00:00Thank you very much.
00:30Good morning, Doc Mike. Welcome po sa Rise and Shine Pilipinas.
00:33Hello, good morning po, Atty. Joe and Josh and sa lahat po nanonood ng Rise and Shine Pilipinas.
00:38Doc Mike, thanks for joining us this morning.
00:40Ito po, ano-ano po ba ang mga pangunahing sanhin ng skin discoloration o dark spots sa balat?
00:46At bakit po ito nangyayari?
00:49So basically, ang pinaka-pangunahing cause ng mga dark spots, lalo na sa mga Pilipinos, is sun exposure po talaga.
00:55In fact, yung sun exposure, yung pag-expose natin sa araw, siya talaga ang pinaka-potent stimulator ng pigmentation or
01:02pag-hyperpigment or darken ang skin natin.
01:06Meron din tayong mga melasma na tinatawag.
01:08So may genetic predisposition siya.
01:10And then also may hormonal component niya.
01:13So usually yung mga melasma nakikita natin yan sa mga pregnant women, no?
01:18And then also pag nagkaroon sila ng mga times na nagtatik sila ng hormonal contraceptives, pwede rin yung mangyari.
01:25Tapos third is sunspots.
01:27So pag tayo ay parati sa araw, love natin mag-beach, ganun.
01:32Tapos hindi tayo nagsa-sunscreen.
01:33And also aging na din, nagkakaroon tayo ng sunspots.
01:36So yun yung ilan.
01:39Doc, nabanggit mo na yung dalawang terms na itatanong ko.
01:41Pero madalas nga nabamagit yung terms na melasma, sunspots, at hyperpigmentation.
01:47Pero para po sa ating mga ka-RSP, ano po ba yung pagkakaiba ng mga ito?
01:52So basically yung hyperpigmentation po, very broad term siya, umbrella term siya.
01:57It means na nag-increase yung pigment or nangitim yung particular area na yun kumpara sa normal surrounding skin.
02:05So yung melasma, sunspots po, sila po ay type ng hyperpigmentation.
02:10So yung melasma natin, nakikita yan natin sa central area ng face natin, sa forehead, sa may nose area,
02:16sometimes sa cheeks, and sometimes sa upper lip.
02:19So nakikita usually natin ito sa mga women of reproductive age.
02:23So usually around 18 to 49 years old yung onset niya.
02:27Tapos kung titignan mo siya closely, para siyang patchy.
02:31Meaning, ibig sabihin, hindi siya regular.
02:33Irregular yung borders niya.
02:34Yung sunspots naman po, usually very demarcated siya.
02:39Bilog na bilog siya, parang coin siya.
02:41So it is located in sun exposed areas.
02:44So may tinatawag din tayo na post-inflammatory hyperpigmentation.
02:49So yung post-inflammatory hyperpigmentation, nangyayari ito kapag nag-resolve na yung mga previous injury natin
02:56or previous inflammation, kagaya ng acne, marami po yan.
02:59So pag nag-heal yung acne natin, nag-leave siya ng parang dark spot.
03:04Yung po ang tawag doon is post-inflammatory hyperpigmentation.
03:07Pwede rin po itong mangyayari sa mga patients na nagkaroon ng rashes dati.
03:12Or may mnemonic po ako tinatawag or nire-refer dito is A, E, I, O, U.
03:17Is acne, and then eczema or yung mga katikati or dermatitis.
03:22Tapos yung E, A, E, I.
03:26So yung I natin is insect bites.
03:28So yung O natin is ouch.
03:30So pag nagkaroon tayo ng injury na slice natin yung skin natin accidentally,
03:35na kutkut natin, na sugatan.
03:38So yung you natin, wala akong mahanap.
03:41But you, your skin care.
03:43So pag nag-masyadong na-irritate yung skin natin because of the skin care,
03:47pwede rin po itong magkaroon ng post-inflammatory hyperpigmentation.
03:52Okay.
03:52Doc, ano po katotoo na mas madaling magkaroon ng skin discoloration,
03:56yung mga morena o yung mga moreno,
03:58kumpara yun sa mga mapuputi, yun sa mga may lighter skin tone?
04:02Bakit po?
04:05Magandang yung question na actually,
04:07and you'll be surprised to know,
04:10na yung mga melanocytes or yung mga cells na gumagawa ng pigments
04:14sa mga Filipinos and different races,
04:17mga blacks and also whites, Caucasians, gano'n po,
04:20pareho po yung number ng melanocytes natin.
04:23Ang difference lang po talaga is yung mga tinatawag nating melanocytes
04:27sa mga Filipinos or darker skin photo types.
04:30Mas madami po yung melanin na ginagawa natin.
04:33And also, may tinatawag tayong mga melanosomes.
04:36So, yung melanosomes po,
04:37doon po pinapa yung mga melanin or yung mga brown pigments.
04:42And mas malaki po sila.
04:43They can actually accommodate more melanin.
04:46And then, mas,
04:47so pag mas malaki po yung mga melanosomes,
04:50sila po yung pumupunta sa skin cells natin.
04:52So, meron ding theory na yung mga skin cells,
04:56yung mga balat ng mga Filipinos and darker skin photo types,
05:00mas maganda or mas efficient ang pag-process natin
05:03at pag-retain ng pigment.
05:05So, these are just some reasons po
05:08kung bakit mas prone tayo to hyperpigmentation.
05:11Okay.
05:11Saka yung pigment po na pinoproduce natin,
05:14sorry po,
05:14is eumelanin,
05:16brown siya,
05:17where sa mga lighter skins,
05:19ang tawag na natin is pheumelanin.
05:21Yung melanin po nila is medyo yellowish.
05:24Kaya rin po yun yung isang reason.
05:26Okay.
05:26So, to simplify, doc,
05:28tama po ba yung pagkakaintindi ko,
05:29mas prone tayong mangitim
05:31pagka nakababad sa araw
05:32kumpara doon sa mga mapupute
05:34sa ibang lahe?
05:35Tama ba?
05:37That's right.
05:37Pero, you'll be surprised, Joss,
05:39kasi Filipino skin is very unique.
05:41Kasi I get mga patients na sobrang puti,
05:44pero sila yung mas prone sometimes
05:46na magkaroon ng pigmentation.
05:48And then, may Filipinos din na darker skin photo types
05:50na hindi sila masyado nagkakaroon ng pigmentation.
05:53So, it's very diverse yung Filipino skin.
05:56Kailangan natin lang mo-research
05:57to understand Filipino skin.
05:59May impact ba kapag ikaw ay morena, moreno,
06:02tapos bigla kang nagpapute,
06:05and then, mas,
06:06kumbaga mas mataas ba yung chance mo
06:07magkaroon ng hyperpigmentation eventually?
06:10Or wala namang impact yun?
06:13Pag mas dark,
06:15theoretically po,
06:16yung agreement namin ng mga dermatologists,
06:18the darker the skin,
06:19mas mataas po yung chance mo
06:21na magkaroon ng side effect.
06:23Pag hindi po tama,
06:24yung paglalighten
06:26or pagbabrighten ang skin mo.
06:28So, pag mali yung technique,
06:30pag nasobrahan,
06:32yes po,
06:32mas lalo tayong magkakaroon ng side effect.
06:35Pag darker yung skin natin.
06:37Okay.
06:38So, Doc,
06:38ano pong may papayin doon
06:40sa mga kababayan natin,
06:41sa natin mga ka-RSP?
06:42Kasi ako narinasan ko to.
06:44Sinubo akong magpapute,
06:45pero hindi umi-effect eh.
06:47So, huwag nalang pinitin, gano'n?
06:48Hmm.
06:50Actually po,
06:51to be honest with you,
06:52ang pinaka,
06:53sa experience ko po,
06:55sa clinical practice ko po,
06:56the most effective,
06:58if you want talaga
06:59na mag-even yung skin tone mo
07:00and medyo mag-lighten siya
07:01from your current skin tone,
07:04is strict sun avoidance.
07:06Na-observe ko po kasi ito
07:07sa mga pasyente ko
07:08na seafallers.
07:10I saw them,
07:11I usually see them
07:12before they go out abroad
07:13sa ship.
07:14And na pagbalik po nila,
07:16sobrang puti nung skin nila.
07:18So, they always tell me
07:19na hindi talaga sila nakakapag...
07:21They don't usually go out
07:22na sa upang sila ng ship.
07:23And then doon,
07:24parang hindi talaga sila
07:26nakakarawan.
07:27So, but,
07:28yeah,
07:29for patients talaga,
07:30sun protection
07:30and sun avoidance
07:32is the most effective
07:33and the most cost effective.
07:35Of course,
07:35nandyan yung mga ingredients natin,
07:37kagaya na ang niacinamide,
07:38hanapin nyo po yan
07:39sa skincare nyo niacinamide,
07:41vitamin C,
07:42yung mga re-etinoids natin,
07:44nakakatulong din,
07:45yung mga chanexamic acid.
07:46Yung iba po yung ginagawa nila
07:48is parang nag...
07:50yun,
07:50mga glutathione,
07:51nag-IV glutathione,
07:52medyo careful po tayo doon
07:53kasi hindi po
07:54FDA approved
07:55yung mga IV glutathione
07:57para sa paglalighten ng skin.
07:59Doc,
07:59when it comes to
08:00applying yung sunscreen,
08:02kasi parang ang common notion
08:03ng mga tao,
08:04dapat magsa-sunscreen ka lang
08:06kapag lalabas ka
08:07at maaarawan ka.
08:08Pero,
08:08ito po ba yung tamang advice
08:10or talagang dapat mag-sunscreen ka
08:12even if hindi ka maaarawan?
08:16Actually,
08:17that's a very interesting question,
08:19attorney.
08:19Because Filipinos,
08:21Filipinos,
08:22and other darker skin photosigns,
08:24meron tayong sensitivity
08:25sa visible light.
08:27So,
08:28lalo na,
08:29especially yung mga patients
08:30na may current hyperpigmentation,
08:32kung meron na po kayong
08:33melasma
08:34or other hyperpigmentation,
08:35ibig sabihin,
08:36mas prone na po kayo
08:37to develop hyperpigmentation.
08:40So, for example,
08:41kasi minsan,
08:41hindi po natin alam
08:42kung bigla tayo lalakad.
08:44Diba?
08:44Like,
08:44bigyan tayo lalabas,
08:46uutusan tayo
08:46para bumili sa tindahan
08:47ng parents natin
08:49or biglang may emergency.
08:51So, minsan kasi,
08:52hindi na natin may isip
08:53na,
08:53oh, kailangan ko mag-sunscreen.
08:54So, mas maganda
08:55na,
08:56like,
08:57for example,
08:57nasa bahay ka lang
08:58within the day
08:59where your sunscreen
09:00kasi sometimes
09:01the sources of visible light
09:03and UV radiation,
09:06pag nasa tabi ka lang
09:07ng pinto
09:08or ng bintana,
09:09if the surface,
09:11yung mga,
09:11yung the road
09:12or the pavement,
09:13nagre-reflect yan
09:14sa skin mo.
09:16So, pwede kang magkaroon
09:17ng hyperpigmentation.
09:18Pero pag sa gabi naman po,
09:20ang sources lang po ninyo
09:22is mga visible light,
09:23like this light lang po,
09:24o LED,
09:25tapos,
09:25wala naman po kayong
09:26hyperpigmentation,
09:27it's okay to forego.
09:29Pero,
09:29if meron na po kayong
09:31mga current hyperpigmentation,
09:33lalo na if nagluluto,
09:34yes,
09:35nagluluto po kayo.
09:36So, that can also cause
09:38hyperpigmentation.
09:39So, better po,
09:40for me,
09:41kasi,
09:42syempre,
09:42pag bigla nyo naisip na,
09:44ay,
09:45para may emergency,
09:45I need to go out.
09:47So, at least,
09:47naka-sunscreen na po.
09:49Well, on that note,
09:50maraming maraming salamat po
09:51sa inyong oras,
09:52Dr. Mike D,
09:53ang ating dermatologist.
09:54Thank you,
09:55Doc.
09:56Bye.
