An interview with Dr. Harald Schnidar, CEO and Founder of SCARLETRED by Kikaku America International.

In today’s skincare market, there are more treatments than the average person can count. Formulas have been developed for people with dry skin, combination skin, oily skin, severely oily skin, and everything in between. Despite the fact that there is currently a highly diverse skincare market, there’s an extreme lack of objective technology for detecting skin issues. The current visual diagnosis of skin disorders can be limiting, as the same condition on different skin tones can look very different to the human eye. Because the dermatology field relies heavily on visual examinations, this issue can be highly time-consuming, with weak information and results. This, in the end, costs healthcare providers a lot of time and money.

SCARLETRED: What is it?

SCARLETRED has designed a digital solution to this visual problem: Scarletred®Vision. Scarletred®Vision is the first certified skin imaging technology, which enables standardization of skin imaging and scoring, real-time online monitoring and analysis, superior data quality compared to conventional methods, and 90% less cost compared to manual data processing. The Scarletred®Vision App is a smart companion and available for free download via the App store and it operates on any iOS system. Developed and tested in clinical trials with medical experts it converts a GCP-compliant process in clinical trial and medical routine applications.

Scarletred®Vision technology has many useful applications, including consumer care, chronic wounds, Biopharma, clinical, cosmetic and discovery. When looking specifically at the Biopharma application, Scarletred®Vision is used to analyze allergic reactions and drug efficacy, eczema, vaccination local site reactions, and psoriasis severity and drug efficacy.

The inspiration behind SCARLETRED

Dr. Schnidar explained his inspiration for starting SCARLETRED and how it came to be, saying the he started the company in 2014 while he was conducting a dermatological clinical trial. He was developing a skin drug to treat severe radiation burns, and he noticed that physicians were only able to perform subjective skin assessments, which was the standard at the time. He saw a need for upgraded technology. “Based on [trial] data, I developed a first skin imaging algorithm, which is after some years now clinically proven, which lead me to develop the Scarletred®Vision technology,” Dr. Schnidar said. “At that time point, there was no technology in the market, which allows to objectify dermatological assessment. And what Scarletred®Vision does is we quantify and allow to quantify skin images by introducing with a mobile app calibration method.

Dr. Schnidar continued by explaining that the system consists of three components, and each are medical-device certified. The first component is the mobile app, which comes together with the skin patch. Using the app, you can upload a calibrated image to the Scarletred®Vision platform, which will then provide clinically validated algorithm to quantify among others skin erythema, pigmentation changes, changes of the size of a lesion, etc. The technology enables physicians to measure everything, beyond what the human eye can see on the skin. Dr. Schnidar said the product has been very successful since 2015. “We’re very successful in our expanding of services also to non-European non-US countries like Japan,” he said.

SCARLETRED and biopharma

Dr. Harald Schnidar, CEO and Founder of Scarletred, and Ph.D. in Genetics Engineering, said that biopharma use of Scarletred®Vision shows what the technology does very well. In medicine, color signal maps are used to visualize where the hot spot of the reaction is. In typical images a physician can only see qualitative traits: size, color, spread, and other visual cues. Scarletred maps the flare-ups, and provides quantitative images which show you where the signal is highest; the more the signal goes into the reddish parts, the higher is the signal. This is what Dr. Schnidar calls augmented dermatology. “It helps also for better interpretation of the signals,” he said. “We do this in the background to fully automate with every image basically, and we can do this as well also for pigmentation and for other visual changes as well.”

With the use of Scarletred®Vision, the time from researching a treatment to the time it goes on the market it much quicker and more efficient; and the value of information goes up quickly. The table below shows the difference in the progress between studies that use the Scarletred®Vision technology and studies with non-use.

SCARLETRED and the researcher

According to Dr. Schnidar, Scarletred®Vision technology is extremely useful and attractive for the clinical researcher, as it removes human error when performing a visual assessment of any dermatological condition, and it also standardizes photos of affected areas on the skin. “In clinical trials, very often they take pictures, but the problem is when you take a picture, the picture looks always different depending on the light condition,” he said. “That’s why those pictures are on the one side very bad for marketing purpose because they look really ugly and you cannot use those images for quantification.” In other words, Scarletred®Vision removes the human error aspect of visual skin checks.

Branching out into cosmetics

The SCARLETRED scope passes far beyond the medical realm and is even used in the cosmetics industry. The L’Oreal company—which is also a research partner with SCARLETRED—uses the Scarletred®Vision technology to quantify pigmentation and depigmentation changes. “Also whether the skin is uniform or not,” Dr. Schnidar said. “The more uniform the skin is, the more cosmetics-appealing it is. The system can quantify this, especially pigmentation changes based on skin lighter or skin tanner. So, when you treat the skin, it should not be freckled afterwards if it was not freckled–we quantify this cosmetics effect.

SCARLETRED and cost savings

In many dermatological clinical trials, photos are taken of patients as a reference for drug treatment effectiveness. Photographs serve as a form of proof and as a reminder of some patients when researchers need to refer back to them. Additionally, photographs often serve as a source of assessment. With these records comes a very high cost of manual processing; the photos/records have to be taken, they have to be processed (if applicable), they must be sorted, labelled, stored, and organized. They also have to be assessed, and as mentioned in the previous section, the photographs can be unclear or inaccurate, depending on the angle, the patient’s skin tone, the lighting, and many other factors. With Scarletred®Vision, Dr. Schnidar says, that cost can be reduced by up to 90%.

[Scarletred®Vision] basically runs fully automated; and in the moment when the study is finished, you immediately have, in real-time, the result. So, there is no data processing time at the end anymore, [and] everything [is] very, very streamlined,” he said.

SCARLETRED as a service

Ordinarily, when any company is trying to get their product in front of the right people, specifically in front of those who are assisting with a clinical research trial, a company will contact the CRO. The current trend is that researchers want access to the technology before spending a lot of money to potentially try something that doesn’t work for their trial. Because of this trend, Dr. Schnidar said that this is why Scarletred®Vision is delivered via a subscription model. “We deliver the software as a service, which is a subscription model. So, depending on the timeline of the trials, some have piloting trials which just take 1, 2, or 3 months or others go with the half year or a 1-year or a 2-year subscription timeframe,” he said. “So, it is independent for us whether they need it for a month or for 1-year; the monthly cost is always the same.”

Dr. Schnidar continued by explaining how the model fits really well with any trial schedule. “Clinicians can easily start and stop; they can upscale the study or downscale. There’s a basis fee and then there is additional flexible fee, which is more data-driven,” he said. “[There is also] a certain kind of data volume involved. Data volume in the sense of number of images. Not gigabyte or terabyte. It’s just simple number of images which counts, and at a certain volume, we have a flexible fee to go beyond the scope.”

So what would something like this mean for a smaller company? According to Dr. Schnidar, for a mid-sized mid-derm company with about 60 medical sales reps, doing clinical research, the cost would scale with the company’s size and needs. “The costs are depending on the size of the studies of course, but we offer our partners a scalable system because of that, meaning the easiest way is to enter with a software as a service agreement for enterprise standards,” he explained. “That starts […] around €3,000 per month, which is the lowest budget, of course.” Most of the smaller studies cost around €50,000, and go up to anywhere between €100,000 and €150,000.

SCARLETRED: The bottom line

The treatment of any dermatological disease starts with the diagnosis, and like everything in the medical treatment realm, is heavily reliant on an accurate diagnosis. In a 2015 study1, Dr. Marie-Luise Rübsam et al revealed that when most people have a skin irritation, they generally ask for help from their general practitioner (GP). Due to a lack of dermatological-specific knowledge—and that most skin diseases start off as an area of redness—GPs can’t always diagnose a skin disorder correctly, resulting in incorrect or delayed treatment. In fact, the name “Scarletred” came from this fact; that the first visual sign is redness of the skin.

About 90 to 95% of all the skin disease relate to skin reddening in the first step. One, it starts with the reddening and then they develop into something, whatever, but it starts very often with reddening in the treatment progress. That’s why this color tells already a lot. It’s a very dermatological color. It’s a sign. It can be also dangerous sign of something. So, it’s a very, very powerful thing,” Dr. Schnidar said.

About SCARLETRED Holding

SCARLETRED is an international dermatology company delivering novel products for high-demand applications in the digital analysis and therapeutic treatment of skin diseases. Their certified medical device product SCARLETRED solves the problem of the lack of standardization and objectivity in teledermatology. The AI-powered software enables high quality remote skin imaging and analysis in a multitude of skin conditions. The award-winning technology is supplied internationally to Biopharma and Cosmetics companies, governments, hospitals, and clinicians. It is easy to use and enables delivery of better skin care products and healthcare services faster at significantly lower cost.

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This interview has been conducted by Kikaku America International in August 2019