# The Kesty Hyperpigmentation Scale: A Study to Validate a New Tool for Assessing Facial Hyperpigmentation

## TL;DR

This paper introduces and validates a new tool, the Kesty Hyperpigmentation Scale, for consistently measuring facial hyperpigmentation in dermatology.

## Contribution

The Kesty Hyperpigmentation Scale is a novel clinical instrument validated for reliable and valid assessment of facial hyperpigmentation.

## Key findings

- The KHS demonstrated high ordinal agreement and strong rank concordance in statistical analysis.
- Participants found the KHS user-friendly and expressed interest in using it in their clinical practice.
- The scale provides an objective framework for tracking patient progress after cosmetic treatments.

## Abstract

Facial hyperpigmentation due to sun damage, post‐inflammatory hyperpigmentation, and other factors is a common complaint of patients. While lasers and topical treatments are frequently used to manage hyperpigmentation, a standardized way of measuring response to treatment is difficult.

The Kesty Hyperpigmentation Scale (KHS) is a novel clinical instrument created to provide a consistent approach for evaluating facial hyperpigmentation in both cosmetic dermatology and broader medical settings.

This study introduces the KHS, describes the process of its creation and validation, and examines its practical uses in clinical settings. Statistical analysis included Gwet's AC2, Kendall's W, Spearman's ρ/rho, weighted Cohen's kappa, and Bland–Altman analysis.

The findings of the statistical analysis included high ordinal agreement, strong rank concordance, and minimal bias. This supports the conclusion that the novel rating approach is both reliable and valid for assessing skin hyperpigmentation on the given 0–3 scale. The KHS offers an objective framework to measure the severity of hyperpigmentation, helping clinicians track patient progress after cosmetic treatments, and fostering improved communication with patients. Participants in this study found the scale to be user‐friendly, and the majority expressed interest in incorporating it into their practices to document patient conditions.

The KHS is an effective and user‐friendly tool for evaluating facial hyperpigmentation, addressing a significant need within dermatology.