earnest pronouncements about public figures based on appearance. One told Tyra Banks that Mr. Obama’s big ears meant he would listen to the country and that the “radiance” from his eyes meant he was a visionary.

But the face actually can reveal more than we might want to admit. At times people seem to have an uncanny ability to size one another up at a glance. Last year, researchers from Tufts University published a study showing that students were surprisingly accurate at telling Democrats from Republicans just by looking at photographs of their faces. In the students’ judgments, Republicans were more likely to look “powerful” and Democrats “warm.”

Astute diagnosticians also glean information from people’s faces. “There are volumes one can say medically about the face,” said Dr. Abraham Verghese, the senior associate chairman for the theory and practice of medicine at Stanford University and a best-selling memoirist and novelist.

Dr. Verghese is an advocate for what many say is a lost art in test-driven modern medicine: the in-person physical exam, the doctor’s ability to detect signs of illness just by looking and listening. He ran through a list of facial changes that can be tip-offs to ill health, and that doctors can pick up at a glance: a sparseness or absence of the outer third of the eyebrows can signal thyroid failure; a moon-shaped face may mean a person is taking steroids; a “laugh line” deeper on one side of the face than the other may indicate a previous stroke or other facial paralysis; a very broad forehead and large nose may signal acromegaly, a dangerous condition caused by too much growth hormone.

“One sees in airports people who have their heads tilted back and seem to be looking down at the world with a suspicious expression,” Dr. Verghese said. “Their eyes look sleepy.” The diagnosis: a neuromuscular disorder, myasthenia gravis, that makes the eyelids droop. To compensate, people tilt their heads back and raise their eyebrows.

The ears can be a tip-off to gout, if they have bumps (called gouty tophi) that look like tiny stones under the skin. A common sign of aging, though not of illness, is the arcus senilis, a whitish or grayish ring that forms around the iris in many older people.

“I can see someone in a certain light and see that they’ve had cataract surgery,” Dr. Verghese said, explaining that the lens implanted during the surgery gives off a “metallic glint” at certain angles.

New York Times

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