Beautiful Bias from ChatGPT

Abstract

Since the release of ChatGPT in 2022, abilities of the large language arti cial intelligence (AI) models continue to be explored.ChatGPT-4 has the capacity to generate AI-based images in response to prompts.Despite major advancements in technology, arti cial intelligence still struggles with skin of color. 1,2Face-analysis algorithms are less accurate for people with darker skin, and new research from Thong et al 1 suggests that AI algorithms are biased against skin with yellow and red hues.With increasing data re ecting disparities for skin of color in arti cial intelligence, it is important to understand just how far this inequity extends.When ChatGPT is prompted to "create an image of the most beautiful [man/ woman/child/teenager], all images produced display subjects with Fitzpatrick Skin Type I.It is essential from a dermatologic perspective to consider what equating beauty with Fitzpatrick Skin Type I means.Intravenous (IV) glutathione is a compound that is increasingly being used in Asian countries to lighten the skin, importantly, this compound is lacking extensive safety data but the Food and Drug Administration (FDA) of the Philippines has issued a warning against this agent. 3The Philippines FDA reports possible adverse e ects that include Stevens-Johnson syndrome, toxic epidermal necrolysis, severe abdominal pain, thyroid dysfunction, renal dysfunction, air embolism, and sepsis. 3Given the extensive use of technology among teenagers and given ChatGPT's bias towards Fitzpatrick Skin Type I images in when prompted to generate the "most beautiful" teenager, it may be warranted for pediatric dermatologists to inform their patients and patients' parents of the harmful e ects of IV glutathione as a means of achieving skin lightening.Another possible consequence of ChatGPT's de nition of beauty is the emotional impact it may have on impressionable youth.The perpetuation of unrealistic beauty standards may impact children with congenital anomalies and their caregivers negatively.These children

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