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Skin Color Types and Indian Skin Characteristics


Abstract and Figures

The color of human skin results from complex mechanisms involving different genes, mainly related to melanin biosynthetic pathway. With its different flows of migration, India presents a wide range of biological diversity. This chapter highlights the uniqueness of Indian skin with its large diversity of color skin tone covering a color scale from very dark to light. Globally skin complexion appears not strongly affected by age compared to other Asian countries with a slight darkening of skin color with age particularly in Southern region. Skin color heterogeneity appears as a hallmark of Indian skin with an increase in facial skin color eveness with age. This heterogeneity can be explained by an increase in pigmentary disorders, i.e. hyper pigmented spots and spread macules. These disorders occur at early stages and increase with age,contributing to overall facial unevenness. Indian facial skin also presents some original hyperpigmented areas, such as lip corners, marionette lines and nose bridges. In india, dark circles are the most prevalent hyperpigmented areas, darkening with age.
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Dening Indian skin as “Asian skin” or “skin of color”
may lack of accuracy1 although India clearly pertains
to Asia geographically. e Indian population shows a
remarkable diversity with more than two thousand ethnic
groups. In addition, great variations exist in terms of
climate, diet and social parameters within the country. In
this context, Indian skin shows a wide variability in color
as well as some specicities. In particular pigmentary
disorders are a major concern in India; of a great
psychologic impact upon quality of life.2
Surprisingly, very few data are available on skin color
diversities in India. Few studies specically dedicated
to Indian population have been performed to date. is
chapter will mainly focus on a large typological study
conducted in 2011, on 1,204 Indian women from dierent
ages and dierent cities in India, Mumbai, Kolkata,
Chennai and New Delhi.
e evolutionary history of Indian ethnic groups and
subsequent migration from central Asia, west Asia and
southern China has resulted in a rich mosaic of socio-
cultural, linguistic and biological diversities that also
reects in the variety of skin colors present on the Indian
subcontinent. Broadly, Indians belong to Austro-Asiatic
(AA), Tibeto-Burman (TB), Indo-European (IE) and
Dravidian (DR) language families.3 Distinct religious
communities, hierarchical castes and sub-castes, and
isolated tribal groups that comprise the people of India
remain largely endogamous. e most comprehensive
survey of genetic variations in India so far analyzed
405 single nucleotide polymorphisms (SNPs) in 55 groups
and identied distinct clusters correlated to language
and geography.3
Association between human skin color and genetic
factors arose with the nding that zebrash with a
variation in the SLC24A5 gene is a golden color and with
fewer, smaller and lighter melanosomes than normal
zebrash.4 Humans also harbor the SLC24A5 gene and
consulting HapMap, a free publicly accessible database
of human genetic polymorphism, revealed that people
of European ancestry as compared to Africans and East
Asians have slightly dierent versions of the SLC24A5
gene Africans and East Asians. Since, the genetic basis
that underlies normal variation in the pigmentary traits
of skin or hair and eye color has been the object of intense
research aiming at understanding the diversity observed
between and within human populations. Several
approaches were undertaken, such as comparative
genomics of candidate genes, identication of the human
genome under positive selection and the genome-wide
and specic allele association studies. Findings from
these studies point towards independent selection
for dierent pigmentation gene sets between Asian,
European and African populations.5
At phenotypic level, human skin color is largely
determined by two biological components, melanin and
hemoglobin, and one major environmental component,
that is exposure to sun ultraviolet (UV) rays. In East
Chapter 4
Skin Color Types and Indian Skin Characteristics
Virginie Hourblin, L’Oréal Research and Innovation, Aulnay-Sous-Bois, France
Suzy Cointereau-Chardon, L’Oréal Research and Innovation, Chevilly-Larue, France
Namita Misra, L’Oréal Research and Innovation, Mumbai, Maharashtra, India
Frédéric Flament, L’Oréal Research and Innovation, Chevilly-Larue, France
Stéphanie Nouveau, L’Oréal Research and Innovation, Aulnay-Sous-Bois, France
Maya Vedamurthy, RSV Skin and Laser Centre and Apollo Hospitals, Chennai, Tamil Nadu, India
Shyam Verma, Nirvana Skin Clinic, Vadodara, Gujarat, India
Basic Science for Modern Cosmetic Dermatology
Asians, additionally the skin adipose tissue or hypodermis
may provide an additional yellowish tinge. A qualitative
assessment of skin color variations on the Indian
subcontinent represents the variation seen throughout
the world. is is indeed reected by genetic studies on
Indian subpopulations. Four genes account for a major
component of color variation amongst Indians: SCL24A5
(ortholog of zebrash golden), TYR (ortholog of mouse
Albino gene), SLC45A2 (ortholog of mouse Underwhite)
and MC1R.6,7 ese genes have also been implicated in
color variation between Europeans and Africans. Light
skin in Europeans and dark skin in Africans is due to
alternate alleles in the same genes. At least some of the
same alleles responsible for this color dierence between
Europeans and Africans seem being involved in Indians.
e SLC45A2 SNP shows an allelic gradient from north to
south in Europe.5 Does this gradient also exists from North
to South in India is a question of much sense. Indeed, a
distinct genetic divergence is seen between Ancestral
North Indians (ANI) and Ancestral South Indians
(ASI) that may also manifest in skin colors of these two
populations.8 e region around the SLC24A5 gene shows
a considerable reduction in heterozygotes suggesting a
major selective sweep of this light skinned allele through
the population. Light skin in Indians and Central/
Western Eurasians have common origin independent of
those in Asians, especially the contribution of SLC24A5
allele. ese results are more indicative of an ancestral
origin rather than a selection sweep driven by sun UV-
damage. On the other hand, the results also suggest that
in South India and Sri Lanka natural selection may keep
a low frequency of the ‘light alleles’, such as SLC45A2.
us genomic variations associated with pigmentation in
South Asian population reect complex phenomenon of
ancestral origin, migration and environmental factors.
Functional testing of variant alleles is paramount
to connect phenotype correlations with biological
dierences. For instance, variant MC1R alleles show
direct correlations between the biochemical signaling
properties of the encoded receptor and the red-hair
fair skin pigmentation phenotype. Direct testing of
a range of clonal melanocyte cultures derived from
donor skin tissue characterized for three causal SNPs
within SLC45A2, SLC24A5 and OCA2 (blue-brown eye
color) has assessed their impact upon melanin content
and activity of tyrosinase. By culminating genetic and
functional studies, it is apparent that genes that impact
melanosome biogenesis or the melanin biosynthetic
pathway are candidates to explain the diversity seen in
human pigmentation that would also apply to Indian
Colorimetry is a technology used to quantify color, and
so describe objectively the color perception. It is similar
to spectrophotometry, but is distinguished by its interest
in reducing spectra to the physical correlates of color
perception, most often the CIE 1931 XYZ color space
tristimulus values and related quantities.
To assess and compare skin color in vivo some methods
are available using calibration and standardization
principles. We do not focus here on clinical tools but on
the interest of objective, non-invasive and reproducible
instrumental devices. Globally these instruments can be
divided into two categories: one, such as Chromameter®
or Spectrocolorimeter®, acquires color parameters and
the other quanties color by analyzing digital images in
RGB model.9,10
Chromasphere® (Fig. 1) is a reference tool11,12 for facial
skin color assessment thanks to its stability, reliability and
its capacity to use diuse lighting systems that faithfully
mimic sun natural daylight (CIE illuminant D65). e
whole face is illuminated with a homogeneous light. Such
Figure 1: Chromasphere®
©L’Oreal Research and Innovation
Skin Color Types and Indian Skin Characteristics
a device is contact-free; avoiding any external pressure that
could aect blood ow and induce change in skin color.
Combining Chromasphere® with dierent equipments
allows various color characteristics to be quantied.
Calibrated images can be obtained with charge-
coupled device cameras, avoiding any drift in digital
camera recording and thus allowing the operator to
analyze data with dierent methods. e heterogeneity
of skin color can be then assessed with coxellography
index approach (co-occurrence matrix). Segmentation
and image analysis allow carnation and pigmented spot
areas to be detected and separated to obtain various
parameters. Spots density, size or color could then be
investigated. Meanwhile, colorimetric information is
computed to describe complexion and contrasts between
pigmented spots and surrounding areas.
Skin color can also be measured with a spectro-
radiometer. is kind of device acquires reectance of
skin from 380 nm to 780 nm every 4 nm. e spectrum
recorded on the visible eld (400–700 nm) is expressed
in the CIE 1976 standard colorimetric spaces L*a*b*C*h
D65/10° (Fig. 2).
e lightness L* uses a grey scale and accounts for
more or less lightness and more or less darkness.
e a* and b* are the color-opponent dimensions.
ese color axes are based on the fact that a color can
not be both red and green, or both blue and yellow,
because these colors oppose each other. On each axis
the values run from positive to negative. On the a-a
axis, positive values indicate amounts of red while
negative values indicate amounts of green. On the
b-b’ axis, yellow is positive and blue is negative. For
both axes, zero is neutral grey.
From the a* and b* values, the angle hue h and the
chroma C* are calculated. e angle hue h correspond
to the angle between the a* and b* axis and is the
colored coordinate. It characterizes the color from
red to yellow within the skin color space.
e Chroma C* or saturation refers to the pureness or
vividness. It refers to the intensity of the hue.
Color Skin Tone in India as Compared to
Other Ethnicities
Previous works indicate that skin color of the Indian
population is very diversied,1,13,14 with phototypes III
to VI, types IV and V being predominant.15 Surprisingly,
skin-related typology studies on Indian population
are scarce. A few available papers being devoted to
colorimetric characterization of Indian women skin
and its specicities (age, homogeneities, etc). e
dierences of skin color across India, and its changes
with geographical location were recently investigated.16
In this article skin colors of 1,195 healthy Indian women
from 18 years to 85 years old originating from four cities
were quantied using an objective colorimetric tool,
Chromasphere®. Results showed a wide diversity of skin
color within Indian women: the population covers a large
range of skin colors, from very dark to light (Fig. 3).
e skin color of women from other ethnicities
was previously evaluated12,17,18 revealing a worldwide
continuum of skin color. e projection of Indian skin
Figure 2: CIE L*a*b* and L*C*h color space
Basic Science for Modern Cosmetic Dermatology
color space in this continuum is closed to the one of
African women and women from African descent but
with a larger range of lightness (Fig. 3). e Indian skin
color space indeed overlaps those of Asian and Hispanic
women. is data highlights the wide diversity of skin
color in India as compared to other ethnicities.
Variation of Skin Color Tone within India:
Differences Depending on Geographical
Considering the diversity of climate/environment in
India, the impact of geographical location on skin color
has to be investigated. Results in Figure 3, arising from a
recently published study, cover populations of four cities
from north to south (Chennai and Delhi) and from west
to the east (Mumbai and Kolkata).16 Results of this study
showed a huge variability in skin color among the four
cities, suggesting an environmental impact upon skin
color (Fig. 4).
e wider variations in skin color are found in
Chennai. Instrumental measurements showed that
Figure 3: Skin color space in L* h plan measured by spectroradiometer in four dierent clusters of skin
color: Caucasian, Asian, Hispanic and African (see Table 1). Projection of Indian women skin color in this
worldwide skin color continuum
©L’Oreal Research and Innovation
Table 1: Skin color continuum studies; detailed studied
population referring to gure 3
Indian Women (n = 1195) From Mumbai, Chennai,
Kolkata and Delhi
Caucasian Women
(n = 2054)
France: Paris
Russia: Moscow
USA: Chicago/New York
Asian Women
(n = 4127)
China: Guangzhou, Shanghai,
Japan: Tokyo
Korea: Seoul
ailand: Bangkok
France: Paris
Hispanic Women
(n = 223)
USA: New York
Brazil: Rio
Mexico: Mexico
African and Women
from African Descent
(n = 853)
South Africa: Johannesburg
France: Paris (with native of
the French West Indies)
USA: New York
the women living in this city present the largest hue
range as well as the darkest, less saturated and reddest
Skin Color Types and Indian Skin Characteristics
Figure 4: Indian skin tones in four cities: Mumbai, Chennai, Kolkata and New Delhi (lightness by hue)
©L’Oreal Research and Innovation
Figure 5: Comparison of skin color parameters per facial area in four Indian cities (Chennai, Kolkata, Mumbai, New Delhi)
(n= 1195 women)
Basic Science for Modern Cosmetic Dermatology
skin whatever the area of the face (Fig. 5). On a scale of
6 skin complexion types identied in India (Fig. 6), 74%
of women skin colors are described as “brown” or “dark
brown” by a dermatologist.16
e results for the three others cities are roughly
similar with some noticeable particularities.
Kolkata shows the largest range of skin lightness
and saturation. According to the graphic representation
(Fig. 4), there is a strong link between lightness and
hue: the darker the skin is, the redder and less vivid
(less saturated) it is. Although skin color in Kolkata is
quite darker as compared to Mumbai, hue or saturation
is similar (Fig. 5). Skin colors of women from Mumbai
and Delhi only dier by the hue component: cheeks are
redder in Delhi than in Mumbai. ose dierences of
skin color complexion were conrmed clinically with
a same rate (34%) of “medium brown” skin (Fig. 6) but
dierent prevalence of “brown” and “wheatish” skin: 41%
of “brown” and 21% of “wheatish” in Delhi versus 10% of
“brown” and 45% “wheatish” in Mumbai.16
Figure 6: Indian skin complexion: Dermatologist assessment
©L’Oreal Research and Innovation
Figure 7: Annual average of sun exposure19
Skin Color Types and Indian Skin Characteristics
e trends observed on cheek or forehead are more
pronounced for the chin (perilabial area) (Fig. 5). is
area is more discriminant since it allows the four cities to
be dierentiated in terms of lightness and saturation.
According to these results, it would appear that there
is a latitude eect and an impact of the environment
(sun UV exposure, life habits, pollution, etc) upon the
skin color of Indian women. e skin colors of women
from Chennai, located in the South of India, are very
dierent from those of the Northern cities. India could
then be split diagonally from South West to North East.
e skin colors of the two cities of the East coast are
darker whereas the skin colors of the two Western cities
are lighter. is dierence was also found in another
study comparing Calicut and Delhi.18 Several hypotheses
could be proposed to explain this phenomenon. e
importance of UV exposure during the year could be
considered (Fig. 7). Chennai area indeed undergoes
higher sun exposure than other cities.19 Nevertheless,
this hypothesis alone might not suce to explain the
huge variations observed in skin color. is might be
also explained by the dierent ows of migration and
the interbreeding of two distinct ancestral lineages:
Dravidians and Indo-Europeans.8
Evolution of Indian Skin Color with Age
Skin darkening with age has been described in various
populations, e.g. a Chinese group living in Chicago as
reported by de Rigal et al.20 However, such age-related
changes were not observed in African-Americans,
Caucasians, and Mexicans living in the same area.20
A recent study on Chinese women living in China21,22
showed a rather linear darkening with age along the
life span. Another study conducted in eight Asian
cities including two Indian cities (Calicut and Delhi)
found that the melanin index increased with age
while L* value decreased, indicating that skin darkens
with age.18
e change in skin color with age in India was
deeper investigated in the study previously mentioned.16
Instrumental measurements showed that overall skin color
darkens with age (Fig. 8). By comparing the changes in L*
parameter with age between Indian women and women
from other countries, it has been highlighted that Indian
skin darkens at a dierent kinetics, i.e. twice slower than
Asian skin and slightly faster than Caucasian skin.
But this age eect has dierent intensity depending
on the Indian city (Fig. 9). Chennai is indeed the only
city where the age eect is signicant in the three color
Figure 8: Average skin lightness, Chroma and Hue according to dierent age groups. Measured on cheek with spectroradiometer®
(n = 1195 Indian women)
Basic Science for Modern Cosmetic Dermatology
parameters with the highest darkening and a skin
becoming redder and less saturated with age.
No signicant change in skin color was found in
Mumbai. Unlike Mumbai, skin color of women from
Kolkata and Delhi darkens with age. is dierence of age
eect between those three cities could be related to the
dierence of skin color previously observed and by the
specic environmental conditions of each city.
The difference of Indian skin color change with age
between a rather photo-protected skin area (upper
inner arm) and an exposed area (cheek) was also
investigated (Fig. 10).16 Chromameter® measurements
showed that after 35 years, the skin becomes slightly
fairer with age on the photo-protected area (Lightness
increase by 6%), when it becomes barely darker on
photo-exposed area (Lightness decrease by 2%). This
may account for overall impression of facial darkening
compared to the whole body for women, although
facial darkening is of a low extent. This has been
investigated in other populations in large cohorts of
Caucasian’s and Korean’s (653 Caucasians and 497
Koreans).23,24 In Caucasians, a significant darkening of
exposed areas was observed after 20 years. Amongest
Koreans, skin color alteration seems close to that
found in the Indian study, the skin color remaining
rather stable with age.
Overall Facial Skin Color Heterogeneity
Another issue concerning Indian skin color
has emerged with regard to its heterogeneity.
Coxellography index approach allows the overall
color heterogeneity of the face to be evaluated taking
into account the variations of color (hyperpigmented
and hypopigmented spots, telangiectasies), and
pores. Results showed that skin color heterogeneity of
the cheek increased with age (Fig. 11), which could
be explained by an increase in pigmentary disorders
and hyperpigmented areas.
Figure 9: Average skin Lightness, Chroma and Hue according to dierent age groups in four Indian cities (Chennai, Kolkata, Mumbai,
Delhi). Measured on cheek with Spectroradiometer® (n = 1195 Indian women)
Figure 10: Average skin lightness in age groups (years) measured
on cheek (photo-exposed area) and upper inner arm (photo-
protected area) (n = 1202)
Skin Color Types and Indian Skin Characteristics
Figure 12: Hyperpigmented spots on two Indian women
©L’Oreal Research and Innovation
Figure 11: Overall skin color heterogeneity per age group in India
(n = 1195)
©L’Oreal Research and Innovation
years, dermatologists observed simplex lentigos
and actinic lentigines in more than 80% of women,
but differentiating them remain difficult. Many
seborrheic keratoses were also observed (about
70% of women). Such a high prevalence and early
onset of actinic lentigines and seborrheic keratoses
(at around 30 years) in India are striking.
Instrumental methods conrmed these results. An
individual analysis of pigmented spots with an automatic
detection of colored objects revealed no change in the
size of pigmented spots with age but an increase in
their number and visibility (by contrast with the skin
Pigmentary Disorders
Few studies document the increased frequency of
disorders characterized by hyperpigmentation in darker
ethnic groups.25-28 e importance of which is also
reported as a frequent concern in Indian population.
Some pigmentary disorders have been described in
India,29 hypopigmentary disorders, such as vitiligo,
pityriasis alba or versicolor, and also hyperpigmentary
disorders, such as melasma and some other facial
Hyperpigmented Spots
Hyperpigmented spots are a major concern with an
early onset and an overall increase with age, well
described in some other Asian countries. Several
studies conducted in China showed that the early
onset of marked pigmented spots is a characteristic of
Asian skin aging.34,35,22 Galzote et al.18 also observed an
increase in mottled pigmentation with age in dierent
Asian populations, India included.
These results were confirmed in the Indian typology
study:16 more than 70% of women over 30 years show
more than 10 small hyperpigmented spots on their face
(Figs 12 and 13), increasing up to 80% in women over
50 years (p < 0.0001). Before 40 years, most of
these small spots are post-inflammatory marks, in
relation to the high prevalence of acne. From 30
Figure 13: Prevalence of hyperpigmented spots (according to age
group) assessed in situ by dermatologists (n = 1204)
Basic Science for Modern Cosmetic Dermatology
complexion). Globally, the spots density increases
signicantly after 35 years, and shows no signicant
change after whereas the overall color contrast (∆E94)
between complexion and spots, i.e. the visibility of spots,
increases signicantly only from 50 years (Fig. 14).
Melasma and Patchily Hyperpigmented Macules
Melasma is a frequently described pigmentary disorder
in the Indian population. e worldwide reported
prevalence of melasma ranges from 8.8% among Latino
females in the Southern United States36 to 40% in Southeast
Asian populations.37 e Indian typology16 conrmed the
high prevalence of melasma in this country. e average
Figure 15: Melasma and dyspigmented macules observed in two
Indian women
©L’Oreal Research and Innovation
Figure 14: Density and overall contrast of facial spots according to age group in India
Figure 16: Prevalence of melasma (according to age group)
assessed in situ by dermatologists (n = 1204)
Figure 17: Prevalence of dyspigmented macules on forehead,
malar or mandibular area (according to age group) assessed
from photographs by dermatologists (n = 1196)
Skin Color Types and Indian Skin Characteristics
age of women with melasma is 51 years with a prevalence
of 19% in the studied population. A peak of melasma
prevalence is observed in situ by dermatologists in
about 30% of women aged from 40 years to 65 years
(Figs 15 and 16).
However, melasma alone do not represent all the
dyspigmented spread macules observed in this study.
Dermatologists’ assessments distinguish other ill-
dened, patchily hyperpigmented macules on the face
which dier from melasma. e prevalence of moderately
to severely dyspigmented macules increases with age
particularly on the malar area reaching 70% of women
(p < 0.0001) (Fig. 17). Furthermore, the prevalence of
spread macules steadily increases with age, unlike the
bell curve distribution of melasma prevalence along life
Hypopigmentary Disorders
e prevalence of vitiligo in India is often claimed higher,
of a 0.46–8.8% range.38 But according to a recent review
focusing on the prevalence of vitiligo in the general
population and excluding studies based on patients of
dermatology clinics, the worldwide prevalence of vitiligo
ranges 0.5–2%.39 is appears consistent with the results
from Hourblin et al.16 who reported a low prevalence
of vitiligo (0.9%), aecting less than 10% of women.
e main diagnoses associated with hypopigmentary
disorders were post-inammatory hypopigmented
marks and pityriasis alba. Some city-related eect
(p <0.0001) was noticed, with hypopigmentary disorders
prevalence varying from 5.2% in Chennai to 15.0% in
Hyperpigmented Areas
Dark Circles
Periorbital melanoses are very common dermatological
disorders particularly in India. Despite its frequency,
little is known about its etiology and management.
Malakar et al.33,40 describe them as a dark brown to black
hyperpigmentation, usually bilaterally symmetrical, and
dene them as an extension of pigmentary demarcation
lines (PDL) of the face. e recent Indian typology
conrms the importance of this disorder in India,16 with
more than 50% of concerned women irrespective of
age, and up to 80% beyond 35 years old. According to
dermatologists’ assessment, almost all women have dark
circles on upper eyelid and on lower eyelid, of a dierent
Figure 18: Atlas of dark circles color intensity
©L’Oreal Research and Innovation
Figure 19: Overall contrast (∆E94) between cheek and dark
circles for each lightness complexion level
Basic Science for Modern Cosmetic Dermatology
intensity with age (Fig. 18). e prevalence of women
with moderate to severe dark circles on upper eyelid,
increases with age from 50% up to 85%.
ese clinical results are conrmed by instrumental
measurements which quantify the dark circles color using
Spectroradiometer® associated with Chromasphere®. e
contrast with the cheek, i.e. their visibility, appears very
important. e visibility of dark circles increases with the
complexion lightness (Fig. 19); they are logically more
visible on the lightest skin.
Facial Pigmentary Demarcation Lines
Pigmentary demarcation lines are physiological abrupt
transition lines from areas of deeper pigmentation to
lighter areas. ey were rst classied into ve types on
the whole body, A through E.41 en it was suggested
that these lines can also occur on the face and lines F,
G and H were added.32 e facial lines dier from the
rest of PDL since they present later, usually around
puberty (lines A to E tend to present in early childhood),
and they aect males less frequently.42 e higher
proportion of aected females may indicate hormonal
inuences. Pregnancy is associated with worsening
of many pigmentary problems. ese lines are almost
always bilateral. In some people the lines merge with
the periorbital pigmented circle.40
Figure 20: Specic hyperpigmented areas on Indian skin. A, Lip
corners and B, Nose bridge
©L’Oreal Research and Innovation
Other Specicities: Perilabial Pigmentation
and Nose Bridge
As previously described,32 Indian typology conrms
that perilabial pigmentation is very frequent in Indian
women. About 30% of women of all ages show moderately
to severely pigmented upper lip. About 70% of women
over 30 years have moderately to severely pigmented lip
corners (Figs 20 and 21) whereas about 40% of women
over 30 years present moderately to severely pigmented
marionette lines.
A distinctive nding was pigmentation of the nose.
About 50% of women of all ages showed pigmentation
at the angles of the nose. In addition, 25% of women had
a hyperpigmented line across the nose (42% of Mumbai
women); in some of them, the line was broad and divided
the nose into a darker area on top and a lighter area
below (Figs 20 and 21). e prevalence of this disorder
increased with age from 10 to 30%. Recent studies have
described linear pigmentation across the nose associated
with a grove or ridge, referred to as transverse nasal
groove or nasal crease. e crease has been particularly
emphasized in the case of the allergic salute.43,44
Skin Color Contrasts of the Face
anks to the analysis of color contrasts between the
dierent facial areas (forehead, cheek, chin and dark
Figure 21: Prevalence of moderately to severely hyperpigmented
areas (according to age group) assessed in situ by dermatologists
(n = 1204)
Skin Color Types and Indian Skin Characteristics
circles), ve clusters (Fig. 22) were identied to illustrate
the unevenness of the Indian women face. Dark circles
play a big part in the segmentation due to their high
frequence in India.
e cheek can be very light as compared to the rest
of face leaving the forehead very dark comparatively
(Group 4) or the chin can stand out by its darkness and
lack of vividness (Group 2).
is again illustrates the importance of skin color
heterogeneity in India with a wide diversity of skin color
contrasts existing between the dierent parts of the face.
e color of the human skin results from complex
mechanisms involving dierent genes, mainly related to
melanin biosynthetic pathway. With its dierent ows
of migration, India presents a wide range of biological
diversity. is chapter highlights the uniqueness of
Indian skin with its large diversity of color skin tone
covering a color scale from very dark to light. According
to this parameter, the country could be split diagonally
from South West to North East, with the darker skin in
the South and East. Globally skin complexion appears
Figure 22: Facial skin color types based on the analysis of skin color contrasts
Basic Science for Modern Cosmetic Dermatology
not strongly aected by age compared to other Asian
countries with a slight darkening of skin color with age
particularly in the Southern region.
Skin color heterogeneity appears as a hallmark
of Indian skin with an increase in facial skin color
unevenness with age. is heterogeneity can be
explained by an increase in pigmentary disorders, i.e.
hyperpigmented spots and spread macules. ese
disorders occur at early stages and increase with age,
contributing to overall facial unevenness. Indian facial
skin also presents some original hyperpigmented
areas, such as lip corners, marionette lines and nose
bridges. In India, dark circles are the most prevalent
hyperpigmented areas, darkening with age. is data
raises the needs to further characterize and explore
the mechanisms underlying the early onset and high
prevalence of hyperpigmented spots, dyspigmented
spread macules, and specic pigmented lines observed
in the studied population.
ese features are obviously of high concern for
dermatological and cosmetological perspectives.
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... Background: Figure 1 [3,4] shows the 3D and 2D view of the CIELAB space. CIELAB color space (or CIE * * ) has three channels denoted as L, * and * channels. ...
... Generally, a-value and b-value are unbounded but range from -127 to 128 for implementation purposes. [3,4]. Figure 2 shows the response of different color channels in the CIELAB space for an RGB image converted to CIELAB color space. ...
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Wildfires can cause significant damage to forests and endanger wildlife. Detecting these forest fires at the initial stages helps the authorities in preventing them from spreading further. In this paper, we first propose a novel technique, termed CIELAB-color technique, which detects fire based on the color of the fire in CIELAB color space. We train state-of-art CNNs to detect fire. Since deep learning (CNNs) and image processing have complementary strengths, we combine their strengths to propose an ensemble architecture. It uses two CNNs and the CIELAB-color technique and then performs majority voting to decide the final fire/no-fire prediction output. We finally propose a chain-of-classifiers technique which first tests an image using the CIELAB-color technique. If an image is flagged as no-fire, then it further checks the image using a CNN. This technique has lower model size than ensemble technique. On FLAME dataset, the ensemble technique provides 93.32% accuracy, outper-forming both previous works (88.01% accuracy) and individually using either CNNs or CIELAB-color technique. The source code can be obtained from
... Overall, 58 healthy men and 172 women (age: 18-45 years) with pigmentation abnormalities normally seen on the face in adults which included actinic lentigines and postinflammatory hyperpigmentation 18 and with Fitzpatrick skin phototypes IV and V were evaluated from June 1, 2015 to October 9, 2015 at Maulana Azad Medical College, New Delhi, India. New Delhi is located at 28.6°N latitude and 77.2°E longitude, and is situated 222 m above sea level. ...
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Background: Regular exposure to ultraviolet rays is high in India, where most Indians present Fitzpatrick skin phototypes IV and V. Aims: To evaluate the efficacy and compare the effectiveness of two sunscreen products on Indian skin types IV and V with pigmentation irregularities. Methods: A randomized, uncontrolled and investigator-blinded, single-center study enrolled adult men and women (18-45 years) with Fitzpatrick skin phototypes IV (28° < individual typological angle <10°) and V (10° < individual typological angle < -30°) with pigmentary abnormalities seen on the face in adults (actinic lentigines and postinflammatory hyperpigmentation), who did not use sunscreens. Participants were randomized (1:1) to either of the two marketed sunscreen products, Product A (sun protection factor 50 PA+++) or Product B (sun protection factor 19 PA+++), applied twice daily before sun exposure for ≥2 h. Primary objectives aimed at assessing possible improvement in hyperpigmented spots and overall skin appearance after 12 weeks of use. Evaluation of skin radiance and skin color was done by means of L'Oréal color chart and colorimetric measurements (Chromameter®). Results: Among the 230 enrolled participants, 216 (93.91%) completed the study. The clinical assessment of the density of pigmented spots and skin radiance showed significant (P < 0.001) improvement in both groups during all visits. The qualitative (participant perception) and quantitative (Chromameter®) data indicated improvement in pigmentation from Week 0 to Week 12. Both products were well-tolerated. Limitations: The study was conducted over a rather short period of time (12 weeks) at a single location. Conclusions: This is the first study conducted on Indian skin phototypes IV and V under real-life conditions. It demonstrated the effect of regular sunscreen usage in the prevention of certain signs of skin photoaging such as increased pigmentation or pigmentary abnormalities, thus providing support and assistance to clinicians in suggesting the use of efficient sun-screening products to patients.
... The other includes the group of darker-skinned people (Indian and African/ African American) of almost inverse variations, higher L* range , lower hue range (42-65). A very recent work from the same group (in press), using same equipment and protocol [38], focusing on the facial skin colour of 1195 Indian women from various Indian cities, confirmed such mapping. Figure 1 allows two major aspects to being reported. ...
A review of the various facets of the colour of human skin is proposed.It aims first at illustrating the paradoxical association of the remarkable recent scientific advances that characterize changes in the skin colour, with some totally inappropriate or out-dated phrasings used in its communication. As a second objective, it aims at proposing an alternative to these wordings. The latter would combine 6 shade-types, defined by Individual Type Angle (ITA) values, a coloured reference chart and associated colour adjectives, highly corresponding to the 6 Photo-types previously defined by Fitzpatrick. Such alternative would overcome most references to both ethnic and ethical related issues.This article is protected by copyright. All rights reserved.
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Background: The color of Indian skin shows great diversity and pigmentary disorders are a major concern of Indian women. Despite great variations in climate, diet, and social parameters within India, studies of the range of skin types have been rather scarce. Aims: This study was aimed at characterizing the color of Indian skin in various geographical locations, its characteristics in terms of overall skin complexion and pigmentary disorders, and the impact of age on these features. Methods: An extensive descriptive study, including skin color parameters (objective measurements and evaluations by dermatologists, clinically or from photographs) was carried out involving 1,204 female volunteers of different ages living in four different Indian cities. Results: Important differences in skin complexion according to the geographical location were observed. Age seemed to have little impact on complexion. Hyperpigmented spots were frequent and were noted at early stages and many lentigines were found. Melasma affected about 30% of middle-aged women, but many other ill defined, pigmented macules were also observed. Additionally, we found pigmented lip corners associated with marionette lines, and linear nasal pigmentation. Conclusions: Indian skin color is diverse and pigmentary disorders are common. Skin complexion is not greatly affected by age. Some hyperpigmented disorders occur at early stages and increase with age, contributing to overall unevenness of facial color.
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In humans, there is a wide range of skin pigmentation, within populations and among different populations. In the recent past, studies on skin colour genetics have reported more than a hundred genes actively involved in pigmentation pathway (Bennett and Lamoreux 2003). The genetic variants of pigmentation-related genes have been studied largely among intercontinental populations. Despite a landscape of biological and cultural diversity, Indian populations have been relatively poorly investigated for pigmentation gene polymorphisms. As a group, Indian population shows a wide range of skin pigmentation variation and, to a smaller extent, variation in hair and eye pigmentation. This preliminary study generates new allelic data for five single-nucleotide polymorphisms (SNPs) located in four pigmentation-related genes SLC45A2, SLC24A5, MC1R and TYRP1 among 749 individuals from different populations (five caste and six tribal) of India, belonging to four major linguistic groups: Indo-European (IE), Dravidian (DR), Austro-Asiatic (AA) and Tibeto-Burman (TB), dispersed among six geographical locations
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Transverse nasal groove is a condition of cosmetic concern which awaits due recognition and has been widely described as a shallow groove that extends transversely over the dorsum of nose. However, we observed variations in the clinical presentations of this entity, hitherto undescribed in literature. We conducted a clinicoepidemiological study of transverse nasal lesions in patients attending our outpatient department. We conducted a prospective observational study. We screened all patients attending our out-patient department for presence of transverse nasal lesions, signs of any dermatosis and associated other skin conditions. One hundred patients were recruited in the study. Females (80%) predominated over males. Most patients were of 15-45 years age group (70%). Majority of the transverse nasal lesions were classical transverse nasal groove (39%) and others included transverse nasal line (28%), strip (28%), ridge (4%) and loop (1%). Seborrhoeic diathesis was the most common condition associated with transverse nasal lesion. Occurrence of transverse nasal line, strip, ridge and loop, in addition to classical transverse nasal groove implies that latter is actually a subset of transverse nasal lesions. Common association of this entity with seborrheic dermatitis, seborrhea and dandruff raises a possibility of whether transverse nasal lesion is a manifestation of seborrheic diathesis.
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The pigmentation patterns of facial skin of 354 healthy Chinese women aged 18-80 years were investigated clinically and instrumentally. Chromasphere® was used to acquire pictures from the cheeks of subjects. Facial skin tone was described by L* parameter from the L,a,b system as well as Individual Typology Angle (ITA). Results show that skin tone becomes significantly darker along the life span. Both size of hyper-pigmented spots and their contrast with surrounding skin were found increased with age. As additional study, 40 women from these 354 subjects were asked to apply daily a whitening cosmetic product for a 2-month period. Such application led to a significantly lighter skin tone, although this study was not vehicle controlled and we cannot exclude that the increase in L* observed was in some part because of cumulative effects of previously used whitening products, there was an association with lighter skin tone as assessed through both instrumental measurements and self-perception by most subjects. © 2011 Society of Cosmetic Scientists and the Société Française de Cosmétologie.
Melasma is an acquired hyperpigmentary disorder commonly seen in Orientals. The pattern of pigmentary change in this condition is very characteristic and the diagnosis is usually evident to the patient. A number of pigmentary disorders mimicking melasma have been reported in Asian people. They include Riehl’s melanosis, pigmented actinic lichen planus, and acquired bilateral naevus of Otalike macules. Increased awareness of these pigmentary disorders should lead to the correct diagnosis. Data on the prevalence of melasma are very limited. In South East Asia, melasma accounts for 0.25 to 4% of patients seen in dermatology institutes, with peak incidence in those aged 30 to 44 years. The disorder is seen much more commonly in females than in males. Although the general prevalence of this condition in the population is not known, one simple survey suggests that the prevalence of melasma may be as high as 40% in females and 20% in males. Multiple causative factors have been implicated in the aetiology of melasma; of these, sunlight appears to be the most important in causing and aggravating the condition in susceptible individuals. Genetic factors are also important: in many studies, 20 to 70% of patients reported having close relatives who were similarly affected. In about 10 to 20% of patients with melasma, the use of contraceptive pills has been implicated as the cause of this disorder. Adverse effects resulting from self-medication and treatments offered by beauticians are frequently encountered. Treatments provided by dermatologists are generally safer and much more effective. The mainstay of treatment is the proper use of safe depigmenting agents. Additional measures such as avoidance of sunlight are important for achieving good therapeutic results.
The skin colour of six endogamous groups of north India has been studied reflectometrically. The percentage reflectance at upper arm and forchead of 650 adult males (20–25 years) is described and discussed using 601 (425 nm), 605 (545 nm) and 609 (685 nm) filters of the “EEL” spectrophotometer. The inter-group heterogeneity is revealed by variance-ratio test. The t-test has been applied to study inter-group differences in pigmentation. Some correspondence has been found in skin colour with caste hierarchy, which holds only when the populations living in the same region are compared. These differences are assigned to adaptive adjustments superimposed by caste endogamy and assortative mating for skin colour.
Background/purposeThis multicenter study assessed the impact of two types of extreme seasons (i.e. summer and winter) on the facial skin of female subjects living in different regions of Asia. Methods Facial skin of female subjects of various Asian ethnicities was characterized during summer and winter using dermatological assessments of the cheek and instrumental evaluations of the forehead and cheek. Approximately, 100 female subjects each from five cities in Asia (Harbin and Shanghai in China; New Delhi, India; Seoul, South Korea; and Sendai, Japan) ranging in age from 14 to 75years were included in this study. ResultsDermatologist assessments revealed a general decrease in severity of roughness, wrinkles, pigmentation, and lentigines during winter compared with summer. Instrumental assessments revealed significant differences in various parameters in winter vs. summer such as reductions in melanin index and skin surface hydration, and increases in transepidermal water loss, skin pH, redness, and sebum production. Conclusion Facial skin in female subjects living in different Asian cities exhibited a wide range of changes and worsening of various biophysical parameters in response to the low temperature and humidity during the winter season as compared with summer.
Cultural factors can influence the experience and presentation of diseases, including psychosomatic diseases. Psychosomatic dermatology refers to skin diseases in which psychogenic causes, consequences, or concomitant circumstances have an essential and therapeutically important influence. Indian culture is one of the oldest and most diverse, and encompasses the various traditions and beliefs of people all over the vast Indian subcontinent. This paper discusses how cultural factors can influence the clinical course of some dermatologic problems and reviews the cultural dimension of some common skin conditions in India, including vitiligo, facial hypermelanosis, acne, atopic dermatitis, psoriasis, and leprosy. The paper illustrates some examples of the contributions of a patient's cultural values, beliefs, and practices to the biopsychosocial model of psychosomatic skin disorders.
Background Vitiligo is an acquired, idiopathic, and worldwide common depigmentation disorder with an estimated prevalence from 0.1 to 8%. These numbers are based on clinical population studies and field research examining inhabitants of geographically enclosed areas. Our aim was to collect all available data on the prevalence of vitiligo in the general population, paying particular attention to children/adolescent groups and adults. Materials and methods Screening of available literature and online databases using several key words. Results We found more than 50 studies that used several methods and subgroups of the general population. The prevalence of vitiligo ranges from 0.06 to 2.28%, whereas this was 0.0–2.16% in children/adolescents populations. Conclusions The often cited prevalence of 8% could not be confirmed after excluding clinical patient populations. Accordingly, the worldwide prevalence of vitiligo ranges between 0.5 and 2%.
Facial melanoses (FM) are a common presentation in Indian patients, causing cosmetic disfigurement with considerable psychological impact. Some of the well defined causes of FM include melasma, Riehl's melanosis, Lichen planus pigmentosus, erythema dyschromicum perstans (EDP), erythrosis, and poikiloderma of Civatte. But there is considerable overlap in features amongst the clinical entities. Etiology in most of the causes is unknown, but some factors such as UV radiation in melasma, exposure to chemicals in EDP, exposure to allergens in Riehl's melanosis are implicated. Diagnosis is generally based on clinical features. The treatment of FM includes removal of aggravating factors, vigorous photoprotection, and some form of active pigment reduction either with topical agents or physical modes of treatment. Topical agents include hydroquinone (HQ), which is the most commonly used agent, often in combination with retinoic acid, corticosteroids, azelaic acid, kojic acid, and glycolic acid. Chemical peels are important modalities of physical therapy, other forms include lasers and dermabrasion.