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

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.

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.

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.

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 the eye contour signs due to age among Mexican women: Comparison with women of other ethnic origins

OBJECTIVE

To evaluate the changes in certain ocular signs because of age, among Mexican women and to compare these with those previously obtained on women of other ethnicities.

MATERIAL AND METHODS

Photographs were taken of the faces of 203 Mexican women of different ages, under standardized conditions. These photographs allowed us to focus and define nine ocular signs, which were then graded by 15 experts and dermatologists, using standardized scales provided by a reference Skin Aging Atlas. Hence, the same protocol, previously used on 3240 women of four other ethnic origins (Caucasian: 600; Chinese: 990; Japanese: 1010; Indian: 300; African: 340), allowed us to compare the results obtained on Mexican women.

RESULTS

The severity of crow's feet wrinkles for Mexican women shows a more intense progression with age than those of women from other ancestries. The lower eyelid wrinkles of Mexican women, that show weak or erratic changes with time, were however found to have higher and significant severity at a young age. Pigmentation disorders of their ocular area were found less pronounced as compared to those of Asian or Indian women. Eye bags were observed with similar slight changes in all five ancestries.

CONCLUSION

The present work confirms that the clinical signs of age for the female eye area develop differently depending on the ethnic origins of the volunteer.

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.

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.