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VISIA system: A possible tool in the cosmetic practice
Abstract
Dyspigmentation is a common complaint in the dermatology office.
We also sought to evaluate whether the VISIA Complexion Analysis System (Canfield Imaging Systems, Fairfield, NJ) could be a tool to help patients better understand their skin complaints.
Twenty-one consecutive women were recruited for VISIA analysis. Each subject underwent VISIA analysis and completed a follow up survey.
86% of respondents reported that the VISIA analysis helped them understand their initial concern. 86% noted that the VISIA brought other skin problems to their attention. 100% of the subjects responded that they would recommend VISIA analysis to others. 62% of subjects responded that they would prefer to go to a practice with a VISIA system in comparison to a practice without VISIA.
The VISIA Complexion Analysis System is a beneficial tool for dermatology and aesthetic practices with the potential to aid in patient education.
... There are several tools to objectively assess skin dyspigmentation, yet are not very convenient in clinical setting and are predominantly used in research. 8 In order to objectively assess skin lesions, VISIA Skin Analysis System (further in text: System of Skin Analysis and Assessment) was developed. A rotating capture module takes a series of images in vertical, horizontal and frontal views. ...
... 9 Moreover, the System of Skin Analysis and Assessment facilitates the knowledge of skin disorders among patients and therefore aids in their education. 8 The aim of our study was to show the effect of concomitant reduction of both vascular and hyperpigmented skin lesions located on the facial area after repetitive 532 nm laser therapy, despite the fact that treatment protocol was dedicated to vascular skin lesions. Moreover, we wished to emphasize that the detection of such observation was possible due to the implementation of the System of Skin Analysis and Assessment in the regular follow-up procedure. ...
... Vascular lesions are identified by the the VISIA system since hemoglobin emits red color which is detected by the System via RBX technology (Red/Brown Subsurface Analysis). 8 The System of Skin Analysis and Assessment has been tested in several trials and is proven to be a reliable tool. Chen et al assessed twenty healthy women with Fitzpatrick skin type IV with melasma. ...
Purpose:
Esthetic medicine is a rapidly developing field of medicine that is not only beneficial in terms of external appearance, but also significantly improves overall quality of life. Currently, pigmented and vascular skin lesions are more prevalent due to multiple environmental factors and are a characteristic manifestation of skin aging. The development of modern laser therapy has contributed to the successful management of multiple skin conditions. The aim of our study was to show the effect of concomitant reduction of both vascular and hyperpigmented skin lesions located on the facial area after repetitive 532 nm laser therapy and to emphasize that the detection of such observation was possible due to the implementation of System of Skin Analysis and Assessment.
Patients and methods:
We retrospectively analyzed 100 patients' records with "VISIA" Skin Analysis System after 532nm laser therapy.
Results:
Laser therapy significantly decreased VISIA scores for all tested lesions, ie, macules, pigmented and vascular lesions (p<0.0001 for all). The efficacy of laser treatment was not significantly different regarding skin phototype (p>0.05) and did not correlate with age of participants (p>0.05). The more laser sessions were performed, the higher improvement in vascular lesion VISIA scores was observed (r=0.26, p=0.0097).
Conclusion:
532 nm laser therapy is effective regarding vascular and hyperpigmented skin lesions located on the facial area. The System of Skin Analysis and Assessment is a good tool to test the treatment efficacy during regular follow-up procedure.
... The VISIA Imaging System (Canfield Scientific Inc.), has been previously studied for its objective measurement of dyspigmentation, erythema, photodamage and skin texture. [10][11][12][13] Here, we trial three-dimensional (3D) multispectral facial imaging as a noninvasive and user-friendly technique to objectively monitor the treatment phase and measure regional changes of actinic damage and skin enhancement following the application of 5-FU. ...
... The seventh generation VISIA is used in cosmetic procedures to measure wrinkles and fine lines, skin texture, pigmentation, UV damage, vascular features and porphyrins. 10 VISIA images captured of study participants were taken via cross-polarised light in triplicate with respect to the left, front and right view of the face, as per each patient's treatment area. The images were then transformed into RBX-Brown and RBX-Red images, using a spectro-colourimetric light transport model to represent the skin, to obtain information regarding the distribution and concentration of melanin (Brown) and haemoglobin (Red). ...
Background
Standardised therapeutic monitoring of field skin cancerisation is challenging. 5‐fluorouracil (5‐FU) is a common topical therapy for ultraviolet radiation (UV) and actinic keratosis (AK) but is often accompanied with adverse side effects. Monitoring of patients following treatment can be improved with novel imaging technologies.
Objective
This case series used new, improved facial imaging technology in assessing topical 5‐FU treatment for actinic damage.
Methods
A case series followed 18 participants treated with topical 5‐FU over 2 weeks, with facial imaging at baseline, at the end of treatment and at Week 12 posttreatment. Skin characteristics were automatically measured across selected treatment areas using the VISIA three‐dimensional (3D) multispectral facial imaging system.
Results
VISIA analysis recorded sharp increases in erythema, UV‐spots and skin roughness at Week 2 followed by reduction of erythema, UV‐spots and skin roughness at 12 weeks posttreatment compared to baseline. Skin hyper‐ and hypopigmentation was observed across treatment areas at Week 2 returning to baseline levels by Week 12. Participants demonstrated improved skin texture indicating smoother skin and significantly diminished UV‐spots.
Conclusion
3D, multispectral facial imaging can facilitate topical treatment monitoring of field cancerisation. 5‐FU treatment of field cancerisation as observed in VISIA images and data are consistent with clinical experience. 3D, multispectral imaging was efficient, noninvasive and objective in monitoring treatment of actinic damage, for example, by measurement of erythema as a surrogate marker for inflammation. For clinical trials of new treatment modalities for facial photodamage and field cancerisation, 3D multispectral imaging features new tools for analysis of skin characteristics, including objective quantification of erythema, skin texture, UV‐spots and other inflammation‐related changes triggered by 5‐FU treatment.
... The ''UV SPOTS'' and ''POR-PHYRINS'' modes were taken under UV light to detect UV spots and porphyrins, respectively. The ''BROWN SPOTS'' and ''RED AREAS'' modes were taken under polarized light to observe brown spots and prominent blood vessels, respectively [15]. Thus, five different modes of images were obtained in one shot, i.e., ''NOR-MAL'', ''UV SPOTS'', ''PORPHYRINS'', ''BROWN SPOTS'', and ''RED AREAS'', which could show different skin characteristics (Supplementary Material Fig. S1). ...
... (3) the ''BROWN SPOTS'' mode could reflect the detection of deeper deposition of melanin under cross-polarized light; (4) the ''PORPHYR-INS'' mode image was photographed in UV light on the basis that porphyrin could fluoresce in UV light; and (5) the ''RED AREAS'' mode image was used as a measurement of hemoglobin content through cross-polarized light [15]. Since the pigmentation of melasma was considered to be a combination of epidermis and dermis [37], the ''NORMAL,'' ''UV SPOTS,'' and ''BROWN SPOTS'' modes might be more useful for dermatologists in melasma diagnosis. ...
IntroductionThe diagnosis of melasma is often based on the naked-eye judgment of physicians. However, this is a challenge for inexperienced physicians and non-professionals, and incorrect treatment might have serious consequences. Therefore, it is important to develop an accurate method for melasma diagnosis. The objective of this study is to develop and validate an intelligent diagnostic system based on deep learning for melasma images.MethodsA total of 8010 images in the VISIA system, comprising 4005 images of patients with melasma and 4005 images of patients without melasma, were collected for training and testing. Inspired by four high-performance structures (i.e., DenseNet, ResNet, Swin Transformer, and MobileNet), the performances of deep learning models in melasma and non-melasma binary classifiers were evaluated. Furthermore, considering that there were five modes of images for each shot in VISIA, we fused these modes via multichannel image input in different combinations to explore whether multimode images could improve network performance.ResultsThe proposed network based on DenseNet121 achieved the best performance with an accuracy of 93.68% and an area under the curve (AUC) of 97.86% on the test set for the melasma classifier. The results of the Gradient-weighted Class Activation Mapping showed that it was interpretable. In further experiments, for the five modes of the VISIA system, we found the best performing mode to be “BROWN SPOTS.” Additionally, the combination of “NORMAL,” “BROWN SPOTS,” and “UV SPOTS” modes significantly improved the network performance, achieving the highest accuracy of 97.4% and AUC of 99.28%.Conclusions
In summary, deep learning is feasible for diagnosing melasma. The proposed network not only has excellent performance with clinical images of melasma, but can also acquire high accuracy by using multiple modes of images in VISIA.
... For example, SPOTS are identified by their color and contrast from the surrounding skin (8). The PORPHYRINS scores reflect fluorescence with UV ray. ...
... The PORPHYRINS scores reflect fluorescence with UV ray. The definition of other parameters was as described previously (7)(8)(9)(10)(11)(12). Average scores were taken from two independent analyses (left and right forearms). ...
We hypothesized that changes in skin characteristics on the forearm could be useful for early diagnosis of systemic sclerosis (SSc). We used VISIA digital imaging system to investigate this possibility for the first time. Twenty-eight Japanese patients who were diagnosed with typical or very early diagnosis of SSc (VEDOSS) were enrolled in this study, and ten age- and gender-matched patients with other disorders were included as a control group. Eight skin characteristics were analyzed. Our method of evaluating forearm skin characteristics was shown to be reproducible. The scores of WRINKLES, TEXTURE, PORES, and PORPHYRINS were higher in SSc subjects with sclerotic forearm skin (SSc forearm+; 11.004, 5.116, 3.230, and 0.084, respectively) and those without (SSc forearm-: 11.915, 4.898, 2.624, 0.0616, respectively) than in the non-SSc control subjects (10.075, 4.496, 2.459, 0.0223, respectively). Also, the scores of SPOTS, TEXTURE, PORES, UV SPOTS, BROWN SPOTS, and PORPHYRINS were elevated in SSc forearm+ (3.182, 5.116, 3.230, 5.761, 6.704, 0.084, respectively) and SSc forearm- patients (2.391, 4.898, 2.624, 9.835, 5.798, 0.0616, respectively) compared with those with VEDOSS (2.362, 4.738, 2.234, 5.999, 4.898, 0.0169, respectively). We found statistical significance in the difference in score of PORPHYRINS between SSc forearm- and VEDOSS groups (p = 0.044), and between SSc forearm+ and VEDOSS groups (p = 0.012). Therefore, they can be used to differentiate VEDOSS from early or mild SSc cases, which is sometimes clinically problematic. Our study also suggests that the porphyrin research will lead to a better understanding of SSc pathogenesis.
... Each participant underwent digital skin analysis (VISIA ® ; Canfield Imaging Systems), 14 standardized 2D frontal and profile digital photographs (Canon, EOS 80D, 24.2 mega pixel resolution) and completed a validated patient-reported outcome measure (FACE-Q). 15 Regular contact by telephone and a text message platform was made during the study treatment period. After completion of 12 weeks treatment, the VISIA digital skin analysis and FACE-Q questionnaires were repeated. ...
... VISIA, a complexion-analysis system, was used to provide an objective measurement, using standard incandescent, cross-polarized, and ultraviolet light settings, of the number of wrinkles, skin surface spots, texture, pores, ultraviolet (UV) spots, porphyrins, red areas, and brown spots on the skin at baseline and following 3 months treatment (Table 1). 15,16 All assessments were performed with a skin free of makeup, with the face wiped with a non-alcoholic cleanser ...
Background
Cosmeceutical products are an important therapeutic option for facial rejuvenation. Of these, topical application of growth factors has been shown to increase dermal collagen synthesis, improve skin texture, and reduce fine lines and wrinkles. Limited data exist for the use of growth factors in combination with microneedling.
Objective
This prospective, single-center, uncontrolled study evaluated the efficacy of topical growth factor treatment in conjunction with transdermal delivery of growth factors via home-based microneedling for facial skin rejuvenation.
Patients/Methods
Eleven healthy female individuals aged 33–61 years, with mild-moderate facial wrinkling were included in the study. Over 3 months, participants received twice-daily application of a topical recombinant human growth factor preparation (SkinGenuity® Regenerative and Reparative Serums) along with twice-weekly transdermal delivery of growth factors using a home-based microneedling (0.2 mm) device. Objective skin analysis (VISIA®) and a subjective patient-reported outcome (FACE-Q®) assessment measuring satisfaction with appearance were performed at baseline and after 3 months.
Results
Objective skin analysis showed a significant improvement in skin texture (17.6%, p < 0.001), wrinkles (17.3%, p < 0.001), red areas (12.4%, p =0.004), and brown spots (6.0%, p =0.03) at 3 months follow-up. FACE-Q scales showed a significant improvement from baseline, including satisfaction with skin, facial appearance, nasolabial folds, cheeks, and lower face/jawline (all p ≤ 0.02). Numerical improvement in adverse effects related to skin was also observed (p = 0.07). No serious adverse effects were reported.
Conclusions
Three months of twice-daily topical growth factor treatment in conjunction with transdermal delivery of growth factors via microneedling improved skin analysis parameters and participant-reported outcome measures, indicative of facial skin rejuvenation.
... This is a broad term that includes disorders of melanin deposition, disorders of superficial vasculature, and disorders of both. The VISIA Complexion Analysis System (Canfield Imaging Systems, Fairfield, NJ) is a device used to measure and quantify a patient's dyschromia, and it's clinically applicable [7]. Via standard, ultraviolet, and cross polarized lighting, it generates a series of photographs to analyze skin characters, including spots, wrinkles, texture, pores, ultraviolet spots, brown spots, red area, and porphyrin. ...
... Spots, wrinkles, texture, and pores are analyzed through standard lighting. Ultraviolet spots and porphyrin are analyzed through ultraviolet lighting, and brown spots, red area through cross polarized lighting [7]. Therefore, our objective of this study is to evaluate and quantify the skin characters of patients with hyperthyroidism before and after thyroidectomy. ...
Background
During clinical practice we have noticed that some patients with hyperthyroidism have finer skin with less wrinkles, pores, and spots after thyroidectomy, and the improvement can be observed within a few weeks after the operation. However, there is no evidence or study in the literature to proof this finding.
Aim and objective
This study was designed to evaluate and quantify the skin characters of patients with hyperthyroidism before and after thyroidectomy.
Material and methods
This is a prospective study to include patients with hyperthyroidism who received total thyroidectomy between March 1st, 2018 and February 28th, 2019. The patients received blood test for T4 and TSH analysis and VISIA measurements for skin texture quantification, at the preoperative stage, three, and six months postoperatively. A total of 8 patients were included. Repeated measurement was used to determine the lab data and VISIA measurement changes before and after the operation. Mauchly’s sphericity test was performed to determine whether the violation of sphericity occurs, and the Greenhouse–Geisser correction was used when the violation of sphericity occurs.
Results
All the patients were female and generally healthy without systemic medical disease except the hyperthyroidism. The T4 and TSH levels were not significantly different before and after the thyroidectomy. In terms of the skin character measurements, the wrinkles, texture, pores, UV spots, and brown spots were not improved after thyroidectomy. A trend of improvement in spots, red area, and porphyrin was noted, although not statistically significant.
Conclusions
Surgical removal of the thyroid gland in patients with hyperthyroidism does not improve the skin quality and texture in examinations via the VISIA system.
... Photography was conducted with the VISIA-CR 4.3 system for repeatable clinical imaging and skin analysis. 26 It allowed rapid attainment of high-resolution images, and the booth-like device ensured that subjects maintained the proper position for the duration of the capture set. The frontal face was captured with "standard light 1" modality. ...
... 17 The VISIA-CR 4.3 system employed in the present study uses digital technology to produce high-resolution images for clinical research, which is a strength of this study. 26 A limitation of this research was the exclusion of subjects with Fitzpatrick skin types IV-VI. In addition, this photonumeric scale was developed for use only in Caucasian subjects. ...
... Recently, photoimaging technology has advanced significantly and non-invasive image analysis of hyperpigmented spots can now be used to analyze the photoaging status. [5][6][7] In a previous study, we conducted a pilot crosssectional survey to determine how factors and nutrients in the diet influence the facial skin status using non-invasive skin analysis. 6 That study demonstrated that subjects with high levels of coffee polyphenol consumption had lower levels of skin hyperpigmentation measured according to a VISIA TM UV Pigmented Spot (PS) score using a digital imaging technique. ...
... 6 That study demonstrated that subjects with high levels of coffee polyphenol consumption had lower levels of skin hyperpigmentation measured according to a VISIA TM UV Pigmented Spot (PS) score using a digital imaging technique. 7 Coffee is the largest source of polyphenols in the Japanese diet and supplies a large amount of antioxidants in daily life. 8,9 We have accumulated a basic knowledge about facial hyperpigmented spots and factors that influence them. ...
Purpose:
Hyperpigmentation of the skin can occur at any age depending on etiological factors but its intensity increases during adolescence in Japanese females and gradually develops further in adults. The purpose of this study was to characterize factors that influence skin hyperpigmentation, including age, skin type and dietary polyphenol sources.
Patients and methods:
A cross-sectional survey of healthy Japanese women aged from 30 to 60 years (n=244) was conducted using food and environmental questionnaires and a VISIA™ facial photoimage analyzer.
Results:
UV Pigmented Spot (PS) scores correlated negatively with the consumption of total polyphenols (TPs) (R=-0.224, p<0.001) and the rate of hyperpigmented spot development (PS score/age after 18 years of age) was suppressed by the consumption of TPs. This trend was independent of the melanin index and the skin type, which indicates the ability of the skin to tan after sun exposure. Consumption of coffee, the largest source of TPs, suppressed the PS score (p<0.001). Consumption of green tea, the second largest source of TPs, also suppressed the PS score, which was weaker than coffee but was statistically significant (p=0.029). The PS score was suppressed the most in subjects with both a high consumption of coffee and green tea.
Conclusion:
Higher consumption of TPs may be beneficial to alleviate photoaging of the skin, and coffee as well as green tea contribute to suppress skin hyperpigmentation through adding large amounts of TPs in the diet.
... 12,13 Instrumental assessment included: 1) measurement of sebum by Sebutape TM strips (CuDerm Corp., Dallas, TX, USA) placed on the patient's forehead, nose, cheeks, and chin and subsequently checked against a black background of a score card; sebum spots are scored on a scale ranging from 1 to 5, where 1 indicates a dry skin without sebum, and 5 identifies a very oily skin, and 2) facial imaging performed by high-tech facial photography characterized by 15 mega pixel resolution and flash cross-polarized Light by Reveal Photo Imager (Canfield Scientific Inc., Parsippany, NJ, USA) at Naples site and by VISIA-CR™ imaging system (Canfield Scientific Inc., Fairfield, NJ, USA) at Catania site. [14][15][16] Additionally, evaluation of product tolerability by a self-administered questionnaire based on 5 parameters (erythema, scaling, dryness, stinging/burning and itch) from 0 to 3 (0 =none; 1=mild; 2=moderate; 3=severe) was carried out. ...
... In detail, licochalcone A is a natural flavonoid substance isolated from Glycyrrhiza glabra and Glycyrrhizainflata (licorice root) with anti-inflammatory and anti-microbial effects, as confirmed by inhibition in vitro and in vivo of pro-inflammatory cytokines (PGE2, LTB4, IL-6 and TNFα), [14][15] as well as anti ROS-induced cell damage action by activating of the expression of antioxidant transcription factor (Nf-E2-related factor 2/Nrf2) and of detoxifying enzymes (Heme Oxygenase 1/HO-1, Glutamate-Cysteine Ligase Modifier subunit/GCLM). [17][18][19] Hydroxy Complex is a combination of three exfoliating agents (Glycolic, Salicylic and Polyhydroxy Acids) able to cause intercorneocyte cell detachment so as to induce a comedolytic effect. ...
Purpose:
Topical cosmetic agents if correctly prescribed and used may improve outcomes in acne therapy. The aim of this study was to assess the efficacy and tolerability of a new daily cosmetic regimen in the treatment of mild facial acne.
Patients and methods:
A multicenter, prospective, observational, clinical study was conducted on 91 adult patients with mild acne. Subjects were instructed to apply a fluid containing Licochalcone A/Salicylic acid/L-Carnitine in the morning and a cream with Licochalcone A/Hydroxy-Complex 10% at bedtime for 8 weeks. The efficacy was clinically evaluated by Global Acne Grading System (GAGS) score and by comedones/papules lesions count and by instrumental assessment (SebutapeTMand Reveal Photo Imager/VISIA-CR™ imaging) at baseline, at 4 and 8 weeks.
Results:
At 4 weeks a statistically significant reduction from baseline of GAGSwas observed. In addition, the mean total count of comedones and papules was significantly reduced by 41% and 45%, respectively, from baseline along with a significant reduction of mean sebum of 47%. At 8 weeks, a further statistically significant reduction from baseline of GAGS, total count of comedones and papules (64% and 71%, respectively), along with an additional sebum reduction of about 52% was also recorded.
Conclusion:
Our results suggest that the daily regimen based on Licochalcone A with Salicylic acid/L-Carnitine as fluid or with Hydroxy-Complex 10% as cream represent an interesting cosmetic approach for treating mild acne.
... The VISIA winkle score was measured at baseline, 1 month, 3 months, and 6 months after the final treatment. The VISIA Complexion Analysis System (Canfield Imaging Systems, Fairfield, NJ, USA) consists of a facial imaging chamber, which is connected to a quantitative analysis software (11). Auto-focusing camera with a resolution of 15 million pixels generates a series of highresolution photographs in seconds using three kinds of light sources: standard incandescent, ultraviolet, and cross-polarized light (12). ...
... In our clinic, we routinely use the VISIA system to assess patient's face to provide information on their overall skin condition, including spots, wrinkles, texture, pore size, ultraviolet spots, porphyrin, brown spots, and red areas. In comparison with the age-and skin type-matched controls, the percentile where each patient falls on the distribution is provided as a score ranging from 0 to 100 to quantitatively illustrate the severity of each skin characteristic (11). Therefore, the VISIA system detects any changes of skin conditions more objectively than the photographic assessment method, which has a limited number of scales (6). ...
Background: Treatment of periorbital wrinkles is a challenging task because of its anatomical significance and delicate nature.
Objective: The aim of this study was to evaluate the efficacy and safety of a microneedle monopolar radiofrequency (RF) device for treating periorbital wrinkles.
Methods and Materials: This retrospective study involved 21 patients who were treated for periorbital wrinkles using a RF device. The type of microneedle used, clinical photography, VISIA wrinkle score, and adverse events were collected from the medical chart. Two independent dermatologists assessed the photographs.
Results: There were 18 female and 3 male patients with a mean age of 50.24 years. The severity of wrinkle was improved according to photographic assessment and VISIA wrinkle score at 6-month post-treatment. When 21 sites treated with a long microneedle (LMN, 1.5 mm) and the other 21 sites treated with a short microneedle (SMN, 0.8 mm) were compared, significant improvement in the VISIA wrinkle score was observed only in those treated with the LMN. No serious adverse events, including scarring and postinflammatory hyperpigmentation, occurred.
Conclusions: We demonstrated the efficacy and safety of the microneedle monopolar RF device in treating periorbital wrinkles. The LMN was superior to the SMN in reducing VISIA wrinkle score.
... Liu et al. [81] used four DL architectures, namely DenseNet, ResNet, Swin Transformer, and MobileNet, to diagnose images of subjects with and without melasma. The research investigated the effect of different photo-taking modes used by VISIA, a device for measuring a patient's dyschromia from images [82]. Each subject was taken five shots, including Normal, UV Spots, Porphyrins, Brown Spots, and Red Areas modes. ...
Over the last ten years, the field of dermatology has experienced significant advancements through the utilization of artificial intelligence (AI) technologies. The adoption of such technologies is multifaceted, encompassing tasks such as screening, diagnosis, treatment, and prediction of treatment outcomes. The majority of prior systematic reviews in this domain were centered on medical dermatology, with the aim of detecting and managing serious skin diseases such as skin cancer. However, the adoption of AI in cosmetic dermatology, which focuses on improving skin conditions for cosmetic purposes, has not been comprehensively reviewed. Therefore, the objective of this systematic review article is to analyze the existing and recent research revolving around applications of AI in the field of cosmetic dermatology. The study encompasses articles published between 2018 and 2023, where a total of 63 publications are deemed relevant based on the established inclusion criteria, divided into five categories based on utilization domains, namely cosmetic product development, skin assessment, skin condition diagnosis, treatment recommendation, and treatment outcome prediction. This systematic review article provides not only valuable insights for researchers interested in exploring new research areas related to aesthetic medicine but also applicable guidance for practitioners seeking to implement AI technologies to address real-world challenges in cosmetic services.
... Cutometer MPA580 (CK, Germany) was used to measure skin elasticity of upper check by suction method; the instrument create a negative pressure to deform skin and the mechanical property of skin is analyzed. VISIA Complexion Analysis (Canfield Scientific, US) was used to obtain the values of skin wrinkles and pores [11]. ...
... Cahaya terpolarisasi digunakan untuk menilai lesi kulit pigmentasi berwarna coklat atau merah. 27 Berbagai penelitian telah banyak menggunakan Visia sebagai alat diagnostik pada subyek kulit putih dan kulit berwarna seperti pada populasi Asia. 28,29 ...
Seiring dengan bertambahnya usia seseorang, kulit sebagai jaringan terluar dari tubuh manusia akan memberikan gambaran paling terlihat dari proses penuaan. Penuaan kulit dipengaruhi oleh dua faktor yaitu faktor intrinsik dan faktor ekstrinsik. Faktor intrinsik terjadi secara alamiah dan berkaitan dengan proses degenerasi seluler. Faktor ekstrinsik berkaitan dengan pajanan sinar matahari, rokok, dan polusi udara. Penyebab utama penuaan kulit akibat faktor ekstrinsik berupa pajanan kronik sinar ultraviolet dikenal sebagai photoaging. Tanda klinis photoaging dapat bervariasi, namun yang sering ditemukan berupa perubahan pigmentasi dan keriput. Saat ini telah tersedia lebih dari 100 instrumen penilaian penuaan kulit menggunakan fotografi, dermoskopi, dan alat diagnostik multifungsi namun masih belum ada yang dianggap sebagai baku emas. Tinjauan pustaka ini bertujuan untuk membahas berbagai instrumen penilaian photoaging yang sering digunakan dalam praktik klinis sehari-hari dan karakteristik dari masing-masing instrumen tersebut.
... A study assessing the clinical value of VISIA suggests that 86% of respondents agreed that VISIA analysis had improved their understanding of and attention toward their skin health. They would all recommend VISIA analysis to other people and 62% of them preferred a clinical practice with a VISIA system [168]. ...
Background:
Thanks to the rapid development of computer-based systems and deep-learning-based algorithms, artificial intelligence (AI) has long been integrated into the healthcare field. AI is also particularly helpful in image recognition, surgical assistance and basic research. Due to the unique nature of dermatology, AI-aided dermatological diagnosis based on image recognition has become a modern focus and future trend. Key scientific concepts of review: The use of 3D imaging systems allows clinicians to screen and label skin pigmented lesions and distributed disorders, which can provide an objective assessment and image documentation of lesion sites. Dermatoscopes combined with intelligent software help the dermatologist to easily correlate each close-up image with the corresponding marked lesion in the 3D body map. In addition, AI in the field of prosthetics can assist in the rehabilitation of patients and help to restore limb function after amputation in patients with skin tumors.
The aim of the study:
For the benefit of patients, dermatologists have an obligation to explore the opportunities, risks and limitations of AI applications. This study focuses on the application of emerging AI in dermatology to aid clinical diagnosis and treatment, analyzes the current state of the field and summarizes its future trends and prospects so as to help dermatologists realize the impact of new technological innovations on traditional practices so that they can embrace and use AI-based medical approaches more quickly.
... Notably, the higher the percentage of porphyrins and red areas, the less severity of the disease. 10 All measurements were conducted according to the manufacturer's instructions. The average values were calculated, and the mean of three measurements was used for analysis. ...
Background:
Although the changed lipid environment of the pilosebaceous unit and the growth of lipophilic Cutibacterium acnes (C. acnes) during puberty has long been considered as the trigger of acne vulgaris, the involvement of the interaction between the epidermal barrier integrity and the skin microbiome in this disease has not been fully elucidated.
Objective:
The aim of this study was to analyze the differences in the epidermal barrier and skin microbiota in patients with acne vulgaris and their correlation.
Methods:
The skin microbial samples and epidermal barrier data from 74 acne patients and 19 healthy subjects were collected in this cross-sectional study. The microbial diversity was analyzed based on a high-throughput sequencing approach that targets the V3-V4 region of the bacteria 16S ribosomal RNA genes.
Results:
Compared with healthy controls, acne patients had significantly increased transepidermal water loss (TEWL), pH levels, sebum, porphyrins, and red areas, and reduced skin microbiome diversity according to the goods coverage diversity index (p = 0.021), Shannon diversity index (p = 0.037), and Simpson diversity index (p = 0.023). Moreover, the diversity gradually decreased with the increase in acne grading. Based on the principal coordinate analysis (PCoA) analysis plot, the skin microbiota of acne patients and healthy controls could be divided into two different sets, which could not be used to separate acne patients with different disease severity. Finally, this study found that both TEWL and sebum were negatively associated with the Shannon and Simpson diversity index. Meanwhile, the taxa Enhydrobacter and Stenotrophomonas were positively associated with TEWL, stratum corneum hydration, respectively.
Conclusion:
This study demonstrated that acne vulgaris exists in patients with both damaged epithelial barriers and associated microbiota dysbiosis; the findings will help improve the understanding of the disease and may contribute to the development of better treatment options.
... VISIA system (Canfield Scientific, Parsippany, NJ, USA) is a common noninvasive imaging system, available to capture high-resolution facial images. 9,14 By using quantitative analysis software (RBX; Canfield Scientific), the VISIA system separates red and brown channels and enables a better visualization of erythema and telangiectasia. 15 In this article, we compared VISIA parameters with physician's subjective assessments and analyzed their correlations to clarify the effectiveness of VISIA system in evaluating rosacea. ...
Background:
Rosacea is a facial chronic inflammatory skin disease with almost 5.5% prevalence. Although there are various scales of rosacea, they are objective and discordant among different dermatologists. Noninvasive objective measurements such as VISIA system might play essential roles in the diagnosis and evaluation of rosacea. Here, we intended to reveal the effectiveness of VISIA system in rosacea.
Materials and methods:
A number of 563 participants diagnosed with facial rosacea were enrolled in study. They all received both full-face image-shoot by VISIA system with quantitative analysis software and physician's assessment via five different scales, including investigator global assessment (IGA), clinician erythema assessment (CEA), numerical score, the National Rosacea Society (NRS) grading system and telangiectasis.
Results:
Absolute score and percentile of red area had significant correlations with IGA and CEA, whereas red area had no significant correlation with numerical score, NRS and telangiectasis. Red area in erythematotelangiectatic rosacea patients demonstrated the highest correlation with IGA and CEA, especially in those aged between 51 and 60. Besides red area, pigmentation parameters in VISIA system (brown spot) also showed significant correlation with IGA and CEA.
Conclusion:
VISIA system might be an effective measurement in the assessment of rosacea severity.
... The GAGS score, porphyrin, and red areas were obtained using the VISIA-CR™ imaging system (Canfield Scientific Inc.) to evaluate improvement in the acne patients. 12 Noninvasive techniques, via sampling of cheek tissue, were used to test epidermal barrier function: transepidermal water loss (TEWL), SCH, skin pH, and sebum levels were tested using the Tewameter ® TM 300, Corneometer ® CM 825, Skin-pH-Meter ® pH 905, and Sebumeter ® (Courage + Khazaka electronic GmbH, Cologne, Germany), respectively. All participants were prohibited from skin washing and topical agent use 24 h before sampling. ...
The disordered skin microbiome has been reported to contribute to the pathogenesis of acne vulgaris, for which benzoyl peroxide (BPO) has long been recommended as the first-line therapy. However, there are no data regarding the effect of BPO treatment on skin microbiota and the epidermal barrier in young adults with acne vulgaris. Thirty-three patients with acne vulgaris and 19 healthy controls were enrolled in the study. All patients received topical treatment with BPO 5% gel for 12 weeks. The epidermal barrier was analyzed at baseline and after treatment. Microbial diversity was analyzed using a high-throughput sequencing approach targeting the V3-V4 region of 16S rRNA genes. After receiving treatment with BPO, patients had significant improvement in their Global Acne Grading System (GAGS) score, porphyrin, and red areas (p < 0.05), and the presence of sebum, stratum corneum hydration (SCH), and transepidermal water loss (TEWL) increased (p < 0.05). When compared with baseline, microbial diversity was significantly reduced after treatment, as calculated by the goods coverage (p = 0.0017), Shannon (p = 0.0094), and Simpson (p = 0.0017) diversity indices. The prevalence of the genus Cutibacterium (before treatment: 5.64 [3.50, 7.78] vs. after treatment: 2.43 [1.81, 3.05], p = 0.011) was significantly reduced after treatment while Staphylococcus (before treatment: 43.80 [36.62, 50.98] vs. after treatment: 53.38 [44.88, 61.87], p = 0.075) tended to increase. The abundance of Staphylococcus was negatively associated with SCH (p = 0.008, r = −0.286). Despite its contribution to an improved GAGS score, BPO treatment for acne vulgaris may reduce microbial diversity and damage the epidermal barrier.
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... Data were recorded using the Visia®-Complexion Analysis (Canfield) equipment (Parsippany, NJ, USA), which uses digital technology and UV light to photograph the most superficial layers of the face [41,42]. Porphyrins (on the sides and on the front of the face) and inflammatory lesions were quantified by the equipment software. ...
In addition to dermatological complications, acne can affect the quality of life of individuals in numerous ways, such as employment, social habits and body dissatisfaction. According to our expertise, caprylic acid and propanediol would not have a direct action on Cutibacterium acnes. Despite this, we investigated the existence of a synergistic effect among xylitol, caprylic acid and propanediol as a mixture of compounds representing a single topical active ingredient that could benefit the treatment against acne. In vitro and in vivo assays were performed to challenge and to prove the efficacy of propanediol, xylitol and caprylic acid (PXCA) against acne. PXCA had its MIC challenged against C. acnes (formerly Propionibacterium acnes) and Staphylococcus aureus, resulting in concentrations of 0.125% and 0.25%, respectively, and it also developed antimicrobial activity against C. acnes (time-kill test). PXCA was able to reduce the 5-alpha reductase expression in 24% (p < 0.01) in comparison with the testosterone group. By the end of 28 days of treatment, the compound reduced the skin oiliness, porphyrin amount and the quantity of inflammatory lesions in participants. According to the dermatologist evaluation, PXCA improved the skin's general appearance, acne presence and size.
... Using standard, ultraviolet, and crosspolarized lighting, the VISIA system is able to make pictures from patients' skin in order to identify the critical points. 13 The Visual ...
Background
In the evaluation of the facial aging, the midface certainly represents the part that undergoes the most modifications and in which the aging process is most evident. The filling and redefinition of this part are fundamental to modify the perception of the age of the face and create a global rejuvenation effect. In general, high G’ fillers with a deep implant are used to treat the midface, taking advantage of the high lifting capacity and persistence of the implant in place.
Methods
We report our experience in the treatment of 20 patients with a hyaluronic acid (HA) filler based on an innovative crosslinking technology (XTR™—eXcellent Tridimensional Reticulation) for midface treatment. GAIS (Global Aesthetic Improvement Scale) at 1 month and 3 months after treatment was evaluated as primary endpoint. Patient satisfaction with the overall appearance, repeatability of treatment, and also an instrumental evaluation of the improvement were performed.
Results
Global Aesthetic Improvement Scale and patient satisfaction were very good 1 month and 3 months after treatment. The majority of patients said they would undergo treatment again. Clinical results were confirmed by instrumental evaluation.
Conclusion
The treatment of midface with this innovative HA high G’ filler is really effective in restoration of the volumes and in reshaping the curves of zygomatic area.
... a P. acnes aktivitása. A Visia rendszer (Canfield Imaging Systems, USA) használata nemcsak a diagnózis felállításában, hanem a páciens edukációban is segítséget jelent: a vizsgálatba bevontak 86%-a vélekedett úgy, hogy az analízis segített a fennálló probléma megértésében és felhívta a figyelmüket más, kísérő tünetekre, 100%-uk ajánlaná mások számára is a vizsgálat igénybevételét, sőt 62%-uk a VISIA rendszert használó praxisokat részesítené előnyben a diagnosztika e módszerét nem alkalmazó rendelőkkel szemben (5). 3D alkalmazásokkal követhetjük az arcforma változását, megtervezhetjük a kezelést és dokumentálhatjuk annak eredményét. ...
The intention to eliminate aesthetic skin lesions and improve the quality of the integument was accompanied by a rather weak collection of medical tools supply at the dawn of cosmetology(1). Energy-based technologies, led by medical lasers, have revolutionized the range of dermatological devices in the last quarter of a century. These devices, like targeted pharmacological products, create an
intended effect in a specific part of the tissues in a targeted
manner. The category of “laser rejuvenation” includes increasing number of different methods of aesthetic dermatology, the treatment protocol is more and more structured, with many options for combinations. The aim of this paper is to summarize the use of lasers for aesthetic purposes, including the methods of rejuvenation, illustrated by the author’s clinical results. Key worlds: cosmetology, aesthetic dermatology, laser, photodamaged skin, aging skin, wrinkles, scars, skin resurfacing, laser rejuvenation, fractional laser.
... VISIA ® standard incandescent, cross-polarized, and ultraviolet light skin analysis settings were used to determine the skin conditions at baseline and following treatment by measuring the variables of wrinkles, skin surface spots, texture, pores, ultraviolet spots, porphyrins, red areas, and brown spots (Table 1). 30 To standardize the procedure, all assessments were performed with a clean skin free of makeup. Percentage scores for each parameter were reported, representing the patient's percentile ranking relative to people of the same age, gender, and skin type. ...
Background
Autologous platelet‐derived preparations have been used in many surgical fields to improve healing outcomes, with benefits reported in several aesthetic indications.
Objective
This single‐center, prospective, uncontrolled study evaluated the efficacy of injectable platelet rich fibrin (i‐PRF) for facial skin rejuvenation using an objective skin analysis system and validated patient‐reported outcome measures.
Patients/Methods
PRF® PROCESS system technology was used to prepare i‐PRP. Eleven healthy female individuals were included in the study and over 3‐months received monthly intradermal injections of i‐PRF in 3 facial regions: malar areas (1 mL each side), nasolabial fold (0.5 mL each side), and upper lip skin above the vermilion border (1 mL). The efficacy of the procedures was assessed by objective skin analysis (VISIA®) and a subjective patient‐reported outcome (FACE‐Q) assessment at baseline and after 3‐months.
Results
A significant improvement in skin surface spots (p=0.01) and pores (p=0.03) was seen at 3‐months follow‐up. Other variables, such as skin texture, wrinkles, UV‐spots, and porphyrins, showed a numerical improvement. FACE‐Q scales that measure satisfaction with appearance all showed a significant improvement from baseline, including satisfaction with skin (p=0.002), satisfaction with facial appearance (p=0.025), satisfaction with cheeks (p=0.001), satisfaction with lower face and jawline (p=0.002), and satisfaction with lips (p=0.04). No major adverse effects were reported.
Conclusions
A series of three i‐PRF injections resulted in significant rejuvenation of the face skin at 3‐month follow‐up, as shown by improved skin analysis parameters and patient self‐assessment scores.
... Skin with a lower score was considered to be more youthful in appearance (range, 0-100). 10 Subscores for surface (spots, rhytids, pores, texture) skin components were measured and compared between groups at both time points. The relation between presenting skin score and subsequent response to PRFM was also evaluated. ...
Background
Despite the increasingly popular use of platelet-rich fibrin matrix (PRFM) for facial rejuvenation, no studies have evaluated its effects on skin.
Objectives
To determine the effect of PRFM on skin quality using the Canfield VISIA Complexion Analysis System.
Methods
This was a 12-week randomized, placebo-controlled trial conducted at a single center comparing two groups. Thirty patients received a PRFM injection in the mid-cheek region and nasolabial fold on one side of the face and saline on the contralateral side. The primary outcome measure was the difference between pre- and post-treatment total VISIA skin scores for each group at 6 weeks and 12 weeks. The change in sub-scores for each skin parameter was also calculated.
Results
There were thirty participants, with a mean (SD) age of 49.9 (13.9) years. At 6 weeks, the median decrease in total VISIA score (IQR) was -1.77 (2.36) in the PRFM group and -0.73 (2.09) in the saline group (p=0.003). The only skin parameter that had a significantly different change in score between the groups was texture (p=0.004). At 12 weeks, median score improvement was -1.31 (3.26) in the PRFM cohort and -0.76 (2.21) in the saline cohort (p=0.34). There was no statistical significance in the change in score for any of the individual skin parameters.
Conclusions
PRFM can objectively improve skin quality compared to placebo. Texture was the only skin parameter that significantly improved, which is consistent with PRFM's role as a filler agent. The results appear to persist for at least 6 weeks.
... Therefore, a device that covers a wide area is required to enable the objective evaluation of skin color distribution, and a standardized high-quality photograph can produce an accurate evaluation as a two-dimensional (2D) colorimeter. [12][13][14][15][16][17] In addition, some studies have extracted color data from the target area of the facial image for quantitative analysis. 13,14,17 However, their analysis is limited to the designated area, and they did not provide an understanding of skin color distribution over a wide area of the face in detail. ...
In this article, we present an evaluation method for the skin color distribution in the face area. Unlike previous methods that extract a specific area, our method subdivides the entire face into small regions and analyzes detailed, per‐frame textures. Our evaluation method for skin color distribution is based on facial feature points and includes segmentation that takes into account the facial skeleton and muscle orientation. The use of facial feature points enables a comparison at relatively equal positions on the face without depending on the shape or size of the individual's face. Our evaluation method is versatile, and as an application, we clarified age‐specific features and seasonal variations of facial color distribution. As a result of applying this evaluation method to the facial images of women aged 20 to 78 years, we confirmed that the lightness of the face decreased as age increased. In particular, the decrease in lightness was remarkable in the region along the cheekbone, from the temple to the center of the cheek. Furthermore, we analyzed the seasonal changes of melanin distribution in the face area. This showed that the melanin index increased particularly in the cheekbone area in the summer when the influence of ultraviolet rays became large. Our novel methodology and the data presented in this article will be useful in various fields, such as dermatology, cosmetics, and computer vision.
... Therefore, the photography method of blackheads counting provides a more accurate evaluation. At present, VISIA-CR analysis system, as a modern image analyzer, is a helpful tool and has been applied in the cosmetic practice [15]. As a method of fluorescence photography measurement, it can be used for image acquisition and skin complaints including skin lesions, winkles, spots, and also for research purposes [16][17][18][19]. ...
Blackheads are a subtype of acne. As a cosmetic problem, it seriously affects patient's facial appearance and psychological condition. So it has attracted more and more public attention in recent years. However due to the evaluation standards are not uniformed, the grade methods of existing acne still are lack of objective quantitative standard. Even for professionals with long training, there remains great variability among the evaluators. The experimental shows that the new intelligent method is similar to the results of professional dermatologists in terms of blackheads counting and has high efficiency advantages. What's more, it achieves the leap from qualitative to quantitative analysis in blackheads identification field.
... To evaluate skin moisture, TEWL, and superficial pH at the cheek, a Corneometer (Courage and Khazaka Electronic GmbH, Cologne, Germany), VAPO SCAN AS-VT100RS (ASCH JAPAN Co., Tokyo, Japan), and Skin-pH-Meter PH905 (Courage & Khazaka Electronic GmbH, Cologne, Germany) were used, respectively. Skin conditions were also evaluated by VISIA Evolution (Canfield Scientific Ltd., Parsippany, NJ, USA), which analyzed spots, wrinkles, pores, texture, porphyrins, UV spots, red areas and brown spots from the picture of the participant's face [61], and DermaLab (Cortex Technology, Hadsund, Denmark), which analyzed echo-graphic density of subcutaneous tissue including epidermis, dermis and subcutaneous fat and calculated collagen score from its ultrasound image. All measurements of skin condition were evaluated in a testing room with stable temperature (21 ± 1 • C) and humidity (50 ± 5%). ...
Aging-associated changes of skin conditions are a major concern for maintaining quality of life. Therefore, the improvement of skin conditions by dietary supplementation is a topic of public interest. In this study, we hypothesized that a composite supplement containing fish derived-collagen peptide and ornithine (CPO) could improve skin conditions by increasing plasma growth hormone and/or insulin-like growth factor-1 (IGF-1) levels. Twenty-two healthy Japanese participants were enrolled in an 8-week double-blind placebo-controlled pilot study. They were assigned to either a CPO group, who were supplemented with a drink containing CPO, or an identical placebo group. We examined skin conditions including elasticity and transepidermal water loss (TEWL), as well as plasma growth hormone and IGF-1 levels. Skin elasticity and TEWL were significantly improved in the CPO group compared with the placebo group. Furthermore, only the CPO group showed increased plasma IGF-1 levels after 8 weeks of supplementation compared with the baseline. Our results might suggest the novel possibility for the use of CPO to improve skin conditions by increasing plasma IGF-1 levels.
... Patients at the National Cancer Center Hospital and Tohoku University Hospital underwent further photographic assessment using VISIA â Evolution (Canfield Scientific, Parsippany, NJ, USA) which generates a series of photographs using standard, ultraviolet and cross-polarized light, and analyzes the recorded photographs to quantify the facial skin characteristics in color as well as surface topography. 13 ...
... Canfield's patented RBXTM (Red/Brown/X) technology provides assessment of the amount of melanin and hemoglobin content. The hemoglobin serves as a measure of the amount of redness in the skin, including erythema, vascular lesions and telangiectasias [10]. ...
... Advanced digital photography techniques may be able to supplement simple clinical assessments of some dermatologic disorders including acne by allowing a more detailed and objective evaluation of the condition, as well as monitoring the effectiveness of therapy and its associated side effects over time. [7][8][9][10][11][12] Clindamycin 1%/tretinoin 0.025% (Clin-RA) is a well tolerated and effective treatment for acne vulgaris, as shown in three 12-week pivotal clinical studies involving 4550 patients. [13][14][15] This fixed-dose combination of a retinoid and an antibiotic was shown to be significantly more effective at reducing inflammatory, non-inflammatory and total acne lesions compared with its monotherapy and vehicle components. ...
Background:
Erythema-directed digital photography is a novel method for evaluating the efficacy and tolerability of topical acne treatments. Here, we describe three case reports in which erythema-directed digital photography was used to evaluate acne before and after up to 12 weeks of treatment with clindamycin 1%/tretinoin 0.025% (Clin-RA).
Materials and methods:
Erythema-directed digital photography was used to evaluate acne in three patients with mild-to-moderate facial acne, two of whom had refused to continue previous topical acne treatment (benzoyl peroxide 5% and clindamycin 1%/benzoyl peroxide 5%) due to persistent irritation. Acne lesions and erythema were evaluated using standard clinical photography and erythema-directed digital photography (VISIA-CR™ system) before and after 8-12 weeks of treatment with Clin-RA.
Results:
Erythema-directed digital photography revealed background erythema from previous topical acne treatments that was not evident from standard clinical photographs and allowed a better visualization of both inflammatory and non-inflammatory lesions. In all patients, there was a clear improvement in background erythema and a reduction in acne lesions following treatment with Clin-RA.
Conclusion:
This study has demonstrated for the first time that erythema-directed digital photography can enhance the evaluation of the efficacy and tolerability of topical acne treatments. These cases show that Clin-RA was associated with improved efficacy and tolerability vs previous treatments with topical monotherapy (benzoyl peroxide 5%) or a topical fixed-dose combination (clindamycin 1%/benzoyl peroxide 5%).
Background
Skin glow is a subcomponent of skin quality. It has become entrenched in the cosmeceuticals and aesthetics lexicons as a synonym for health and youth, but is not well‐defined as a scientific metric.
Aims
To examine the concept of skin glow and determine if it is an objective concept that can be defined and quantified.
Methods
Literature review was used to develop a survey on current concepts relating to skin quality. The survey results were analyzed descriptively and presented to a focus group comprising five dermatologists and four aesthetic physicians. This group then discussed the concept of skin glow, how to define it and what metrics could be used to assess it.
Results
Surveyed practitioners ( n = 38) ranked skin quality as the fourth most important factor related to a person's overall aesthetic first impression. Almost all (95%) respondents reported routinely assessing skin quality, citing serial photography (83%), and visual inspection (67%) as the main means of achieving this. The focus group defined skin glow as even reflectance from an unaffected papillary and reticular dermal collagen layer, which is created only when skin does not exhibit any characteristics that detract from this even reflectance. Due to its complexity, the focus group proposed a hierarchal framework for assessment, encompassing patient self‐rating, practitioner severity rating, and supplemental use of validated measurement devices.
Conclusions
Skin glow can be defined and quantified. More work is warranted to develop a practical skin glow assessment tool suitable for use in the clinic setting.
Objective:
Cutaneous relief analysis is crucial in the development of new skincare products, as well as in the evaluation of dermatological treatments. The analysis can be performed by qualitative or quantitative methods. We propose a new algorithm to detect wrinkles and quantify skin roughness by image processing from a dermatoscope.
Methods:
A clinical study was carried out with 33 research participants, and images were collected with the dermatoscope and PRIMOS equipment for wrinkle evaluation at two different times: Day 0 (D0) and 45 days (D45) after the use of a dermocosmetic product. Later, a new algorithm was developed to detect wrinkles in the acquired images by applying filters and image transformations that generate a segmented image highlighting the wrinkles. A roughness calculation method is proposed from the pixels belonging to wrinkles.
Results:
Correlation between the values obtained by the PRIMOS equipment and the proposed system was verified. No correlation was found for data obtained at D0; however, there was correlation at time D45 by Spearman's similarity coefficient. By comparing roughness between times D0 and D45, the treatment was statistically significant for both PRIMOS and the proposed methodology data.
Conclusion:
The wrinkle detection algorithm, in addition to the roughness calculation, demonstrated a sensitivity comparable to the PRIMOS system in evaluating the effectiveness of the dermocosmetic treatment.
Significance:
Considering the simplicity of the dermatoscope design compared to other established devices such as PRIMOS, the proposed system is promising as an alternative for dermatological evaluations.
Background:
Skin characteristics show great variation from person to person and are affected by multiple factors, including genetic, environmental, and physical factors, but details of the involvement and contributions of these factors remain unclear.
Objectives:
We aimed to characterize genetic, environmental, and physical factors affecting 16 skin features by developing models to predict personal skin characteristics.
Methods:
We analyzed the associations of skin phenotypes with genetic, environmental, and physical features in 1472 Japanese females aged 20-80 years. We focused on 16 skin characteristics, including melanin, brightness/lightness, yellowness, pigmented spots, wrinkles, resilience, moisture, barrier function, texture, and sebum amount. As genetic factors, we selected 74 single-nucleotide polymorphisms of genes related to skin color, vitamin level, hormones, circulation, extracellular matrix (ECM) components and ECM-degrading enzymes, inflammation, and antioxidants. Histories of ultraviolet (UV) exposure and smoking as environmental factors and age, height, and weight as physical factors were acquired by means of a questionnaire.
Results:
A linear association with age was prominent for increase in the area of crow's feet, increase in number of pigmented spots, decrease in forehead sebum, and increase in VISIA wrinkle parameters. Associations were analyzed by constructing linear regression models for skin feature changes and logistic regression models to predict whether subjects show lower or higher skin measurement values in the same age groups. Multiple genetic factors, history of UV exposure and smoking, and body mass index were statistically selected for each skin characteristic. The most important association found for skin spots, such as lentigines and wrinkles, was adolescent sun exposure.
Conclusion:
Genetic, environmental, and physical factors associated with interindividual differences of the selected skin features were identified. The developed models should be useful to predict the skin characteristics of individuals and their age-related changes.
Background:
Hyperpigmentary disorder is one of the commonest skin concerns in dermatology clinics. The availability of noninvasive instruments provided a convenient, objective, and reproducible methodology for the evaluation of pigmentation and skin color. The aim of this study is to compare CSKIN and VISIA in measuring facial hyperpigmentation, as well as to assess the correlation between the instrumental analyzing and clinical evaluation.
Methods:
Eighty Chinese patients were enrolled. Images were taken and analyzed by VISIA from Canfield and CSKIN from Yanyun Technology, and the facial hyperpigmentation was graded by three dermatologists.
Results:
Feature counts within the facial pigmented areas analyzed by VISIA showed positive correlations with brown pixels (r = 0.331, p < 0.05) and brown percent (r = 0.395, p < 0.0001) measured by CSKIN. The parameters measured by CSKIN and VISIA were significantly correlated with visual scores graded by the dermatologists, with VISIA presenting a moderate correlation (r = 0.509, p < 0.001) and CSKIN a slightly stronger correlation with the visual scores (r = 0.653, p < 0.001).
Conclusion:
CSKIN could serve as an alternative in the assessment and follow-up of skin disease featuring with facial hyperpigmentation.
Background
: To construct a neural network model (ATBP) for predicting susceptibility to Post-inflammatory hyperpigmentation (PIH), which is a rapid, objective, and reliable decision-support method before physical and chemical interventions in dermatology clinics for pigment disorders.
Material and Methods
: A dataset was established based on the VISIA Skin Analysis System detection results of 1953 patients with pigment disorders including 93477 labeled data under 8 indicators. A novel Post-inflammatory hyperpigmentation susceptibility prediction model incorporating Multi-head self-attention mechanism and Back-propagation neural network is proposed to capture the patterns of skin detection data to predict PIH susceptibility.
Results
: The results of comparison experiments indicate that Attentive BP (Back Propagation Neural Network) has a significant superiority in prediction accuracy (0.8604) compared with other machine learning models. The ablation experiments prove that the Multi-head self-attention mechanism substantially improves the accuracy and the stability of prediction. The results of the 10-fold cross-validation experiment prove that ATBP is robust and avoids turbulence in predicting.
Conclusion
: Leveraging Multi-head self-attention mechanism and the architecture advantage of BPNN, the proposed model ATBP obtains the robust and efficient prediction performance in predicting PIH susceptibility via processing large-scale and hi-dimension data, i.e., considering comprehensive skin conditions of individual patient. It can be proved from the experimental results that the proposed model is reliable for decision-support work of PIH susceptibility.
The aim of the present study was to evaluate the efficacy and safety of a unipolar focused-RF device used to rejuvenate the middle and lower face and to create an assessment system. This retrospective study comprised 52 patients with mild-to-moderate skin laxity and wrinkles who received 1-3 treatments 1 month apart and were followed up for 1-7 months. At baseline and post-treatment, three blinded observers measured facial contour and lines, analyzed VISIA scores, and assessed the results using Alexiades Comprehensive Grading Scale (ACGS) and Global Aesthetic Improvement Scale (GAIS). Significant improvements were observed (P < .05) in facial width (left 5.95%, right 5.66%), nasolabial folds (left 18.98%, right 20.56%), marionette lines (left 18.88%, right 25.80%), and cheek lines (left 3.35%, right 3.05%) and in the scores of wrinkles (15.37%), texture (13.67%), pores (6.48%), and red areas (6.57%) using VISIA. There was an obvious reduction in wrinkles, laxity, erythema/telangiectasia based on ACGS, and 75% improved and 5.8% much improved using GAIS. There was no severe side effect. We suggest that the unipolar focused-RF device is an effective and safe technique for middle and lower face rejuvenation and provides a series of comprehensive assessment methods based on standardized photos using VISIA.
Background
Intrinsic aging promotes wrinkles formation by an imbalance between matrix synthesis/degradation in favor of degradation. This is accelerated by the exposome leading to overproduction of protease and fewer remodeling.
Objective
Protecting the integrity of extracellular matrix appears as the most efficient anti-aging solution. We developed a grafted HA specifically designed to get anti-aging property due to a specific molecular weight and acetylation degree.
Methods
A transcriptomic analysis was performed on fibroblasts, followed by a measurement of MMP secretion and subsequent effect on collagen degradation. MMP expression in skin explants concerned by chronobiological and extrinsic aging was analyzed by immunostaining. A clinical study was conducted on volunteers presenting wrinkles on face to evaluate flash reduction of wrinkles after 6 h of application by profilometry and anti-aging efficacy after 2 months by VISIA® CR2.3.
Results
Transcriptomic analysis evidenced an inhibition of MMP gene expression with acetylated HA, confirmed by an inhibition of MMPs release by fibroblasts, and a protection of type I collagen against degradation. We confirmed the reduction of MMPs in mature skin and in skin explants exposed to UV and urban dust. We demonstrated during clinical studies the flash reduction effect of acetylated HA on crow's feet wrinkles and a filling of nasogenian areas 6 h after application, and a wrinkles number reduction on nasogenian area up to 2 months of application.
Conclusion
We developed a new grafted HA owing protective properties against ECM degradation induced by chronobiological and extrinsic aging, leading to a significant and efficient anti-wrinkles effect.
Background:
The 2,940 nm erbium-doped yttrium aluminium garnet and 1,064 nm neodymium-doped yttrium aluminium garnet lasers have been widely applied in facial rejuvenation, but no randomized trials exist to evaluate the efficacy of the combination treatment.
Objective:
The efficacy of the combined treatment for facial rejuvenation.
Materials and methods:
A total of 20 subjects with facial aging were enrolled and randomly assigned into 2 groups: one side of the face was treated with a 2,940 nm or 1,064 nm laser alone and the other side was treated with the combined lasers. The patients were treated by 3 sessions with 1-month intervals. The efficacies were quantitatively accessed by digitalized high-resolution photographs.
Results:
The 1,064 nm laser alone showed significant improvements on indexes of skin texture, spore, brown spots, elasticity, and melanin as compared with the baseline (p < .05). The 2,940 nm laser alone showed significant improvements on indexes of wrinkle, texture, pore, and elasticity (p < .05). The combined treatments showed significant improvements on the abovementioned indexes as compared with either a 1,064 nm or 2,940 nm laser treatment (p < .05).
Conclusion:
A combination of 1,064 nm and 2,940 nm laser treatment renders significantly better efficacies for facial rejuvenation as compared with a 2,940 nm or 1,064 nm laser alone.
Background
Klotho is a protein known for its beneficial effects on longevity. Centcyamine is an alkaloid present in certain plants whose extracts have an anti-inflammatory effect. Skin fibroblasts are essential to the formation and structure of the dermis.
Objective
Centcyamine is an indole-based alkaloid composed of coumaric acid, a resveratrol precursor and methoxytryptamine, which can be both a precursor, or a derivative, of melatonin. Given these building blocks and their well-known bioactivities, it was of interest to explore the potential benefits of using this aryl-alkaloid, in cosmetic skin care applications.
Methods
We tested cultured normal human dermal fibroblasts (NHDF) in vitro to observe how supplementation with Centcyamine improves properties of the cells to counteract the effect of aging. The expression of genes and proteins of interest was quantified. The effect on doubling time and cell function was evaluated following treatment of the cells over several replication cycles. Skin firmness, red spot index and skin isotropy were measured with Dynaskin®, Visia® and Primos® equipment respectively and compared over two months in a vehicle controlled clinical trial on 60 persons.
Results
Centcyamine activates the expression of the gene KL and the related protein Klotho in dermal fibroblasts. Moreover, Centcyamine slows the replicative aging process of fibroblasts in culture. These cells retain cellular functions identical to those of young cells: the synthesis of Lamin B1, a crucial regulatory protein of proliferation, as well as of Collagen I and Elastin is retained in aged cells. The clinical data are shown to improve skin isotropy in a majority of subjects, to reduce the red spot intensity and to maintain skin firmness in the treated group vs. the vehicle.
Conclusion
The alkaloid Centcyamine induces changes in the metabolism of the aging process of human dermal fibroblasts. The up-to-now unobserved implication of both Klotho and Lamin B1 to maintain homeostasis of the skin opens new venues for the prevention of age-related changes in skin structure. The in vitro and clinical data, while not demonstrated to be causally related, converge toward a common goal of skin repair and slower ageing processes.
Port‐wine stain (PWS) is a benign capillary malformation that most commonly occurs in the head and neck. It is present at birth and progresses over time. It is formed by progressive dilatation of post‐capillary venules and is associated with hypertrophy and nodularity with increasing age, leading to cosmetic disfigurement and psychological aggravation. It is caused by genetic mosaicism in GNAQ and GNA11 genes. Histopathology is the gold standard for assessment of PWS but it is invasive and may cause scarring. Inadequate characterization of the lesions may predispose to inadequate treatment protocols as well as higher treatment dosages. Clinical evaluation of treatment efficacy is subjective and may not be a representative of actual results. Therefore, an objective visualization modality is required. With evolving technology, numerous optical instruments have been developed for objective evaluation and visualization of subsurface structures. These include VISIA‐CR™ system, videodermoscopy, high‐frequency ultrasound (HFUS), laser speckle contrast imaging (LSCI), reflectance spectrophotometers and tristimulus colorimeter, laser Doppler flowmetry (LDF), cross‐polarized diffuse reflectance imaging system (CDR), reflectance confocal microscopy (RCM), optical coherence tomography (OCT), and spatial frequency domain imaging (SFDI). These semi‐quantitative modes of diagnosis are complementary to each other. Some can be used in the clinical setting while others, due to high instrument cost, are limited to the research settings. In this review, we bring to you a brief overview of noninvasive diagnostic modalities in PWS.
Background:
The 10,600-nm ablative fractional laser (AFL) is widely used for treating facial atrophic acne scars but with evident side effects. By contrast, the common Er:Glass non-AFL (NAFL) is safer but lacks of comparable outcomes. A novel 1,565 nm Er:Glass NAFL improves thermal energy delivery and could yield better outcomes.
Objective:
We aimed to compare the effectiveness and safety between the 1,565-nm NAFL and 10,600-nm AFL in treating mild-to-moderate facial atrophic acne scars.
Methods:
Nineteen patients with mild-to-moderate bilateral facial atrophic acne scars were enrolled in a randomized split-face trial, which involved 3-session procedures for each laser. The effectiveness and safety were evaluated by doctors and patients who were blinded to the treatment assignment.
Results:
Both lasers improved the acne scar profiles comparably. A marked reduction in erythema, crusting durations, and degree of pain were noted on the sides treated with the 1,565-nm NAFL, relative to those treated with the 10,600-nm AFL.
Conclusion:
Both 1,565 nm-NAFL and 10,600-nm AFL can improve mild-to-moderate acne scars. Patients should never expect complete resolution. The 1,565-nm NAFL has less side effects.
Background
Skin suffers progressive decrement. An endogenous regenerative technology has been developed that has the versatility to provide an autologous injectable gel (Endoret‐Gel) or a liquid plasma rich in growth factors (PRGF) based on the patient´s own platelet rich plasma.
Objective
To compare the efficacy of the combined therapy with Endoret‐Gel and PRGF versus Endoret‐Gel alone in the management of facial rejuvenation.
Materials and methods
Twenty clinically diagnosed patients with aged skin received either Endoret‐Gel monotherapy or Endoret‐Gel+PRGF combined therapy. Patients underwent three sessions at one‐month intervals and were clinically assessed for six months. Corneometry, sebumetry and high‐resolution topographic analysis were carried out. Patient self‐assessment questionnaires and clinical improvement scores were also performed.
Results
The combined therapy showed to promote a higher hydration index. These results were also significant for spot improvement at three months, while conversely, monotherapy with Endoret‐Gel demonstrated higher UV spot improvement. A significant decrease of sebum production and wrinkle development was observed for both treatment groups. Red areas also improved in a similar way at the end of the follow up period. After Endoret‐Gel or Endoret‐Gel+PRGF therapy, 30% and 70% of patients refereed to be very satisfied, respectively. Accordingly, 40% and 80% showed a “very improved” aesthetic performance. None of the patients reported a negative change and no adverse events were recorded.
Conclusion
Both Endoret‐Gel monotherapy and the combined treatment with PRGF were shown to promote facial rejuvenation and to palliate the age‐related cutaneous atrophy. The combined therapy may exert a synergistic effect that addresses both skin quality improvement and soft tissue restoration in a shorter period.
Background
With the development of cosmetic industry in China, an aging evaluation method of Chinese women is in great need.
Aims
The aim of this study is to establish a skin aging assessment method using convenient portable machine Antera 3D.
Methods
The quantitative approach was developed by capturing 11 areas of the face, and overall, 48 parameters were extracted for aging evaluation. Later, 297 subjects were recruited to take facial image and life style questionnaire. Evaluation of age was accomplished by establishing prediction method with detected skin traits.
Results
The age prediction model was built by using the evaluated facial traits, and a R square of 0.6 is achieved by comparing to the chronological age. The crow's feet, cheek skin pigmentation, forehead skin tone, and wrinkles around the month are critical factors in evaluating Chinese women skin aging. In addition, we also explored life styles associated with important skin aging traits.
Conclusion
The method developed in this research provides reliable alternative in aging study of Chinese women.
Over the years, digital photography in dermatology has been proven to be an indispensable tool for documenting various diseases for clinical, scientific, didactic, and medico-legal aims, for archiving and for medical-scientific communication. Three-dimensional imaging is a new branch of digital photography with countless advantages. Thanks to specific software, the elaboration of the image allows to evaluate in an objective way the pigmentation, the vascular characteristics, and the skin texture and to measure areas and volumes. The observation of the photographic images is of paramount importance both for a correct diagnosis aimed at the choice of the best therapeutic approach and for a correct evaluation in follow-up, through the comparison between the images “before and after.” The fields of application are from clinical medicine to surgery, from esthetics to the prevention of skin tumors. Today the focus is on new 3D systems that allow to store, to analyze, and to reproduce healthy and pathological skin in a more detailed way and in accordance with reality.
Background
Redness is the most common symptom among many facial dermatoses. With the rapid development of optical instruments, spectral imaging, and image processing technology, there appear varieties of skin color analysis methods and instruments. The aim of this study is to reveal the differences and correlations in measuring the facial redness between CSKIN® and VISIA®, as well as the relevance between the instrument parameters and clinical evaluation.
Materials & Methods
Forty‐three Chinese patients were enrolled. Images were taken and analyzed by VISIA® from Canfield and CSKIN® from Yanyun Technology, and the facial erythema was graded by the dermatologists.
Results
Feature counts within the red areas measured by VISIA® were found to have significantly positive correlations with red pixels and percent which were measured by CSKIN® on both sides of the face (r = .45 ~ .566, P < .01). The parameters analyzed by CSKIN® and VISIA® feature counts were correlated with visual scores graded by the dermatologists, VISIA® presented with a weak correlation (r = .213, P < .05), while CSKIN® had a moderate correlation with the visual scores (r = .472 ~ .492, P < .001).
Conclusion
CSKIN® may be another alternative option when encountering with measurement and follow‐up of facial erythema.
Objective
To evaluate the efficacy and safety of a Chinese medicine (CM) Modified Qufeng Runmian Powder (加减祛风润面散, MQFRMP) for the treatment of acne vulgaris with CM syndromes of dampness and blood stasis.
Methods
In this multicenter, randomized, double-blind, placebo-controlled clinical trial, 220 acne vulgaris patients with CM syndrome of dampness and blood stasis were included and randomly assigned using a central area group random design to receive either MQFRMP or the placebo, with 110 cases in each group. MQFRMP or a placebo at 145 g/bag were administered once daily for 4 weeks, respectively. The primary index of efficacy was the effective rate according to the acne severity score (ASS). The secondary indices of efficacy included the changes in the dermatology life quality index (DLQI) score, VISIA scores (spots, pores, brown spots, porphyrins and red areas) and skin assessment (skin pH, sebum amount and hydration) according to a SOFT skin multianalyzer.
Results
(1) Follow-up: a total of 204 patients completed the follow-up, with 103 in the treatment group and 101 in the control group. (2) Effective rate: the total effective rate of the treatment group was significantly higher than the control group [83.5% (86/103) vs. 31.7% (32/101), P<0.01)] with 95% confidence interval of 39.3%–66.4%. (3) DLQI: DLQI scores were significantly decreased the treatment and control groups (both P<0.01), but the treatment group was more obvious than the placebo group (P<0.01). (4) VISIA scores: the scores of spots, brown spots and red areas in the treatment group decreased compared with baseline (P<0.05). In the control group, the scores of brown spots and pores decreased compared with baseline (P<0.05). The improvement was more obvious in the treatment group than in the control group for all items (P<0.05). (5) Skin assessment: the pH and sebum score in the both groups decreased drastically compared with the baseline (all P<0.01), however, the improvement was more obvious in the treatment group than in the control group (P<0.01). The hydration amount in the two groups showed no statistically significant difference compared with the baseline (both P>0.05). (6) Safety: two cases of mild drug allergy were observed in the treatment group.
Conclusion
MQFRMP was effective and safe for the treatment of acne vulgaris with syndromes of dampness and blood stasis. (No. ChiCTR1900020479).
Backgrounds:
Striae distensae (SD) has a known psychological impact due to the resulting cosmetic disfigurement. Many treatment modalities have been used over the years, but no standard interventions or evaluation methods have been proposed to date.
Objective:
We compared the efficacy and safety of non-insulated microneedle radiofrequency (NIMRF) and fractional CO2 laser treatments of SD by objective measurements with dermoscopy and VISIA.
Methods:
Fourteen females with severe SD were enrolled. These subjects had been treated three sessions of NIMRF and fractional CO2 laser for the right and left abdomen, respectively. Dermoscopy and VISIA imaging data, and photographs were collected at baseline and 2 months after the last treatment session. The global aesthetic improvement scale (GIAS) was scored by patients, and blinded investigators, pain score and satisfaction score were also documented. Any side effects were recorded.
Results:
Ten patients completed the study. The GIAS from investigators and patients showed an overall improvement but without a significant difference (P = 0.18, P = 0.17, respectively). The decreased width measured by dermoscopy was between 5% and 32% (right side) and 6-31% (left side). There was no significant difference between both sides in either the per-protocol or intention to treat analyses (P = 0.149, P = 0.161, respectively). The mean pain score was 5.35 and 2.35 on the right side and left side, respectively, which was significant (P = 0.0016). Postinflammatory hyperpigmentation (PIH) manifested in six patients on their left sides and four patients on their right sides. In most cases, this had resolved by the 3-month follow-up.
Conclusion:
Non-insulated microneedle radiofrequency and fractional CO2 laser are both effective and safe treatment options for SD. PIH is a possible side effect but is more likely with fractional CO2 laser treatment. However, it clears up in most cases. Dermoscopy and VISIA are both convenient, digitalized methods of tracking subtle changes and monitoring the efficacy of SD treatments.
Introduction
The clinical characteristics of skin were investigated to study the inter‐relationship and changes in the biophysical properties of the epidermal and dermal layers associated with aging using noninvasive methods.
Methods
Our study included 100 healthy women aged between the early 20s and late 60s. Biophysical characteristics of skin such as color (brightness and spots), transparency, wrinkle on crow's feet, elasticity, hydration, sebum content, glossiness, and transepidermal water loss measured under controlled conditions.
Results
This study performed in a Korean population demonstrated that aging significantly affects human skin in terms of parameters such as wrinkles, skin color, elasticity, and epidermal hydration. Age‐related changes in skin hydration showed varying patterns between the epidermis and dermis. Skin color showed heterogeneous characteristics between the upper and lower epidermal layers associated with aging. Skin elasticity and wrinkles were observed to show and inversely proportional relationship in the early 40s.
Conclusions
We confirmed the significant influence of aging on the biophysical properties of skin and determined the distinct age‐related biophysical changes in the epidermal and dermal layers of skin using noninvasive method. This study indicates the need for further research to investigate the distinctive age‐related changes in characteristics of the epidermal and dermal layers of human skin.
Background
Hematoporphyrin monomethyl ether photodynamic therapy (HMME-PDT) is an effective method for treating port wine stains (PWS). However, methods to evaluate the treatment of HMME-PDT for PWS effectively and objectively are lacking.
Background
Hematoporphyrin monomethyl ether photodynamic therapy (HMME-PDT) is an effective method for treating port wine stains (PWS). However, methods to evaluate the treatment of HMME-PDT for PWS effectively and objectively are lacking.
Objective
This study aimed to describe the different noninvasive diagnostic techniques used in the evaluation of treatment response to HMME-PDT for PWS.
Methods
Thirty-one lesions of 22 patients with PWS were treated with HMME-PDT. Four noninvasive diagnostic techniques including VISIA-CR™ system, dermoscopy, high-frequency ultrasound (HFUS), and laser speckle contrast imaging (LSCI) were used to obtain standard radiographic data on skin color, skin thickness, blood vessel morphology, blood vessel distribution, and blood perfusion from lesions and surrounding normal skin before and after HMME-PDT.
Results
The standard image pattern of VISIA-CR™ system showed color change in the lesions of PWS after HMME-PDT. RBX red image of VISIA-CR™ system showed that erythema was highly aggregated even in invisible lesions at baseline but decreased after HMME-PDT. The erythema index reduced value d was related to the efficacy rating (γ = 0.631, P < 0.05). Dermoscopy showed that the number of spot-like and irregular linear vessels increased, which was correlated with the increase in clinical classification. After HMME-PDT, vascular rupture was observed by dermoscopy. The response rate of lesions with vascular rupture was 100.00% (20/20). Moreover, the response rate of lesions without vascular rupture was 63.64% (7/11). Vascular rupture sign was correlated with better efficacy (P < 0.05). HFUS showed that the dermis of PWS thickened and was arranged loosely with scattered linear hypoechoic signal. After HMME-PDT, the dermal layer of the lesions became thinner with a decreased linear hypoechoic signal. The response rate of the lesions with linear hypoechoic signal was 76.92% (10/13), and that without linear hypoechoic signal was 94.44% (17/18). The lesions without linear hypoechoic signal in the dermis showed better efficacy (P < 0.05). In some lesions, LSCI showed high blood perfusion signal in PWS lesions and blood perfusion reduction after HMME-PDT.
Conclusion
VISIA-CR™ system can be used to observe not only visible but also invisible lesions of PWS. Moreover, lesions fading after HMME-PDT can be described objectively by VISIA-CR™ system. Dermoscopy played an important role in the clinical classification of PWS, including assessing vascular injury after HMME-PDT, guiding the adjustment of therapeutic dose, and selecting the end point of treatment. Both HFUS and LSCI can be used to assist treatment response evaluation of HMME-PDT.
The Melasma Area and Severity Index (MASI), the most commonly used outcome measure for melasma, has not been validated.
We sought to determine the reliability and validity of the MASI.
After standardized training, 6 raters independently rated 21 patients with mild to severe melasma once daily over a period of 2 days to determine intrarater and interrater reliability. Validation was performed by comparing the MASI with the melasma severity scale. The darkness component of the MASI was validated by comparing it with the difference between mexameter scores for affected versus adjacent normal-appearing skin. The area component of the MASI was validated by comparing it with the area of each section of the face determined by computer-based measurement software.
The MASI score showed good reliability within and between raters and was found to be valid when compared with the melasma severity scale, mexameter scores, and area measurements. Homogeneity assessment by raters showed the least agreement and can be removed from the MASI score without any loss of reliability.
Patients were limited to Hispanic, African, and Asian backgrounds.
The MASI is a reliable measure of melasma severity. Area of involvement and darkness are sufficient for accurate measurement of the severity of melasma and homogeneity can be eliminated.