Skin in the Tropics (Sunscreens and Hyperpigmentations) Gintong Alay Award for Comprehensive Coverage, 2002

As the cultural and ethnic makeup of the United States continues to diversify, dermatologists are seeing greater numbers of "nonwhite" patients. Understanding physiologic differences and therapeutic responses between skin types is indispensable, particularly to physicians practicing in metropolitan areas with a large immigrant population.

Skin in the Tropics: Sunscreens and Hyperpigmentations, a first-edition text by Dr Verallo-Rowell, is divided into 2 parts. The first part is divided into 6 sections in a question-and-answer format addressing ecology and photobiology in the tropics, pigmented skin physiology and pathology, and sunscreens. It contains useful information, such as ozone depletion and climate changes, not found in most other dermatology textbooks. The question-and-answer format is a particularly useful guide for patient-directed discussions. The tables and figures are well designed and easy to comprehend.

Of particular interest is a questionnaire designed to determine Fitzpatrick skin type in nonwhites by history of reddening, ancestry, and skin undertones. This modified phototyping has a wide range of implications in the treatment of skin conditions. The section on sunscreens contains a detailed listing of sunscreen brand names as well as ingredients. However, some of the products listed are not available in the United States.

The second part of the book contains 24 studies, mostly conducted in Dr. Verallo-Rowell”s department. Many of the studies, particularly some regarding phototyiping, sunscreens and sunscreens with cosmetic efficacy, provide useful new information on pigmented skin. Also of interest are photopatch studies to determine the effects of indoor light on melasma and the efficacy of various bleaching regimens.

The scope of information presented in the book is extremely useful to dermatology residents, clinicians with a particular interest in tropical skin type, and patients. In conclusion, this engaging, well-written and well-illustrated book provides practical information as well as promising research on pigmented skin. -Zakia Rahman, MD, New York (Archives of Dermatology, July 2003)

The book starts with a prologue, in which the author gives a basic introduction of the topics to be covered; the prologue is followed by 79 pages of Asian skin-related topics covered in a question-and answer format. This section ends with an epilogue, wherein the author promises that a second volume is forthcoming. The remainder of the book presents the 24 studies that the author and her colleagues have performed over the years.

The section on the tropics is particularly well written; extremely readable with good references. Sections cover light sources, skin phototype, the use of sunscreen to protect brown skin, and facial hyperpigmentation. The author presents intriguing suggestions, as yet unpublished in peer-reviewed journals, that visible and infrared light could elicit photocontact allergy (page 17, Table 1), that indoor lights could act synergistically with sunlight in inducing photoaging and photocarcinogenesis (page 36), and that exposure to artificial indoor lights could play a role in the development of melasma (page 49). The latter hypothesis, if confirmed will clearly change our current understanding on the pathophysiology of melasma.

There are inaccuracies in the book that probably are a reflection of the limitations of a single-authored textbook. For example, the reading of skin darkening 2 hours or more after exposure to UVA radiation was defined as immediate pigment darkening (pages 49 and 55); in all other centers, this reading would be considered persistent pigment darkening. The evaluation of irradiation test sites immediately after irradiation was “to check for any perceptible erythema that would indicate photosensitivity” (page 112); in most photobiologic centers, the most meaningful information obtained at this time point would on immediate pigment darkening, or on the development of urticarial response indicatitve of solar urticaria. Despite these minor shortcomings, Dr. Verallo-Rowell is to be congratulated for having published a book focusing on skin in the tropics. – Henry W. Lim, M.D. (AAD Journal, Volume 50, Feb 2004)

Rx: Coconuts! (The Perfect Health Nut)

“Expounds on the clinical usefulness of our discovery on monoglycerides… A must read for anyone concerned with their health and the way they look… I wish I could write half as well.” — Jon Kabara, B.S., M.S., Chicago, IL

“An enlightening read on coconut oil’s efficacy for various skin problems, infections and precancerous lesions… Ideal for the dermatologist and the average person interested in skin care, weight control and all aspects of their health” — Conrado S. Dayrit, M.D., FACC, Fellow, American College of Cardiologists, FPCP, FPCC

“..once I started, I could not put it down!!!” — Adolf Oriña, Retired U.S. MD, Baguio, Philippines

more testimonials

Dermatological Effects of Topical and Oral VCO and its Monoglyceride Derivative by Vermén M. Verallo-Rowell, MD, FABD, FABDP, FPDS read more

Crazy For Coconut Oil by Lori Corbin, ABC7 read more

Coconut Oil is Cholesterol Free by Ernesto M. Ordoñez, Philippine Daily Inquirer read more

White Oil that Heals Published on page A12 of the September 17, 2006 issue of the Philippine Daily Inquirer read more

Copyright 2009. Dra. Vermén M. Verallo-Rowell. All rights reserved.