Evaluating age-related changes of some facial signs among men of four different ethnic groups

SCAWA scales: A new digital tool for wrinkles clinical grading based on AI

OBJECTIVE

Clinical assessment of wrinkle depth is essential for efficacy evaluations of anti-ageing products. Standardized photographic scales, representative of different wrinkle depths are often used by experts to assign subjects reliable grades. These tools, based on real pictures, usually exist as hard copies (printed books or sheets) for in vivo gradings. Our project aims at developing a methodology to create digital standardized computer-generated scales, allowing photograph and real-life gradings, and providing raters with greater comfort, accessibility, and flexibility in their construction, thanks to the artificial intelligence significative contribution.

METHODS

A completely new approach, based on machine learning, allows the creation of Standardized ColorFace® AI-based Wrinkle Assessment (SCAWA) scales. Instead of using real photographs, the scale images are computer-generated. A generative adversarial network (GAN) is trained to create realistic wrinkle samples that are finely controllable by exploring the GAN latent space. Finally, the scale images are selected among hundreds of artificial images depicting natural wrinkle appearances, such as the illustrated wrinkle evolution is well-detailed (small gaps between grades), morphologically stable, and mathematically linear according to a criterion of wrinkle conspicuous depth.

RESULTS

The created 12-point scale for crow's feet wrinkle evaluation on ColorFace® pictures is proven to be realistic, linear, and robustly and accurately usable for photograph assessments. The scale coherence in terms of image ranking has been validated, as well as its reliability and acceptability in real conditions of use. Additionally, the wrinkle grades obtained by the SCAWA scale are well correlated (R = 0.94) with the ones obtained by the Skin Aging Atlas on the same pictures. The AI methodology and digital format brought also interesting side results, such as an enhanced harmonization between experts and a higher representativeness, that is, a decrease of out-of-range pictures.

CONCLUSION

SCAWA scale makes the most of machine learning to provide an innovative digital tool to ease wrinkles in visual assessment of pictures, while optimizing linearity, homogeneity, and accuracy aspects. The experts' enthusiastic feedback about the scale format and quality is promising regarding the adaptation of the methodology to other signs and a larger distribution of this tool in the market of cosmetic product efficacy assessment.

Awareness of sun exposure risks and photoprotection for preventing pigmentary disorders in Asian populations: Survey results from three Asian countries and expert panel recommendations

BACKGROUND

In this article, we review and discuss the photoprotection behavior of Asians based on the literature, along with a subanalysis of an original online survey, and make recommendations to optimize photoprotection for Asian populations to prevent photoaging and pigmentary disorders.

METHODS

An international panel of eight dermatologists from Asia (China, Korea, Japan, Singapore, Indonesia, and Vietnam) met to discuss sunscreen photoprotection for Asian patients. Additionally, a subanalysis of an online survey by 3000 respondents from three Asian countries (China, Indonesia, and Japan) investigated general public awareness and attitudes to sun exposure.

RESULTS

A pre-meeting survey of the eight experts from Asia showed key concerns of Asian patients consulting dermatologists are pigmentary disorders, especially actinic/senile lentigo, post-inflammatory hyperpigmentation, melasma, vitiligo, and Hori's nevus. The survey subanalysis of participants from China, Indonesia, and Japan with predominantly Fitzpatrick skin types (FST) II to IV revealed that they are particularly concerned about sun exposure causing photoaging and pigmentary disorders. Most of the respondents indicated they have limited knowledge on sunlight radiation and appropriate sunscreen protection factors. Only 22%, 13%, and 3% for China, Indonesia, and Japan, respectively, systematically use multiple protective measures (using sunscreen, avoiding midday sun, staying in the shade, wearing a hat, protective clothing, and sunglasses) when exposed to the sun.

CONCLUSIONS

Further education is needed for Asian populations on the importance of comprehensive daily photoprotection, including broad-spectrum sunscreen, with high UVA and visible light protection, to reduce and prevent photoaging and pigmentary disorders.

Skin ageing and topical rejuvenation strategies

Skin ageing is a complex process involving the additive effects of skin's interaction with its external environment, predominantly chronic sun exposure, upon a background of time-dependent intrinsic ageing. Skin health and beauty is considered one of the principal factors perceived to represent overall 'health and wellbeing'; thus, the demand for skin rejuvenation strategies has rapidly increased, with a worldwide annual expenditure expected to grow from $US24.6 billion to around $US44.5 billion by 2030 (https://www.databridgemarketresearch.com/reports/global-facial-rejuvenation-market). Skin rejuvenation can be achieved in several ways, ranging from laser and device-based treatments to chemical peels and injectables; however, topical skin care regimes are a mainstay treatment for ageing skin and all patients seeking skin rejuvenation can benefit from this relatively low-risk intervention. While the most efficacious topical rejuvenation treatment is application of tretinoin (all-trans retinoic acid) - a prescription-only medicine considered to be the clinical 'gold standard' - a hybrid category of 'cosmeceutical' products at the midpoint of the spectrum of cosmetics and pharmaceutical has emerged. This article reviews the clinical manifestations of skin ageing and the available topical treatments for skin rejuvenation, including retinoids, peptides and antioxidants.

Line-field confocal optical coherence tomography coupled with artificial intelligence algorithms to identify quantitative biomarkers of facial skin ageing

Quantitative biomarkers of facial skin ageing were studied from one hundred healthy Caucasian female volunteers, aged 20-70 years, using in vivo 3D Line-field Confocal Optical Coherence Tomography (LC-OCT) imaging coupled with Artificial Intelligence (AI)-based quantification algorithms. Layer metrics, i.e. stratum corneum thickness (SC), viable epidermal thickness and Dermal-Epidermal Junction (DEJ) undulation, as well as cellular metrics were measured for the temple, cheekbone and mandible. For all three investigated facial areas, minimal age-related variations were observed in the thickness of the SC and viable epidermis layers. A flatter and more homogeneous epidermis (decrease in the standard deviation of the number of layers means), a less dense cellular network with fewer cells per layer (decrease in cell surface density), and larger and more heterogeneous nuclei within each layer (increase in nuclei volume and their standard deviation) were found with significant variations with age. The higher atypia scores further reflected the heterogeneity of nuclei throughout the viable epidermis. The 3D visualisation of fine structures in the skin at the micrometric resolution and the 1200 µm × 500 µm field of view achieved with LC-OCT imaging enabled to compute relevant quantitative biomarkers for a better understanding of skin biology and the ageing process in vivo.

Exploring artificial intelligence from a clinical perspective: A comparison and application analysis of two facial age predictors trained on a large-scale Chinese cosmetic patient database

BACKGROUND

Age prediction powered by artificial intelligence (AI) can be used as an objective technique to assess the cosmetic effect of rejuvenation surgery. Existing age-estimation models are trained on public datasets with the Caucasian race as the main reference, thus they are impractical for clinical application in Chinese patients.

METHODS

To develop and select an age-estimation model appropriate for Chinese patients receiving rejuvenation treatment, we obtained a face database of 10 529 images from 1821 patients from the author's hospital and selected two representative age-estimation algorithms for the model training. The prediction accuracies and the interpretability of calculation logic of these two facial age predictors were compared and analyzed.

RESULTS

The mean absolute error (MAE) of a traditional support vector machine-learning model was 10.185 years; the proportion of absolute error ≤6 years was 35.90% and 68.50% ≤12 years. The MAE of a deep-learning model based on the VGG-16 framework was 3.011 years; the proportion of absolute error ≤6 years was 90.20% and 100% ≤12 years. Compared with deep learning, traditional machine-learning models have clearer computational logic, which allows them to give clinicians more specific treatment recommendations.

CONCLUSION

Experimental results show that deep-learning exceeds traditional machine learning in the prediction of Chinese cosmetic patients' age. Although traditional machine learning model has better interpretability than deep-learning model, deep-learning is more accurate for clinical quantitative evaluation. Knowing the decision-making logic behind the accurate prediction of deep-learning is crucial for deeper clinical application, and requires further exploration.

Objective and automatic grading system of facial signs from smartphones' pictures in South African men: Validation versus dermatologists and characterization of changes with age

OBJECTIVE

To evaluate the capacity of the automatic detection system to accurately grade, from selfie pictures, the severity of eight facial signs in South African men.

METHODS

Selfie pictures (obtained from frontal and back cameras) of 281 South African men differently aged (20-70 years) were obtained and analyzed by an automatic artificial intelligence (AI)-based automatic grading system. Data were compared with the clinical gradings made by experts and dermatologists.

RESULTS

In all facial signs, both series of gradings were found highly correlated with, however, different coefficients (0.59-0.95), those of marionette lines and cheek pores being of lower values. No differences were observed between data obtained by frontal and back cameras. With age, in most cases, gradings show up to the 50-59 year age-class, linear-like changes. When compared to men of other ancestries, South African men present lower wrinkles/texture, pigmentation, and ptosis/sagging scores till 50-59 years, albeit not much different in the cheek pores sign. The early onset (mean age) of visibility of wrinkles/texture for South African men were (i.e., reaching grade >1) 39 and 45 years for ptosis/sagging.

CONCLUSION

This study completes and enlarges the previous works conducted on men of other ancestries by showing some South African specificities and slight differences with men of comparable phototypes (Afro American).

Artificial Intelligence Confirming Treatment Success: The Role of Gender- and Age-Specific Scales in Performance Evaluation

In plastic surgery and cosmetic dermatology, photographic data are an invaluable element of research and clinical practice. Additionally, the use of before and after images is a standard documentation method for procedures, and these images are particularly useful in consultations for effective communication with the patient. An artificial intelligence (AI)-based approach has been proven to have significant results in medical dermatology, plastic surgery, and antiaging procedures in recent years, with applications ranging from skin cancer screening to 3D face reconstructions, the prediction of biological age and perceived age. The increasing use of AI and computer vision methods is due to their noninvasive nature and their potential to provide remote diagnostics. This is especially helpful in instances where traveling to a physical office is complicated, as we have experienced in recent years with the global coronavirus pandemic. However, one question remains: how should the results of AI-based analysis be presented to enable personalization? In this paper, the author investigates the benefit of using gender- and age-specific scales to present skin parameter scores calculated using AI-based systems when analyzing image data.

Structural and Functional age-related changes in some facial signs of Chinese men. A Pilot study

OBJECTIVE

To associate, on the same Chinese male subjects, changes in facial aging signs with some biomechanical skin properties.

METHODS

The severities of 20 facial aging signs of 219 differently aged Chinese men (20-65y) were graded in blind by trained experts through standardized photographs, using a referential skin Atlas dedicated to Asian men. On each subject, the mechanical properties were assessed on the cheek area (left or right at random) by the validated suction technique Cutometer®. Finally, the skin color parameters were assessed on images from VISIA-CR device.

RESULTS

Clinically speaking, the severity of almost all facial aging signs increases from 30y to 65y, in a linear like progression, whereas the 20-30y shows weak increases. Skin color shows slight but progressive decreases in Luminance and ITA, whereas the yellow and red components slightly increased between 40y and 65y. At the exception of skin firmness, the skin mechanical properties show a clear decline during the 30-50y period and plateau beyond.

CONCLUSION

The present study suggests that the 20-30y period, albeit more clinically "silent" than the other periods of age, seems to be an age-range during which early alterations of some dermal elements' onset. Deeper in vivo investigating techniques (Echography, Multiphotonic microscopy) are needed to confirm such hypothesis.

Objective and automatic grading system of facial signs from selfie pictures of South African women: Characterization of changes with age and sun‐exposures

OBJECTIVE

To evaluate the capacity of the automatic detection system to accurately grade, from smartphones' selfie pictures, the severity of fifteen facial signs in South African women and their changes related to age and sun-exposure habits.

METHODS

A two-steps approach was conducted based on self-taken selfie images. At first, to assess on 306 South African women (20-69 years) enrolled in Pretoria area (25.74°S, 28.22°E), age changes on fifteen facial signs measured by an artificial intelligence (AI)-based automatic grading system previously validated by experts/dermatologists. Second, as these South African panelists were recruited according to their usual behavior toward sun-exposure, that is, nonsun-phobic (NSP, N = 151) and sun-phobic (SP, N = 155) and through their regular and early use of a photo-protective product, to characterize the facial photo-damages.

RESULTS

(1) The automatic scores showed significant changes with age, by decade, of sagging and wrinkles/texture (p < 0.05) after 20 and 30 years, respectively. Pigmentation cluster scores presented no significant changes with age whereas cheek skin pores enlarged at a low extent with two plateaus at thirties and fifties. (2) After 60 years, a significantly increased severity of wrinkles/texture and sagging was observed in NSP versus SP women (p < 0.05). A trend of an increased pigmentation of the eye contour (p = 0.06) was observed after 50 years.

CONCLUSION

This work illustrates specific impacts of aging and sun-exposures on facial signs of South African women, when compared to previous experiments conducted in Europe or East Asia. Results significantly confirm the importance of sun-avoidance coupled with photo-protective measures to avoid long-term skin damages. In inclusive epidemiological studies that aim at investigating large human panels in very different contexts, the AI-based system offers a fast, affordable and confidential approach in the detection and quantification of facial signs and their dependency with ages, environments, and lifestyles.

Shape Prediction of Nasal Bones by Digital 2D-Photogrammetry of the Nose Based on Convolution and Back-Propagation Neural Network

In rhinoplasty, it is necessary to consider the correlation between the anthropometric indicators of the nasal bone, so that it prevents surgical complications and enhances the patient's satisfaction. The penetrating form of high-energy electromagnetic radiation is highly impacted on human health, which has often raised concerns of alternative method for facial analysis. The critical stage to assess nasal morphology is the nasal analysis on its anthropology that is highly reliant on the understanding of the structural features of the nasal radix. For example, the shape and size of nasal bone features, skin thickness, and also body factors aggregated from different facial anthropology values. In medical diagnosis, however, the morphology of the nasal bone is determined manually and significantly relies on the clinician's expertise. Furthermore, the evaluation anthropological keypoint of the nasal bone is nonrepeatable and laborious, also finding widely differ and intralaboratory variability in the results because of facial soft tissue and equipment defects. In order to overcome these problems, we propose specialized convolutional neural network (CNN) architecture to accurately predict nasal measurement based on digital 2D photogrammetry. To boost performance and efficacy, it is deliberately constructed with many layers and different filter sizes, with less filters and optimizing parameters. Through its result, the back-propagation neural network (BPNN) indicated the correlation between differences in human body factors mentioned are height, weight known as body mass index (BMI), age, gender, and the nasal bone dimension of the participant. With full of parameters could the nasal morphology be diagnostic continuously. The model's performance is evaluated on various newest architecture models such as DenseNet, ConvNet, Inception, VGG, and MobileNet. Experiments were directly conducted on different facials. The results show the proposed architecture worked well in terms of nasal properties achieved which utilize four statistical criteria named mean average precision (mAP), mean absolute error (MAE), R-square (R²), and T-test analyzed. Data has also shown that the nasal shape of Southeast Asians, especially Vietnamese, could be divided into different types in two perspective views. From cadavers for bony datasets, nasal bones can be classified into 2 morphological types in the lateral view which “V” shape was presented by 78.8% and the remains were “S” shape evaluated based on Lazovic (2015). With 2 angular dimension averages are 136.41 ± 7.99 and 104.25 ± 5.95 represented by the nasofrontal angle (g-n-prn) and the nasomental angle (n-prn-sn), respectively. For frontal view, classified by Hwang, Tae-Sun, et al. (2005), nasal morphology of Vietnamese participants could be divided into three types: type A was present in 57.6% and type B was present in 30.3% of the noses. In particular, types C, D, and E were not a common form of Vietnamese which includes the remaining number of participants. In conclusion, the proposed model performed the potential hybrid of CNN and BPNN with its application to give expected accuracy in terms of keypoint localization and nasal morphology regression. Nasal analysis can replace MRI imaging diagnostics that are reflected by the risk to human body.

Evaluation of facial skin age based on biophysical properties in vivo

OBJECTIVE

The evaluation of skin age, reflecting overall facial characteristics, has not been established. Previous studies focused on visual assessment or individual-specific feature such as wrinkles or skin color. We studied the evaluation model of skin age index (SAI) including the overall aging features including wrinkles, skin color, pigmentation, elasticity, and hydration.

METHODS

Total 300 healthy women aged between 20 and 69 years included in this study. Pearson correlation analysis performed to identify the key factors among the biophysical properties with aging and developed the prediction model of SAI. Statistical regression analysis and machine learning technique applied to build the prediction model using the coefficient of determination (R² ) and root mean square error (RMSE). Validation study of the SAI model performed on 24 women for 6 weeks application with anti-aging product.

RESULTS

Prediction model of SAI consisted of skin elasticity, wrinkles, skin color (brightness, Pigmented spot, and Uv spot), and hydration, which are major features for aging. The cforest model to assess a SAI using machine learning identified the highest R² and lowest RMSE compared to other models, such as svmRadial, gaussprRadial, blackboost, rpart, and statistical regression formula. The cforest prediction model confirmed a significant decrease of predicted SAI after 6 weeks of application of anti-aging product.

CONCLUSION

We developed a prediction model to evaluate a SAI using machine learning, and led to accurate predicted age for overall clinical aging. This model can a good standard index for evaluating facial skin aging and anti-aging products.

Subcutaneous Face and Neck lift: A Traditional Method With Definite Effects Among Asians

BACKGROUND

The mainstream facelifts in Western countries always involve the superficial fascia/superficial musculoaponeurotic system treatment. Meanwhile, subcutaneous face and neck lifts are widely applied among Asians.

OBJECTIVES

The authors sought to evaluate outcomes of subcutaneous face and neck lift, including patient-reported and 3-dimensional (3D) measurement outcomes, and report on details of surgical procedures.

METHODS

Patients who received a subcutaneous face and neck lift from January 2017 to June 2019 were asked to complete FACE-Q scales, and facial information was collected by the Vectra 3D imaging system preoperatively and postoperatively. Volume changes in midface and possible displacement of facial landmarks were measured. The range of dissection and the amount of skin removed were recorded intraoperatively.

RESULTS

In total, 119 patients (median age, 46 years, interquartile range, 40-53 years) received a subcutaneous face and neck lift. Among them, 88 patients completed pre- and postoperative FACE-Q scales. Patients' satisfaction with facial subunits improved and wrinkles were significantly relieved (P < 0.001). Nineteen patients (38 midface sides) completed 3D image data collection. Postoperatively, zygomatic volume increased, and nasolabial and lateral cheek volumes decreased (volume change of 2.2 ± 1.3 mL). Mouth, nose, and eye displacements were negligible postoperatively. The widths of skin removed at the middle temporal, front of the sideburns, upper helix, earlobe, and retro-auricular were 13.8 ± 1.9 mm, 19.6 ± 3.1 mm, 27.6 ± 3.9 mm, 16.4 ± 3.9 mm, and 32.2 ± 4.0 mm, respectively.

CONCLUSIONS

The authors' subcutaneous face and neck lift was effective in relieving nasolabial sagging, improving wrinkles, and achieving facial rejuvenation.

LEVEL OF EVIDENCE: 4

Defining skin aging and its risk factors: a systematic review and meta-analysis

Skin aging has been defined to encompass both intrinsic and extrinsic aging, with extrinsic aging effected by environmental influences and overlaying the effects of chronological aging. The risk factors of skin aging have been studied previously, using methods of quantifying skin aging. However, these studies have yet to be reviewed. To better understand skin aging risk factors and collate the available data, we aimed to conduct a systematic review and meta-analysis. We conducted our systematic review in compliance with Preferred Reporting Item for Systematic Review and Meta-Analyses (PRISMA) guidelines. Embase, PubMed and Web of Science databases were searched in October 2020 using specific search strategies. Where odds ratios were reported, meta-analyses were conducted using the random effects model. Otherwise, significant factors were reported in this review. We identified seven notable risk factors for various skin aging phenotypes: age, gender, ethnicity, air pollution, nutrition, smoking, sun exposure. This review's results will guide future works, such as those aiming to examine the interaction between genetic and environmental influences.

A new procedure, free from human assessment, that automatically grades some facial skin signs in men from selfie pictures. Application to changes induced by a severe aerial chronic urban pollution

OBJECTIVE

These were two folds: at first, to develop an automatic grading system specifically dedicated to some facial signs of men, similar to the one previously validated on women of different ethnic ancestry and second, to assess its potential in detecting and grading the possible impacts of a severe aerial urban pollution on some facial signs of Chinese men.

METHODS

In both studies, selfie images were obtained from differently aged men. Nine facial signs were automatically graded through a specific A.I-based algorithm and clinically assessed by a panel of experts and dermatologists. Selfie pictures were taken from individual smartphones of variable optical properties. The first study, designed for developing an automatic grading system, involved three comparable cohorts of men from three different regional ancestries (African, Asian, Caucasian, 110 each) the selfie images of which were acquired under four different lighting conditions. As a second use case study, the facial signs of two cohorts of Chinese men (101 and 100, each), differently aged, regularly exposed to very different aerial urban pollution conditions (UP) were analysed by the same algorithm, selfies being taken under only one lighting condition.

RESULTS

-The new automatic grading system of facial signs suits well to men, showing comparable results than that the one dedicated to women and provides data in close agreement with experts' assessments. -In both cases (expert's or automatic methodology), the accuracy of the scores appeared ethnic-dependent. -The applied case confirmed previous results obtained clinically, that is, that many facial signs were found of an increased severity among men exposed to a severe urban pollution, as compared to those living in a less polluted city. -In both studies, statistical agreements between the automatic grading system and expert's assessments were reached. In some facial signs, the automatic grading system seems offering a slightly better accuracy than the assessments made by the experts.

CONCLUSION

Apart from some minor limitations, this A.I-based automatic grading system, free from human intervention, performed as well as the one previously developed in women, in close agreement with expert's assessments. In epidemiological studies, this system offers an easy, fast, affordable and confidential approach in the detection and quantification of male facial signs.

Changes in facial signs due to age and their respective weights on the perception of age, on a tired-look or a healthy glow among differently aged Chinese men

OBJECTIVE

To determine the respective weights of certain facial signs on the assessment of perceived age, tired-look and healthy glow on Chinese men of different ages.

MATERIAL AND METHODS

Photographs were taken of the faces of 420 Chinese men of different ages, under standardized conditions. These photographs allowed to focus and define 15 facial signs, which were then graded by 15 experts and dermatologists, using standardized scales provided by a reference Skin Aging Atlas. The facial signs were dispatched into 5 clusters, namely wrinkles/texture, ptosis/sagging, pigmentation disorders, vascular disorders and cheek skin pores. A naïve panel, composed of 80 Chinese women, of similar age range were asked, when viewing full-face photographs, to: (i) attribute on a 0-10 scale their perception of both the tired-look and healthy glow aspects and (ii) estimate the age of the subject.

RESULTS

With the exception of vascular disorders, the severity of all 4 clusters increased with age, although at different rates. The ptosis/sagging or pigmentation disorders showed a rather regular progression. Although perceived ages and real ages were found to be closely correlated, the vast majority of subjects were judged older by 2-10 years. The changes in facial signs (and their related clusters) were significantly correlated with perceived age, with the exceptions of skin spot density and cheek skin pores. Although the aspects of tired-look and healthy glow were logically found to be anti-correlated, tired-look was more statistically associated with perceived age for the five clusters. Signs of eye contour appear to be closely correlated with the perception of a tired-look.

CONCLUSION

Within facial clinical clusters, wrinkles/texture and ptosis/sagging are major factors in the assessment of perceived age in Chinese men. Tired-look appears to be strongly associated with perceived age.

Changes of the human skin microbiota upon chronic exposure to polycyclic aromatic hydrocarbon pollutants

BACKGROUND

Polycyclic aromatic hydrocarbons (PAHs) are of environmental and public health concerns and contribute to adverse skin attributes such as premature skin aging and pigmentary disorder. However, little information is available on the potential roles of chronic urban PAH pollutant exposure on the cutaneous microbiota. Given the roles of the skin microbiota have on healthy and undesirable skin phenotypes and the relationships between PAHs and skin properties, we hypothesize that exposure of PAHs may be associated with changes in the cutaneous microbiota. In this study, the skin microbiota of over two hundred Chinese individuals from two cities in China with varying exposure levels of PAHs were characterized by bacterial and fungal amplicon and shotgun metagenomics sequencing.

RESULTS

Skin site and city were strong parameters in changing microbial communities and their assembly processes. Reductions of bacterial-fungal microbial network structural integrity and stability were associated with skin conditions (acne and dandruff). Multivariate analysis revealed associations between abundances of Propionibacterium and Malassezia with host properties and pollutant exposure levels. Shannon diversity increase was correlated to exposure levels of PAHs in a dose-dependent manner. Shotgun metagenomics analysis of samples (n = 32) from individuals of the lowest and highest exposure levels of PAHs further highlighted associations between the PAHs quantified and decrease in abundances of skin commensals and increase in oral bacteria. Functional analysis identified associations between levels of PAHs and abundance of microbial genes of metabolic and other pathways with potential importance in host-microbe interactions as well as degradation of aromatic compounds.

CONCLUSIONS

The results in this study demonstrated the changes in composition and functional capacities of the cutaneous microbiota associated with chronic exposure levels of PAHs. Findings from this study will aid the development of strategies to harness the microbiota in protecting the skin against pollutants. Video Abstract.

Depiction of ethnic facial aging by forensic artists and preliminary assessment of the applicability of facial averages

Many characteristics of facial aging are common to all. The age of their onset and which characteristics tend to predominate varies among individuals depending on many factors including their genetic makeup, life experiences, environment in which they live, and the regional, ethnic, or socially perceived group to which they belong. Forensic artists are often asked to provide sketches, 2D or 3D digital renderings, or sculptures representative of how an individual may appear at an older age based on a provided photograph, victim or witness description, and/or cranial remains. The challenge escalates when the subject is a member of a regional, ethnic, or other socially perceived group to which the artist has had little or no exposure. We describe aspects of adult facial aging that are of particular relevance to the forensic artist, applicable software tools, and pertinent facial databases, especially those emphasizing non-white populations. We demonstrate that facial averaging offers two key advantages to the artistic portrayal of facial aging: first, the technique requires relatively small reference databases from groups that may present logistical challenges to collect and second, that a facial average provides a useful representation of the gestalt of the age and ethnicity cohort to which a subject belongs. The artist may use an average along with other available information such as photo reference books, eyewitness descriptions, photos of immediate family members, and cranial structure to guide production of a facial composite drawing, digital age progression, or sculpture of the subject in question.

Gender-related differences in the facial aging of Caucasian French subjects and their relations with perceived ages and tiredness

OBJECTIVES

(a) To assess and compare the changes in five facial signs with age between genders of Caucasian subjects and (b) to evaluate their links with perceived ages and tiredness.

MATERIAL AND METHODS

Once zoomed from standardized digital photographs, five facial signs of 518 Caucasian French subjects of both genders and different ages (18-69 years) were graded by 15 experts, using a referential Skin Aging Atlas. A large naïve panel of 1000 French subjects (500 men and 500 women) was asked to attribute a perceived age and a degree of tiredness to 200 subjects (among the 518).

RESULTS

The severity of the facial signs increases with time at a linear-like rate. The changes in marionette lines significantly differ between genders, much more pronounced in women, and nasolabial fold was found more pronounced in men at older ages (>50 years). Before 50's, Forehead wrinkles present a slightly higher severity in men whereas at 50's women present more severe ptosis. Crow's feet wrinkles did not show significant changes. Perceived ages were found significantly correlated with the severities of the facial signs and the perception of tiredness was associated with perceived ages in men, but not in women older than 40 years. The gender-related perceptions from the naïve panel in both perceived ages and tiredness showed a low discrepancy. Interestingly, as for changes in facial signs, the upper-half face seems more affected for men and lower-half face for women; after 40 years, the naïve panel seems more focusing on the same areas to predict a perceived age.

CONCLUSION

As compared to the previous Chinese study, the present work reveals some slight ethnical-related differences, indicating that the facial signs of the lower face play a major role in the assessment of perceived age of both genders from different ethnicity.

Assessing the impact of an aerial chronic urban pollution (UP) on some facial signs of differently-aged Chinese men

OBJECTIVE

To assess the impact of an aerial chronic urban pollution (UP) on the severities of some facial signs of Chinese men living in two close but differently polluted Chinese cities.

MATERIALS AND METHODS

Standardized digital photographs were taken on 201 subjects from two cohorts of Chinese men (100 inhabitants of Baoding/very polluted and 101 inhabitants of Dalian/less polluted) differently aged (20-60 years) allowing a focus on 17 different facial signs. The latter were graded by 15 experts, using a clinical referential skin atlas. A questionnaire was filled by all subjects collecting their habits and uses with regard sun-exposures and skincare products. A naïve panel of 80 Chinese women, of comparable ages, attributed a perceived age to each subject under blind conditions.

RESULTS

These confirm previous data obtained on Chinese women, with a similar protocol, i.e. that some facial signs show an increased severity in the more polluted city. However, changes in facial signs, with age, are of a different pattern according to gender. In Chinese men, most signs show early onsets with however low age-related changes, inversely to those observed in women, at the exception of vascular disorders. Habits of sun-exposures and uses of skincare product were found totally similar in both cohorts, reinforcing the specific role of UP in the progressive changes of facial signs. Similar to the results previously obtained on Chinese women, men living in a more polluted city were judged older than those living in a less polluted aerial environment.

CONCLUSION

The present work confirms that a more severe UP increases the severities of some facial signs in Chinese men.

Aging and the Indian Face: An Analytical Study of Aging in the Asian Indian Face

Supplemental Digital Content is available in the text.

Asian Indians make up almost one-sixth of the world’s population. Although some aspects of facial beauty are universal, anthropometric morphology and age-related changes differ in all ethnic groups. Currently, there are hardly any published studies highlighting the process of aging in Asian Indians. We wanted to understand the aging patterns in different ethnic subgroups within Asian Indians and also compare the aging patterns with Caucasians.

Distinct Habits Of Sun Exposures Lead To Different Impacts On Some Facial Signs Of Chinese Men Of Different Ages

OBJECTIVE

To clinically evaluate the impacts of sun exposures on some facial signs of differently aged Chinese men with a distinct behavior vis à vis sun exposures.

METHODS

Two comparable cohorts of Chinese men (aged 18-75 years old), living in two cities (Shanghai, Hong Kong) were created according to their usual behavior towards sun exposure and through their variable use(s) of a photo-protective product, i.e. non-sun-phobic (N = 127) and sun-phobic (N = 134). Standard photographs (full-face and 45° lateral) allowed to focus on 13 facial signs that were further graded by 15 experts and dermatologists, using a referential Skin Aging Atlas. Absolute differences in the scores of each sign were used (non-sun-phobic minus sun-phobic), by age-classes, to better ascertain the impact of sun exposures and a photo-protecting product, when used.

RESULTS

Most facial signs, particularly wrinkles and skin texture, differentiated the two cohorts. Some others showed some erratic changes with age, albeit more pronounced at older ages. In contrast with previous results obtained in Chinese women, the changes observed in men were not only of a lessened severity but were undetected at early ages (<30 years old). Overall, these different behaviors with regard to sun exposures led to significant differences in the facial signs of Chinese men. The latter can be illustrated by two virtual morphings that combine the impacts of both intrinsic and extrinsic aging processes.

CONCLUSION

The present work illustrates, for the first time, some specificities of the impacts of sun exposures on the facial skin of Chinese men, more expressed at older ages, inversely to those observed in Chinese women, occurring at younger ages.

A new procedure, free from human assessment that automatically grades some facial skin structural signs. Comparison with assessments by experts, using referential atlases of skin ageing

OBJECTIVE

To develop an automatic system that grades the severity of facial signs through 'selfies' pictures taken by women of different ages and ethnics.

METHODS

1140 women from three ethnics (African-American, Asian, Caucasian), of different ages (18-80 years old), took 'selfies' by high resolution smartphones cameras under different conditions of lighting or facial expressions. A dedicated software, was developed, based on a Convolutional Neural Network (CNN) that integrates training data from referential Skin Aging Atlases. The latter allows to an immediate quantification of the severity of nine facial signs according to the ethnicity declared by the subject. These automatic grading were confronted to those assessed by 12 trained experts and dermatologists either on 'selfies' pictures or in live conditions on a smaller cohort of women.

RESULTS

The system appears weakly influenced by lighting conditions or facial expressions (coefficients of variations ranging 10-13% for most signs) and leads to global agreements with experts' assessments, even showing a better reproducibility on some facial signs.

CONCLUSION

This automatic scoring system, still in development, seems offering a new quantitative approach in the quantified description of facial signs, independent from human vision, in many applications, being individual, cosmetic oriented or dermatological with regard to the follow-up of medical anti-ageing corrective strategies.