Last week, Google announced the imminent launch of Derm Assist, a new artificial intelligence tool that aims to help people identify skin, hair and nail conditions. But is self-diagnosis and a reliance on Dr Google ultimately a good thing for patients and their skin? Dermatologists of the UAE have their doubts.
Dr Bina Rabadia, specialist dermatologist at Dubai London Clinic & Speciality Hospital, says she had a number of initial concerns after reading about Derm Assist.
"What if the general public consider this online tool a substitute for a dermatologist consultation and start self-diagnosing and treating skin conditions, with the help of over-the-counter medications, without understanding the implications of such actions and side effects of medications?" Rabadia tells The National.
“In the process, they may complicate their condition, causing a delay in diagnosing the real condition or making it difficult to be diagnosed by their dermatologist, losing valuable time.”
The AI tool, which is expected to launch later this year, claims to recognise up to 288 skin conditions.
To access the tool, users must upload images of the medical condition in question to the Derm Assist website. They will also answer a series of questions about their symptoms.
While the technology company made it clear that Derm Assist should not be used as a substitute for a medical diagnosis, Rabadia worries that is not the way the general public will use it.
“We cannot rely on self-regulation and self-control when it comes to easily available tools. Unfortunately, the majority of the general public still think that using topical medications would not harm them because they are not ingesting it, so they use it without a dermatologist’s advice,” she says.
A Google search 'no match' for a medical degree
A Google representative said "the tool is not intended to provide a diagnosis".
"Rather, we hope it gives you access to authoritative information so you can make a more informed decision about your next step.”
It is no secret that people can type their symptoms into Google and walk away with, to their mind, a diagnosis that suitably fits the bill. Sites such as WebMD and Symptomate provide thorough breakdowns of various ailments, along with diagnosis and advice for their treatment, which can be used as a substitute for a medical appointment by some patients.
There is a reason, after all, a coffee mug that reads “Please do not confuse your Google search with my medical degree” can be seen on doctors’ desks around the world.
A delay in diagnosis
The concern is that when patients self-diagnose and self-treat, it then takes longer for them to seek professional medical help.
"I do find many patients who have self-diagnosed their conditions and have self-medicated, have caused more harm to their skin health than good," says Rabadia. "Such patients do tend to delay their visit to the doctor, hoping that an over-the-counter cream will work for them."
This is something that Dr Shadan Naji, dermatologist at Dr Kayle Aesthetic Clinic in Dubai, has also witnessed. Even when a patient does land on the correct diagnosis, it can be difficult for them to fully understand a condition how it should be treated, she says.
“Sometimes, patients can read information on the internet which is either not true or an opinion rather than hard scientific fact. I always tell people to view anything they read on Google with a degree of scepticism as not all the information you find there is trustworthy," she says.
"Also, for the information that is correct, sometimes the language can be so complex, it can be confusing to understand if you do not have a medical background.”
Dr Ghada Ashour, specialist dermatologist at Medcare Hospital Al Safa, says many patients who self-diagnose and treat from a Google search often end up aggravating skin conditions.
“A tool like this will delay the diagnosis [of conditions], treatment and may cause potentially dangerous side effects. It can never substitute the expertise and skills of a trained specialist.”
Of her first impressions of the AI tool, she says it is "bad news for dermatologists, good news for pharmacists and general practitioners", saying: "I feel sorry for the patients who will be lost in the middle of all of this."
Dermatology concerns in the Mena region: pigmentation, sun damage and skin cancer
Measuring an average of two square metres, skin is the largest organ on the human body, but is often relegated when it comes to causes of concern, especially when patients have tried to self-medicate using Google findings.
The tech company revealed that there are 10 billion searches for skin, hair and nail issues on its search engine annually.
"In most cases, it is best to seek professional advice so you can get a full diagnosis of the condition and put a treatment plan in place," Naji says.
"Even a GP would refer patients to a skin specialist [dermatologist] rather than handle the case itself, as they do not feel confident that they have the knowledge or expertise needed."
When it comes to dermatological concerns in the region, pigmentation and sun damage are two of the most prevalent issues, "thanks to the desert climate", says Naji.
“We need to be aware not just of the ageing effects that sun exposure can cause, but the risk of skin cancer, too.”
Using the example of moles, Naji explains there are criteria that differentiate between benign ones and ones that are a cause for concern.
"It is not an easy exercise to decide whether they pose a risk. Only experts who have studied for a long time and are well-versed in the anatomy of moles can differentiate between the two; patients cannot detect the differences, even with a tool such as this.”
That is not to say there is no place for AI in medicine, but tools like this should be more for medical professionals' use, Rabadia says.
“AI use in the field of healthcare or medicine requires strict regulation and should be used by qualified people,” she says. “When the user is a qualified person from the same field of medicine rather than the general public, AI could help in the management of health issues of the general public.
“We need to remember that everyone who has access to surgical scalpel cannot become a good surgeon, and everyone who has access to Derm Assist tool cannot become a dermatologist.”
