For years, dermatologists have been warning people about the dangers of the sun while desperately trying to get the perception that pale is chic to trend. But to no avail, it would seem.
Skin cancer is the most common type of cancer worldwide, and melanoma (the most fatal type of skin cancer) is the seventh most common in Canada. The Melanoma Network of Canada says that cases of diagnosis in the country have tripled in the last 30 years, and Statistics Canada reports that only 38 per cent of people apply sunscreen regularly.
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Those are some alarming numbers, and what Dr. David Fisher, chairman of the department of dermatology at Massachusetts General Hospital and Harvard Medical School, calls “an embarrassing fact.”
“Skin cancer is one of the few cancers for which we have rock solid evidence of what the cause is — UV radiation.”
For this reason, Fisher has been at the helm of developing a new drug that when applied to the skin, would trigger melanin production without the need for UV light exposure. The drug would be applied topically in the same way as a cream or lotion, and it would penetrate the epidermis where melanocytes (the cells responsible for colouring the skin) are present and stimulate pigment production.
It’s kind of like a medical-grade self-tanner. But it’s not.
“Self-tanners are cosmetic agents that act like pigments — they look like a certain colour but it’s not melanin. They adhere to the surface of the skin,” Fisher explains. “This actually stimulates the pigment pathway of the cells to produce melanin because it penetrates the epidermis.”
In other words, it would look more like a real tan versus those muddy, orange-y self-tanners.
But Fisher’s motivation wasn’t cosmetic. His hope is that a drug of this nature will help curb the frequency of skin cancer.
“Based on the data we have, darkly pigmented skin is more protective against UV radiation. The acute effects of aging, like wrinkles, are [less prevalent], and based on epidemiology it suppresses skin cancer risk,” he says. “We know skin cancer has lower frequency rates in people whose skin is dark or those who tan easily.”
This drug wouldn’t need to tan skin very deeply, either. He points to cultures like Mediterraneans, Hispanics and Southeast Asians as having dramatically lower rates of skin cancer because their skin is already fairly pigmented.
Fisher is quick to emphasize, however, that this will in no way supplant sunscreen.
“This would be supplementing sunscreen to block UV rays as much as possible. The darkened pigment would add an additional dimension [of protection.] Without question, a broad-spectrum UV blocking agent is still very important,” he says.
Dr. Jaggi Rao, clinical professor of medicine at the University of Alberta, says a drug of this nature would be beneficial to a lot of people, especially tanorexics.
“I think people who are obsessed with having a darker skin tone will be more inclined to use this product and benefit from the lack of tanning bed usage,” he says. “Those who burn easily may have some added sun protection, but it would not be to the point that sunscreen would be unnecessary.”
Unfortunately, Rao says the “emotional” aspects of sunbed tanning, like the feel of the UV rays on skin and their instant results, probably wouldn’t keep die-hard tanners off the beds.
“Sadly, I don’t think this emotional feeling would be replaced by a topical drug. However, I think it may be greatly useful in patients who have depigmentation disorders such as vitiligo and other skin conditions that have made them lose pigment and appear more whitish. It would be promising to offer these groups of patients a safe way to restore their level of pigmentation.”
So far, the drug has only been tested on mice and discarded human skin. While red-headed mice have shown it to be very potent and effective, their skin is considerably thinner than human skin. Where the mice showed evidence of the drug’s efficacy in a day or two, human skin took four to five days.
It is also very localized to the area where it’s being applied, which means once this is put into a formulation that can be sold to the public, the same care would need to be used as with a self-tanner. In other words, don’t bid farewell to stained ankles and streaky legs just yet.
It’s also still a couple of years away from mass production.
“We need to learn how safe this drug is before we can put it in an application; we want to make sure it’s not doing something totally unexpected,” Fisher says. “But if we’re so lucky as to see toxicity is truly minimal, the hope would be that people would stop using tanning beds and lying in the sun for hours without sunscreen. If anything would dissuade people from exposing themselves to UV radiation, it would almost certainly lower the risk of skin cancer.”
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