Grading facial aging: Comparing the clinical assessments made by three dermatologists with those obtained by an AI-based scoring system that analyses selfie pictures. A focus on Chinese subjects of both genders

OBJECTIVE

The objective of this study is to assess the correspondence, in live conditions, between clinical gradings of facial aging signs by three dermatologists and those afforded by an automatic AI-based algorithm that analyses smartphones' selfie images of Chinese subjects.

METHODS

In total, 125 Chinese subjects of both genders, aged 18-62y, took a selfie using their own smartphones and were immediately viewed by three dermatologists. The latter graded the severity of 15 facial signs in women and 9 in men, using the standardized values afforded by a Skin Aging Atlas referential dedicated to Asian skin. The data issued by both methodologies were then statistically compared.

RESULTS

The absolute gradings of the automatic system were found highly correlated with clinical assessments, with lower values in most cases. In women, large differences in absolute values were found on the gradings for size of isolated spot, cheek fold, spread macules, and texture of mouth contour women. Analysis of the Mean Absolute Errors (M.A.E) revealed that these rarely exceed 0.6 grading units in women and to a lesser extent in men.

CONCLUSION

The present study confirmed the value of the automatic system towards an extended use towards large human cohorts as a surrogate of clinical evaluations and allowed to detect the points where improvements must be brought to the system.

Differences in the annotation between facial images and videos for training an artificial intelligence for skin type determination

BACKGROUND

The Grand-AID research project, consisting of GRANDEL-The Beautyness Company, the dermatology department of Augsburg University Hospital and the Chair of IT Infrastructure for Translational Medical Research at Augsburg University, is currently researching the development of a digital skin consultation tool that uses artificial intelligence (AI) to analyze the user's skin and ultimately perform a personalized skin analysis and a customized skin care routine. Training the AI requires annotation of various skin features on facial images. The central question is whether videos are better suited than static images for assessing dynamic parameters such as wrinkles and elasticity. For this purpose, a pilot study was carried out in which the annotations on images and videos were compared.

MATERIALS AND METHODS

Standardized image sequences as well as a video with facial expressions were taken from 25 healthy volunteers. Four raters with dermatological expertise annotated eight features (wrinkles, redness, shine, pores, pigmentation spots, dark circles, skin sagging, and blemished skin) with a semi-quantitative and a linear scale in a cross-over design to evaluate differences between the image modalities and between the raters.

RESULTS

In the videos, most parameters tended to be assessed with higher scores than in the images, and in some cases significantly. Furthermore, there were significant differences between the raters.

CONCLUSION

The present study shows significant differences between the two evaluation methods using image or video analysis. In addition, the evaluation of the skin analysis depends on subjective criteria. Therefore, when training the AI, we recommend regular training of the annotating individuals and cross-validation of the annotation.

A cross-sectional epidemiological study conducted in Argentina to evaluate the impact of the exposome on skin aging

BACKGROUND

Skin aging is a gradual cumulative process that may be accelerated by various exposome factors.

AIMS

To investigate associations between exposome factors and facial skin aging in 11 locations in Argentina.

PATIENTS/METHODS

An observational, cross-sectional study with assessments by exposome questionnaire, Glogau photoaging classification from I to IV, AI-based algorithm analysis of 7 skin aging signs, and SCINEXA score.

RESULTS

Of 1346 participants, most were women (82%), aged 31-50 years (62%), of skin phototype III (52%), and living in urban areas (94%). The Glogau skin age was higher than the chronological age for 28% of overall participants, 36% of men, and 45% of participants from Ciudad de Buenos Aires versus 12% from Jujuy (p < 0.001). Being male (OR = 1.59; 95% CI 1.18-2.13), exposed to agrochemicals (OR = 1.59: 95% CI 1.01-2.51), of lower socioeconomic levels (OR = 2.06; 95% CI 1.32-3.21) and doing outdoor physical activity (OR = 1.33; 95% CI 1.00-1.76) increased the risk for premature aging. Odds decreased with high daily intake of water (OR = 0.76; 95% CI 0.59-0.97), daily dermocosmetic use (moisturizers [OR = 0.72; 95% CI 0.55-0.94], cleansers [OR = 0.53; CI 95% 0.42-0.67], retinoids [OR = 0.61; 95% CI 0.39-0.95]), and antiaging treatments (OR = 0.74; 95% CI 0.57-0.97).

CONCLUSIONS

Some exposome factors increased the risk for premature skin aging (physical outdoor activity, exposure to agrochemicals), while others were protective factors (high water intake, antiaging treatments, use of dermocosmetics). Locations with higher pollution levels had more premature skin aging.

Applications of the new Aeva-HE™ imaging system: Its link with the visual evaluation of facial wrinkles and its potential in screening tensile products

OBJECTIVES

To evaluate, in vivo, a recently developed imaging system (Aeva-HE™), based on fringe projection methodology: (i) its correlation with expert's assessments and real age of 85 French Caucasian women and (ii) its potential, as a screening tool, in rapidly selecting prototypes of tensile cosmetic products.

MATERIALS AND METHODS

First, the bare faces of 85 differently aged French/Caucasian women were photographed under standard conditions and further analyzed by the Aeva-HE™ device. An expert aesthetician graded the severity of wrinkling on a fixed scale, helped by the use of a dedicated Skin Aging Atlas. A panel of 15 judges performed the same task on full-face standard photographs. The Aeva-HE™ software yielded various wrinkle's parameters (density, volume, mean depth, etc.) on different facial locations, according to age-groups. Second, seven women, balanced in age and wrinkling severity, were recruited in a separate study. These women applied at Day 1 a prototype of the tensile product and at Day 2, they applied another prototype of the tensile product. The whole faces (before and after products application) of the seven studied women were captured and analyzed by the Aeva-HE™ system.

RESULTS

The density of wrinkles was significantly highly correlated with the aesthetician scores and, unsurprisingly, with age. Some parameters (volume, depths) of different wrinkles (glabellar, crow's feet, cheeks) were quantified, showing different absolute values and of statistically different progressions with age. The amplitudes of the rapid effects brought by the two prototypes of tensile products were clearly differentiated.

CONCLUSION

The recently developed device Aeva-HE™ is an efficient system for rapidly establishing a faithful and precise status of facial wrinkles, in vivo and seems like a precious tool in the rapid screening of tensile products, possibly performed on a rather limited number of subjects.

Photoaging's portrait: The road map towards its photoprotection

OBJECTIVE

To summarize key research published by the author's group, dealing with skin photoaging and its photoprotection.

MATERIALS AND METHODS

Two methodologies (standard photographs and selfies imaging) resulting from referential skin ageing atlases were applied on 2487 subjects of different ancestries, ages and gender. These aimed at first to best assess and grade the variable severities of some facial signs (texture/wrinkles, pigmentary spots, sagging and vascular disorders) that occur progressively during the photoaging process. Second, such methodologies were used to record the benefits brought by a photoprotective regimen (671 women and men).

RESULTS

In all studied ancestries, each facial sign show an increase severity along decades, at its own pace, some showing a linear like progression, whereas some plateau at early ages. These changes differed according to skin innate colour (phototype) and with individual behaviours vis-à-vis sun exposures, more so among European women than North-East Asian women. An effect of gender (less severe alterations) was observed on Chinese men, as compared to Chinese women. Pigmentary disorders were found hallmarks of photo-aged North-East Asian women. Globally, photoaging impact the apparent age of the different subjects. The counteracting effects of strong topical Photoprotective regimens were evidenced along a 6-month seasonality in Chinese and French women or 1-year period in Brazilian women with phototypes II to VI. Photoprotection led to a more even skin complexion among Indian subjects with pigment irregularities.

CONCLUSION

Two factors clearly hamper a better assessment of the efficiency of photoprotection of the sun-induced cutaneous ageing: short durations (months) of the studies with regard to the global fate of photoaging by decades and the number of studied subjects, limited to hundreds for practical reasons. The methodology based on the automatic analysis of facial signs through selfies images could theoretically bypass both factors, allowing thousands of subjects to be studied along years.

Evaluation of adapted dermocosmetic regimens for perimenopausal and menopausal women using an artificial intelligence-based algorithm and quality of life questionnaires: An open observational study

BACKGROUND

The decline in estrogen levels from several years before (perimenopause) and during menopause has various negative effects, including skin specific issues, which often receive less attention than other menopausal symptoms despite having a significant negative effect on quality of life (QoL). The objective of this study was to evaluate the effectiveness of anti-aging dermocosmetic products designed for women during the perimenopause and menopause.

MATERIALS AND METHODS

An open study of 101 perimenopausal women (no menstruation for 4-12 months or irregular menstruation for <5 years) and 101 menopausal women (no menstruation for >12 months), not taking hormone replacement therapy, was conducted. Adapted dermocosmetic regimens, specific to each group (day cream, night cream and serum), were applied for 56 days. Assessments included automatic artificial intelligence diagnostics of eight clinical facial signs, hydration and transepidermal water loss (TEWL), and a menopause skin QoL questionnaire.

RESULTS

Mean age was 50 ± 3.9 years (range 41-57) and 59 ± 3.8 years (range 50-66) for the perimenopause and menopause groups, respectively. Significant improvements in wrinkles and vascular signs, increases in hydration, decreases in TEWL, and a positive impact on QoL were observed after 56 days of application of the respective dermocosmetic regimens for both the perimenopause and menopause groups.

CONCLUSION

The anti-aging skin care products designed specifically for perimenopausal and menopausal women increased skin hydration and improved wrinkles with a positive impact on QoL.

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).

Accuracy and clinical relevance of an automated, algorithm-based analysis of facial signs from selfie images of women in the United States of various ages, ancestries and phototypes: A cross-sectional observational study

BACKGROUND

Real-life validation is necessary to ensure our artificial intelligence (AI) skin diagnostic tool is inclusive across a diverse and representative US population of various ages, ancestries and skin phototypes.

OBJECTIVES

To explore the relevance and accuracy of an automated, algorithm-based analysis of facial signs in representative women of different ancestries, ages and phototypes, living in the same country.

METHODS

In a cross-sectional study of selfie images of 1041 US women, algorithm-based analyses of seven facial signs were automatically graded by an AI-based algorithm and by 50 US dermatologists of various profiles (age, gender, ancestry, geographical location). For automated analysis and dermatologist assessment, the same referential skin atlas was used to standardize the grading scales. The average values and their variability were compared with respect to age, ancestry and phototype.

RESULTS

For five signs, the grading obtained by the automated system were strongly correlated with dermatologists' assessments (r ≥ 0.75); cheek skin pores were moderately correlated (r = 0.63) and pigmentation signs, especially for the darkest skin tones, were weakly correlated (r = 0.40) to the dermatologist assessments. Age and ancestry had no effect on the correlations. In many cases, the automated system performed better than the dermatologist-assessed clinical grading due to 0.3-0.5 grading unit differences among the dermatologist panel that were not related to any individual characteristic (e.g. gender, age, ancestry, location). The use of phototypes, as discontinuous categorical variables, is likely a limiting factor in the assessments of grading, whether obtained by automated analysis or clinical assessment of the images.

CONCLUSIONS

The AI-based automatic procedure is accurate and clinically relevant for analysing facial signs in a diverse and inclusive population of US women, as confirmed by a diverse panel of dermatologists, although skin tone requires further improvement.

Skin moisture assessment using Hydration Sensor Patches coupled with smartphones via Near Field Communication (NFC). A pilot study with the first generation of patches that allow self-recordings of skin hydration

OBJECTIVES

To evaluate the potency of a new skin hydration sensor patch in the fast self-recording of skin hydration.

MATERIAL AND METHODS

The Skin Hydration Sensor Patch (SHSP) turns the user's smartphone into a wireless skin moisture measuring device. The SHSP combines a capacitive measurement unit and Near Field Communication technology (NFC) for transmitting data and energy. The probe is fixed onto the back of the smartphone and pressed to the skin for a few seconds where the application immediately calculates the capacitance value. Once recorded, the probe is then immediately taken off from the skin. In a first study, this system was compared to the Corneometer^® technique, in vivo, on various skin sites of 23 healthy French women. In a second study, 20 women with moderate dry skin on face and forearm self-recorded, through the SHSP the changes in skin hydration induced by a Xanthan gel containing 3% (w/w) of Glycerol, along 24 hours. A questionnaire based on 5 types of questions was established to be filled by subjects about their perception of the use of this new system.

RESULTS

In the first study, the values recorded by the SHSP were found highly correlated with those provided by the Corneometer^® . The second study allowed to observe significant differences in skin hydration of both sites at all times, as compared to values obtained before the application of the gel. Differences between both sites were observed, the face being less hydrated than forearm. From a practical aspect, the self-recordings on the face show a higher variability (approx. 10% than those of the forearm). The questionnaire led to positive answers on almost all points.

CONCLUSION

This SHSP appears as a promising approach in the field of connected skin-related devices. As such, it opens or enlarges a new paradigm in the relationships between a consumer and a cosmetic product.

Developing an Artificial Intelligence (A.I)-based descriptor of facial appearance that fits with the assessments of makeup experts

OBJECTIVE

To develop an A.I-based automatic descriptor that detects and grades, from selfie pictures, 23 facial signs, hairs included, as a help to making-up procedures.

MATERIAL AND METHODS

The selfie images taken in very different conditions by 3326 women and men were used to create (90% of dataset) and validate (10% of dataset) a new algorithm architecture to appraise and grade 23 different facial signs such as lips, nose, eye color, eyebrows, eyelashes, and hair color as defined by makeup artists. Each selfie image was annotated by 12 experts and defined references to train Artificial Intelligence (A.I)-based algorithm.

RESULTS

As some the 23 signs present a continuous or discontinuous feature, these were analyzed by two different statistical approaches. The results provided by the automatic descriptor system were not only in good agreement with the expert's assessments but were even found of a better precision and reproducibility. This automatic descriptor system has proven a good and robust accuracy despite the very variable conditions in the acquisition of selfie pictures.

CONCLUSION

Such automatic descriptor system seems providing a valuable help in making-up procedures and may extend to other activities such as Skincare or Haircare. As such it should allow large investigations to better evaluate the consumers' needs of esthetical improvements.

Comparing the self-perceived effects of a facial anti-aging product to those automatically detected from selfie images of Chinese women of different ages and cities

OBJECTIVE

To assess the agreement, after 1-month application of a popular and efficient anti-aging product, between self-perceived facial signs of aging and those detected and graded by an automatic A.I-based system, using smartphones' selfie images.

MATERIAL AND METHODS

Of 1065 Chinese women, aged 18-60 years, from eight different Chinese cities were recruited. They were asked to apply daily, for 1 month, a referential anti-aging product onto their whole face. Selfie images were taken by all subjects at D₀ and D₂₈ and sent to our facilities for being analyzed through 10 different facial signs. At D₂₈ , all subjects were asked to fill a questionnaire on the status of their faces, through six general statements.

RESULTS

A global agreement between both approaches is reached, particularly among women older than 40 years where the severity of facial signs is already more pronounced or among younger women who present at least facial signs scored above one grading units. This limit becomes, therefore, a prerequisite in the recruitment of Chinese subjects in the case of anti-aging applied studies and possible automatically based on automatic grading system. When respecting such conditions, the positive effects of the product on most facial signs can be demonstrated after 28 days of successive applications.

CONCLUSION

Such methodological approach paves the road in fulfilling the need of consumers of a better transparency in the claims of an anti-aging product.

A preliminary study to understand the effects of mask on tinted face cosmetics

Background

The recent COVID‐19 pandemic has generalized the use of face mask in public area, and it is now common to wear it for long hours. But face mask interfere with cosmetics, and key concerns for tinted products are staining of the mask and degradation on face. Consumers have modified beauty routine by a decrease of makeup, but are now expecting new products adapted to face mask. Little is known about the mechanisms that affect most the makeup under the face mask, so that further studies are needed to develop adequate evaluation methods and products. In this study, the color transfer on mask and makeup degradation on face are assessed through a mixed approach of consumer and instrumental evaluation.

Materials and Methods

Two tinted face products (A and B) were applied by half face on 11 Japanese women, who conducted real‐life activities with a face mask during 4 hours. Panelists evaluated the stain of their face mask by visual assessment, while the makeup degradation on face was evaluated by color measurement by instrumental method.

Results

No difference was observed between the two products for lasting on face, but consumer evaluation showed a better resistance of product A for color transfer on mask.

Conclusion

The mix of instrumental and consumer evaluation is a promising way to evaluate the makeup degradation on face and color transfer on mask, which are two key factors to develop mask resistant makeup products.

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.

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.