Do facial appearance apps work?

Q. How do phone apps for facial appearance work?

There seems to be an app for everything: losing weight, measuring hair loss, and facial appearance. The apps appear to be highly sophisticated and are very popular with consumers, but how do they work?

The facial appearance apps work by allowing consumers to download and use the software for free. The phone images taken by the consumer using the app become part of a database. Consumers answer several questions including age, sex, ethnicity, skin color, eye color, sun exposure history, etc. These answers and their images are stored by the app developers to construct a database that can be used to create overall skin health assessments, as well as an evaluation of spots, lines, wrinkles and dark circles.

Each new user enriches and improves the image analysis capabilities of the app. Individual user images are compared to the database to allow a numerical score to be applied to the skin appearance characteristics of other individuals of the same, younger, or older age. These scores are then put into an algorithm to provide an apparent age assessment, which may elate or depress the user.

Q. Are these phone apps accurate?

The accuracy of the apps depends on the expectations of the consumer. Adolescents are always happy if they look older, however mature individuals are always happy when they look younger than their chronological age. Problems with phone apps arise when expectations are not met.

One problem dermatologists may encounter is the patient who undergoes toxin and filler injections for appearance improvement and then uses her phone app to assess the results of her investment. Her phone app says she looks three years older after treatment than before. She returns to her physician’s office in tears stating the results of her treatment have been substandard and she demands her money back. Is it possible that she actually looks three years older? Should you return her money?

Q. How can phone apps be influenced?

No, you do not need to refund her money, but it would be worthwhile to point out how phone apps can be manipulated. I performed a study on the effect of lighting on phone app results. We enrolled 60 female subjects Fitzpatrick skin types I-IV age 25-45 years. Higher Fitzpatrick skin types were excluded from the research because phone app companies state their apps are inaccurate for deeply pigmented skin. Reproducibly, patients looked three years younger under incandescent lighting than fluorescent/LED lighting.

Why? Because white LED lighting highlights edges, which accentuates the appearance of fine lines and wrinkles increasing apparent age. Incandescent lighting, on the other hand, has a yellow hue and softens edges. LED light is also a point source while incandescent light provides better overall illumination.

Better lighting also minimizes the shadows of lines and wrinkles. You can easily demonstrate this phone app effect in your office for the patient. It is important to remember that the purpose of appearance assessing phone apps is not to provide an accurate assessment of consumer age, but rather to function as a targeted in-home portal for cosmetic and skincare product sales!