Development and application of artificial intelligence-based facial skin image diagnosis system: Changes in facial skin characteristics with ageing in Korean women.

OBJECTIVE: To develop and validate an artificial intelligence (AI)-based diagnostic system for analysing facial skin images using expert judgements and explore its feasibility for skin ageing research, specifically by evaluating facial skin changes in Korean women of various ages. METHODS: Our AI-based facial skin diagnosis system (Dr. AMORE®) uses facial images of Korean women to analyse wrinkles, pigmentation, skin pores, and other skin red spots. The system is trained using clinical expert evaluations and deep learning. We assessed the system's precision and sensitivity by analysing the correlation between the diagnoses by the AI system and those of the experts. We used 120 images of Korean women aged 10-60 years to evaluate the changes in various facial skin characteristics with ageing. RESULTS: The precision and sensitivity of the developed system were excellent (>0.9%), and the diagnosis scores using the detected area and intensity of each item were correlated significantly higher with the visual evaluation results of the clinical experts (>0.8, p < 0.001). We also analysed facial images of Korean women aged 10-60 years to quantify changes in the scores of wrinkles, pigmentation, and skin pores with age. We identified the age group with the most significant changes as 20s to 30s. Analysis of the detailed skin characteristics of each item showed that wrinkles and pigmentation changed significantly in the 20s-30s, and skin pores increased significantly in the 10s-20s. There was no significant correlation with age or change according to the age group for skin red spots. CONCLUSION: Developed AI-based facial skin diagnosis system can automatically diagnose skin conditions based on clinical expert judgement using only photographic images and analyse various items in detail, quantitatively, and visually. This AI system can provide new and useful approaches in research areas that require a lot of resources and different characterizations, such as the study of facial skin ageing.

OBJECTIF: Développer et valider un système de diagnostic basé sur l'intelligence artificielle (IA) pour analyser les images de la peau du visage à l'aide de jugements d'experts et explorer sa faisabilité pour la recherche sur le vieillissement de la peau, en particulier en évaluant les changements de la peau du visage chez les femmes Coréennes de différents âges. MÉTHODES: Notre système de diagnostic de la peau du visage basé sur l'intelligence artificielle (Dr. AMORE®) utilise des images du visage de femmes Coréennes pour analyser les rides, la pigmentation, les pores de la peau et d'autres taches rouges de la peau. Le système est entraîné à l'aide d'évaluations d'experts cliniques et de l'apprentissage profond. Nous avons évalué la précision et la sensibilité du système en analysant la corrélation entre les diagnostics du système d'IA et ceux des experts. Nous avons utilisé 120 images de femmes coréennes âgées de 10 à 60 ans pour évaluer les changements de diverses caractéristiques de la peau du visage avec le vieillissement. RÉSULTATS: la précision et la sensibilité du système développé étaient excellentes (>0.9%), et les scores de diagnostic utilisant la zone détectée et l'intensité de chaque élément étaient corrélés de manière significativement plus élevée avec les résultats de l'évaluation visuelle des experts cliniques (>.8, p < 0.001). Nous avons également analysé des images du visage de femmes coréennes âgées de 10 à 60 ans afin de quantifier les changements dans les scores des rides, de la pigmentation et des pores de la peau avec l'âge. Nous avons identifié le groupe d'âge présentant les changements les plus significatifs comme étant celui des 20­30 ans. L'analyse des caractéristiques détaillées de la peau pour chaque élément a montré que les rides et la pigmentation changeaient de manière significative chez les 20­30 ans, et que les pores de la peau augmentaient de manière significative chez les 10­20 ans. Il n'y avait pas de corrélation significative avec l'âge ou de changement en fonction du groupe d'âge pour les taches rouges de la peau. CONCLUSION: Le système de diagnostic de la peau du visage basé sur l'IA peut diagnostiquer automatiquement les affections cutanées sur la base d'un jugement d'expert clinique en utilisant uniquement des images photographiques et analyser divers éléments en détail, quantitativement et visuellement. Ce système d'IA peut fournir des approches nouvelles et utiles dans des domaines de recherché qui nécessitent beaucoup de ressources et de caractérisations différentes, comme l'étude du vieillissement de la peau du visage.

A long term study of the difference in efficacy and effect rate of various concentrations of retinol (1500-6600 IU) in middle aged women.

Retinol is widely used for topical application for antiaging. However, the efficacy and effect rate of different concentrations of retinol have been rarely analyzed. Therefore, in this study, the efficacy and rate of effect of retinol concentrations from 1500 to 6600 IU, on various skin parameters, have been compared. Seventy-two Korean women aged 40-59 years participated in this study. Retinol was used by them for 24 weeks; the effects were measured at 0, 2, 4, 8, 12, and 24 weeks. The measurement parameters for aging were crow's feet, forehead wrinkles, nasolabial fold, dermal density, and elasticity and that for skin color were skin brightness, yellowness, redness, and standard deviation of skin brightness. The texture of the skin was measured by measuring the skin roughness and pores, and the skin barrier function was evaluated through hydration, sebum, and desquamation. Low concentration retinol (1500-2500 IU) had a significantly higher effect in skin color, brightness, and elasticity and faster improvement rate in skin brightness and elasticity compared to that for high concentration (3300-6600 IU). High concentration of retinol had a significantly higher effect in wrinkles, dermal density and pores and faster improvement rate for wrinkles, skin texture, pores, and desquamation compared to that for low concentration. This study evaluated the changes caused by different concentration of retinol over a long period of time. The results of this study have great implications as the optimal concentration of retinol can be prescribed for an accurate period for the desired results without side effects.

Effects of one year of daily face mask wearing on the skin during the coronavirus disease 2019 pandemic.

BACKGROUND: As coronavirus disease 2019 (COVID-19) continues, the long-term daily use of masks is increasing. A full year includes the four seasons of spring, summer, autumn, and winter. Skin may have been affected by the seasons and further affected by the use of masks. In a previous study, we confirmed the short-term and 6-month effects of wearing face masks. In this study, we investigated how certain characteristics of the skin change when wearing a mask for 1 year. Furthermore, we compared skin covered by the mask (mask-skin zone) to skin that was not covered. MATERIALS AND METHODS: The participants were 18 healthy adults (8 men; 10 women) who were asked to wear masks in their daily lives from June 2020 to June 2021. During this period, participants' skin characteristics, such as trans-epidermal water loss, skin hydration, skin elasticity, skin keratin amount, skin pore area, skin temperature, skin redness, and skin color, were measured five times. RESULTS: Trans-epidermal water loss, skin keratin amount, skin pore area, skin color, and skin elasticity changed significantly during the year. Furthermore, trans-epidermal water loss, skin hydration, skin keratin amount, skin pore area, and skin color were significantly different between the mask-wearing and non-mask-wearing areas of the face. CONCLUSION: The skin characteristics of the mask-skin zone can be affected by long-term wearing of a face mask under lifestyle and environmental conditions. During the COVID-19 pandemic, skin care for the mask-skin zone is also necessary for people who do not wear masks on a daily basis.

Skin biophysical properties including impaired skin barrier function determine ultraviolet sensitivity.

BACKGROUND: The levels of burning susceptibility to ultraviolet (UV) radiations are affected by various factors, including Fitzpatrick skin types, skin color, sex, and ethnicity. However, studies on the relationship between skin biophysical properties and erythemal responses to UV radiations are rare. OBJECTIVE: This study aimed to investigate biophysical properties of the skin that determined individual skin sensitivity to UV radiation. METHODS: As an indicator of skin sensitivity to UV radiation, Korean women were subjected to minimal erythema dose (MED) testing. The skin biophysical properties, such as skin hydration, transepidermal water loss (TEWL), were measured. MED were also evaluated in further variations in the skin, including barrier disruption. RESULTS: A significant negative correlation was observed between TEWL and MED. With an increase in TEWL, that represents reduced skin barrier function, skin UV sensitivity also increased. Artificial alteration of skin conditions also changed erythemal response to UV radiation. When the skin barrier was disrupted, MED significantly decreased, indicating increased skin UV sensitivity. It is hypothesized that the altered penetration of UV radiation into the stratum corneum under the respective skin conditions caused different erythema reactions. CONCLUSION: For the first time in a clinical study, the skin biophysical properties, including skin barrier function, were found to have significant effects on skin sensitivity to UV radiation. This finding could help predict individual susceptibility to UV damage. Therefore, skincare products that improve skin conditions associated with UV sensitivity, as well as sunscreen are important for protection against the hazards of UV radiation.

Evaluation of changes in skin characteristics due to the poor quality of sleep caused by smartphone usage.

BACKGROUND: Blue wavelengths are thought to have an effect on circadian rhythms. Using a smartphone, which emits a 453 nm blue light, can worsen the quality of sleep. AIMS: To study the skin changes caused by poor sleep quality induced by smartphone usage. METHODS: The participants were 22 Korean women aged 20-39 years, with no sleep problems and a Pittsburgh Sleep Quality Index (PSQI) score of <5. The participants used a smartphone for 2 h before normal sleep hours. The measurement points were as follows: after a good sleep (D0), after bad sleep day 1 (D1), after bad sleep day 3 (D3), and after bad sleep day 7 (D7). The sleep time, wake-up time, shallow sleep rate, and sleeping time duration were recorded using a smartwatch. RESULTS: The quality of their sleep deteriorated. The average time of falling asleep extended to 2 a.m., which was about 34 min later. Additionally, their skin moisture content decreased, and sebum content increased. Skin desquamation was increased, and skin gloss, transparency, and elasticity decreased mainly on the skin surface. CONCLUSIONS: Sleep quality decreases with smartphone usage among people who do not usually use their smartphones before going to sleep and do not have any sleep problems. The results showed significant changes in skin optics and surface properties when the quality of sleep was degraded for 7 days.

Efficacy of ethyl ascorbyl ether-containing cosmetic cream on blue light-induced skin changes.

BACKGROUND: Office workers are consistently exposed to blue light, mainly from sunlight and digital device. Recent studies report that blue light has various harmful effects, including cellular changes via reactive oxygen species. Studies on blue light-induced skin changes have only been conducted in vitro and have not been clinically confirmed. OBJECTIVE: We provide novel methods to evaluate the effect of the product on the recovery of skin changed by blue light. METHODS: Internet surveys were conducted for workers in their 20s and 40s regarding exposure time to blue light in various environments. To study the effects of long-term exposure to blue light (456 nm) on the skin, we designed three light intensity conditions, and various skin characteristics were observed. After blue light irradiation, various skin characteristics were analyzed before and after applying ethyl ascorbyl ether (EAE)-containing cosmetic cream for 2 weeks. RESULTS: When exposed to strong blue light for approximately 16 days, the L* value, skin hydration, transparency, and elasticity decreased, and the melanin index, erythema index, a* value, and b* value increased. Furthermore, after short-term blue light irradiation (dose, 269 J/cm2 , the equivalent of blue light exposure for approximately 38 days in daily life), the L* value and elasticity decreased, and the melanin index and erythema index increased. However, when EAE cream was applied on skin for 1-2 weeks, the skin recovered. CONCLUSION: This study clinically confirms the skin changes caused by blue light and the effect of EAE in relieving such changes.

Long-term effects of face masks on skin characteristics during the COVID-19 pandemic.

BACKGROUND: Nowadays, face masks are a crucial part of our daily life. Previous studies on their impact on the skin usually focused on the adverse effects of face masks. Few studies have assessed their influence on skin characteristics. In a previous study, we identified the short-term effects of wearing face masks. Herein, we describe the long-term skin effects of face masks, for a period of 6 months. MATERIALS AND METHODS: Healthy volunteers (19 men and women), who wore face masks, participated in the study from June 2020 to December 2020. In all participants, skin characteristics such as trans-epidermal water loss (TEWL), skin hydration, skin elasticity, skin pore area, skin keratin amount, skin temperature, skin redness, skin temperature, skin redness, and skin color were measured three times. RESULTS: TEWL, skin hydration, skin elasticity, skin pore area, skin keratin amount, and skin color changed significantly after 6 months. TEWL, skin hydration, skin pore area, skin keratin amount, and skin color were significantly different between the mask-wearing and non-mask-wearing areas. CONCLUSION: Long-term daily use of face masks can alter skin characteristics. Special care should be focused on the mask-wearing regions.

Skin characteristics following repeated exposure to simulated outdoor and indoor summer temperatures in South Korea and Southeast Asia.

BACKGROUND: Although changes in skin depend on the external environment, researchers have performed only a few studies on effect of the actual environment. Most studies have researched skin characterization based on changes in the humidity or temperature. AIM/OBJECTIVE: This study aimed to evaluate changes in the skin based on the difference in indoor and outdoor temperatures and humidity during summer in South Korea and Southeast Asia. METHODS: Twenty-two female participants aged 25-39 years were included. Skin hydration, sebum (cheek, forehead), colour, transparency and pores of the participants were measured after a 30-min exposure to high temperature and high humidity (HTHH) environment and a 30-min exposure to low temperature and low humidity (LTLH) environment. Subsequently, exposure to HTHH environment for 30 min +LTLH environment for 30 min was performed after a total of 1 h and repeated. RESULTS: Repeated exposure to HTHH and LTLH environments increased the skin's sebum content and haemoglobin index. Additionally, skin elasticity was significantly reduced, with patients in their 30 s showing greater changes than those in their 20 s. CONCLUSION: Repeated differences in temperature and humidity cause skin ageing, loosen skin vessels and reduce skin elasticity, thereby leading to skin ageing.

CONTEXTE: Bien que les changements cutanés dépendent de l'environnement extérieur, les chercheurs n'ont réalisé que quelques études sur l'effet réel de cet environnement. La plupart des études ont examiné les caractéristiques de la peau en fonction des changements d'humidité ou de température. BUT/OBJECTIF: Cette étude visait à évaluer les changements de la peau en fonction de la différence de température et d'humidité à l'intérieur et à l'extérieur pendant l'été en Corée du Sud et en Asie du Sud-Est. MÉTHODES: Vingt-deux femmes âgées de 25 à 39 ans ont participé. L'hydratation de la peau, le sébum (joues, front), la couleur, la transparence et les pores des participants ont été mesurés après une exposition de 30 min à une température élevée et à un environnement à forte humidité (« high temperature and high humidity ¼, HTHH) et une exposition de 30 min à une température faible et à un environnement à faible humidité (« low temperature and low humidity ¼, LTLH). Par la suite, l'exposition à l'environnement HTHH pendant 30 min + environnement LTLH pendant 30 min a été effectuée après une durée de 1 h, puis répétée. RÉSULTATS: L'exposition répétée aux environnements HTHH et LTLH a augmenté la teneur en sébum et l'indice d'hémoglobine de la peau. En outre, l'élasticité de la peau était significativement réduite, les patientes ayant dépassé la trentaine montrant des changements plus importants que celles dans la vingtaine. CONCLUSION: Les variations répétées de température et d'humidité provoquent le relâchement des vaisseaux cutanés et réduisent l'élasticité de la peau, aboutissant ainsi au vieillissement de la peau.

Clinical brightening efficacy and safety of Melasolv™ (3,4,5-trimethoxy cinnamate thymol ester, TCTE) in Southeast Asian women.

BACKGROUND: Skin darkening because of increased and irregular synthesis of melanin causes melasma, solar lentigo, and freckles. Melasolv™, produced in the early 2000s, shows potent depigmenting effect and has low cytotoxicity. It has been used as a brightening agent in cosmetics for decades. AIMS: This study was conducted to investigate whether Melasolv™ is effective for the skin of ASEAN (Southeast Asia) women. METHODS: We recruited ASEAN women in Singapore and divided them into two groups (active group vs. placebo group). Melasolv™ and placebo formulations were applied twice a day for 12 weeks. The changes in the pigmented spots were visually evaluated by an expert and assessed using a spectrophotometer and Mexameter at 0, 4, 8, and 12 weeks. RESULTS: The visual evaluation revealed significant improvements, in both size and color intensity, in the active group compared with those in the placebo group at 12 weeks. In the spectrophotometric evaluation, the L* value of the pigmented spots in the active group was significantly higher than that in the placebo group at 12 weeks. Similar results were obtained in the evaluation using the Mexameter. After 12 weeks, the melanin index of the pigmented spots significantly decreased, and it was significantly higher than that in the placebo group. There was no significant change in the erythema index. In the image analysis, there were no significant differences in skin color brightness and evenness in the active group compared with those in the placebo group. CONCLUSION: Melasolv™ can be effective used for skin brightening.

Clinical evaluation method for blue light (456 nm) protection of skin.

BACKGROUND: Blue light from electronic devices enriched with a peak at 456 nm affects circadian rhythm and antioxidant balance of skin, necessitating the study of photoprotection against the 456-nm blue light. AIMS: This study aims to report that blue light (456 nm) can cause skin pigmentation and proposes a new clinical evaluation method for blue light (456 nm) protection based on the skin pigmentation level. PATIENTS/METHODS: We developed a clinical device (ABC deviceTM ) that emits blue light (peak = 456 nm). Based on the minimal persistent pigment darkening dose (MPPD) determined from visual evaluation and melanin index measurements, we proposed the "protection grade of blue light (PB)" guideline to assess the protective ability of skin against blue light. RESULTS: Human skin irradiated with blue light (456 nm) showed a light dose-dependent degree of pigmentation. The MPPD on unprotected and protected skin was 135 J/cm2 or 180 J/cm2 and 135-225 J/cm2 , respectively. The ABC device™ and the proposed clinical method were used to test the four blue light blocking assessments of TiO2 . Consequently, the inorganic filter with TiO2 effectively blocked the blue light (456 nm). The AP product demonstrated the ability to block blue light by 1.15 times (PB = 1.15), which significantly lowered the melanin index of the skin after irradiation as compared to that of the unprotected skin (P < .001). CONCLUSION: We propose an objective clinical evaluation method for blue light protection. This study elucidates the properties of blue light blockers for customers suffering from blue light pollution.