title: Utilization of a high-resolution digital imaging system for the objective and quantitative assessment of hyperpigmented spots on the face.
abstract: OBJECTIVE
  The aim of this study was to quantify and confirm the efficacy of cosmetic formulations for hyperpigmented spots over a wide area of the face using a high quality digital imaging system that we developed.
  
  
  METHODS
  A total of 120 Japanese female volunteers aged 25-60 years with solar lentigines were treated for 6 months with a skin lightening moisturizer (SLM, thereafter) containing 3% magnesium ascorbyl phosphate on one side of the face and vehicle on the other side. During the course of the study, facial images were collected by the image analysis to measure facial skin colour and the total area of hyperpigmented spots. The evaluation was also conducted by visual grading. Measurements were made before and 1, 3, and 6 months after starting the application, and again 6 months after discontinuing the treatment. Three similar clinical studies using the same protocol were repeated for up to one-month to confirm the reproducibility of the results and to examine seasonal variation.
  
  
  RESULTS
  SLM significantly reduced the total area of hyperpigmented spots (P < 0.005) after one month of treatment compared to the vehicle, with no significant variation in facial skin colour tone in the areas outside the hyperpigmented spots. The results of the visual grading were consistent with those obtained by image analysis. The total area of hyperpigmented spots 6 months after discontinuing the treatment had returned to pre-treatment levels. The reproducibility of these clinical results was demonstrated in three follow-up studies.
  
  
  CONCLUSIONS
  A high-resolution digital imaging method, combined with a split-face clinical protocol is sensitive enough to prove that SLM readily reduces hyperpigmented spots, while maintaining normal facial skin colour.
authors.affiliation: Department of Dermatology, School of Medicine, The University of Tokushima, 3-18-15, Kuramoto-cho, Tokushima, 770-8503 Japan. miyamoto.k.2@pg.com
authors.forename: Kukizo
authors.initials: K
authors.lastname: Miyamoto
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Takiwaki
authors.forename: Greg G
authors.initials: GG
authors.lastname: Hillebrand
authors.forename: Seiji
authors.initials: S
authors.lastname: Arase
mesh_terms: D000328:Adult; D001205:Ascorbic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D005145:Face / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017495:Hyperpigmentation / Q000145:classification / Q000175:diagnosis* / Q000188:drug therapy*; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D007564:Japan; D008875:Middle Aged; D014677:Pharmaceutical Vehicles / Q000627:therapeutic use*; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D014677:Pharmaceutical Vehicles; C011669:ascorbate-2-phosphate; D001205:Ascorbic Acid