On melanin, skin whitening, and sun protection

The Philippine Dermatological Society (PDS) is the specialty organization of trained and board-certified physicians in the care of the skin, hair and nails.

Established in 1952, the PDS has provided the country with knowledgeable and competent medical specialists. As such, it is the authority on cutaneous diseases as well as issues relevant to skin health and protection.

One of the more popular, nay, controversial, themes in current practice is the ongoing trend for skin whitening. Our history as a nation, more specifically colonialization, has spawned a decades-old mentality that our native brown skin is socially unappealing and less attractive than light, fair skin.

This mindset has launched a lucrative skin-lightening paradigm in the commercial sector, the massive advertising of which has lured young individuals into thinking that native brown skin is a disease that must be treated.

It is true than in common dermatological practice, skin specialists use preparations to improve limited skin areas that have been darkened by inflammation or injury. However, commercial products often propose whitening or lightening of extensive areas.

There are many claims – oftentimes unsupported – that these new whitening agents can "shift" one’s natural brown skin tone to a fairer, lighter one. Promises are myriad: whitening achieved in a limited time, whitening of entire body surfaces, or permanently fair skin. The use of commercial endorsers who are naturally beautiful, with smooth and fair complexion, only adds to the illusion of promised results.

While the PDS’ primary mandate is to deliver quality and ethical medical care, it is also committed to educate patients and the general public on matters such as these. It aims to share basic information in order to generate sound decision-making by better-informed consumers and provide guidelines for healthcare support workers.

On brown skin and melanin. Melanin is the pigment that imparts the brown skin color. It is essentially the amount of this pigment, synthesized in cells called melanocytes, that determines the varying shades of human skin.

Two types of skin color exist: constitutive and facultative. Constitutive skin color, which may be called in the vernacular as "natural na kulay," is genetically and racially determined, and is almost impossible to alter permanently.

Facultative skin color results from a response to external and environmental factors, mainly sun exposure ("umitim, kasi laging nagbibilad," for instance), as well as trauma and injury. It is this facultative component that is the target of potential skin whitening.

Sunlight, beyond the normal amount needed for vitamin D synthesis, has deleterious effects that are both acute and chronic. Sun exposure between 10 a.m. and 4 p.m. is generally considered the most harmful.

Acute effects of ultraviolet radiation (UVR) from the sun manifest as sunburn and darkening of the skin, while chronic consequences include premature skin aging, the induction of certain cancers, the exacerbation of existing skin diseases and the suppression of the immunity cells in the skin, to name a few.

The melanin pigmentary system is the main line of defense against damage from UVR: more melanin, more protection. Lighter-colored skin is more prone to the development of skin cancers, and ages more prematurely. Blemishes, sun spots and wrinkling are more apparent. It is ironic that this same protective melanin is sacrificed by skin lightening agents in the name of cosmetic enhancement.

On protection and sunscreen use. The more important issue is not the standards of beauty, but skin health and protection. The PDS says it maintains that brown skin, being our natural color, must define us as a people. Brown skin is beautiful and must be protected from disease and injury. Rather than insist or aim for lightening, the prevention of further darkening appears to be a more sensible and realistic objective.

In addition to natural defenses, the PDS says it is recommending the use of ample sun protection, with a prudently selected sunscreen with a sun protection factor (SPF) of at least 15. SPF indicates the sunscreen’s ability to protect against sunburn which is due to UVB rays, but not tanning which, on the other hand, is due to UVA rays.

A complete sunscreen will "guard" against the ultraviolet A (UVA) and ultraviolet B (UVB) rays of the sun. Physical sunscreens like zinc oxide and titanium dioxide and a few chemical sunscreens (avobenzone, mexoryl) adequately cover against both UVB and UVA rays.

The PDS says it is calling on the commercial sector to be transparent with regards to over-the-counter products and their claims. Full product information and an extensive, well-designed scientific research of product lines are recommended, it adds.