DOH warns glutathione for cancer treatment, not skin whitening | ABS-CBN
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DOH warns glutathione for cancer treatment, not skin whitening
DOH warns glutathione for cancer treatment, not skin whitening
MANILA -- Glutathione is not for skin whitening, the Department of Health (DOH) reminded the public on Monday, adding that glutathione is used for cancer treatment--and as a side effect, it affects melanin in a person's body, which is a pigment responsible for the color of the skin, hair, and eyes.
In an interview with ABS-CBN News, Health Asec. Albert Domingo said melanin is actually a protection from ultraviolet rays.
"Ibig sabihin, 'pag tayo ay naarawan, hindi tayo basta basta nagkakaroon ng skin cancer kumpara sa mga lahi na mas maputi sa atin. Ang tawag nga nila is protective [aspect] siya sa skin cancer. Ang siyensya is kapag ang isang tao ay natural na mas maitim, mas mababa typically iyong kanyang risk na magkaroon ng skin cancer," he explained.
MANILA -- Glutathione is not for skin whitening, the Department of Health (DOH) reminded the public on Monday, adding that glutathione is used for cancer treatment--and as a side effect, it affects melanin in a person's body, which is a pigment responsible for the color of the skin, hair, and eyes.
In an interview with ABS-CBN News, Health Asec. Albert Domingo said melanin is actually a protection from ultraviolet rays.
"Ibig sabihin, 'pag tayo ay naarawan, hindi tayo basta basta nagkakaroon ng skin cancer kumpara sa mga lahi na mas maputi sa atin. Ang tawag nga nila is protective [aspect] siya sa skin cancer. Ang siyensya is kapag ang isang tao ay natural na mas maitim, mas mababa typically iyong kanyang risk na magkaroon ng skin cancer," he explained.
"In general, nakakaputi pa rin siya. Pero it will really depend on how your body responds to it. Iyong iba, mas mabilis iyong pagputi, iyong iba hindi ganoon kabilis ang pagputi. But again hindi talaga siya pamputi. Hindi dapat siya ginagamit for that," he added.
Discussions on the use of glutathione came to light anew when TV host Mariel Rodriguez-Padilla was criticized for her drip session in the office of husband Sen. Robin Padilla.
Rodriguez-Padilla later on clarified that what was injected to her was not glutathione, but vitamin C.
Both vitamin C and glutathione drips are not recommended by the DOH.
"DOH categorically states that there are no published clinical trials that have evaluated the use of injectable glutathione for skin lightening. There are also no published guidelines for appropriate dosing regimens and duration of treatment. Injectable glutathione is approved by FDA Philippines as an adjunct treatment in cisplatin chemotherapy. The [Food and Drug Administration] has not approved any injectable products for skin lightening," the agency said in a statement on Feb. 24.
Domingo said liver, kidney, and skin problems may arise from the use of glutathione as skin whitening, while intravenous vitamin C may cause kidney problems.
Meanwhile, the official explained that only manufacturers--not the FDA or DOH--can initiate clinical trials for glutathione as a skin-whitening drug.
"Ang gumagawa po niyan ay ang manufacturer ng gamot. Kunwari meron tayong bagong gamot o kasalukuyang gamot na gusto nating palisensyahan ng bagong gamit... Maraming manufacturers ng glutathione, sila iyong mag-clinical trial at may proseso iyan. May apat na phases - Phase 1, 2, 3, 4 - tapos lahat iyan may kaukulang dami ng tao. Sa Phase 1, nagsisimula iyan sa kaunting tao, mga 10 lang. Phase 2, dadami, mga 100 to 500, parami nang parami. Phase 3, tens of thousands. Phase 4, ibig sabihin, pinayagan na iyon pero may post-marketing surveillance," Domingo said.
"It is up to the manufacturer (to start a clinical trial or not). Pero as I hinted, magastos din kasi. Kung nakikita ng manufactuter na hindi naman talaga iyon ang pakay nila, kunwari iyong gumawa ng glutathione as an intravenous drug. Kung para sa cancer talaga ang pakay niya, doon sila nagpa-register. It's up to them to decide if they want to register it for other indications or not," he added.
AN 'ETHICAL' CONCERN
Still, a number of clinics offer such products, promising fairer skin to their customers.
Why does glutathione use for skin whitening remain prevalent, with some doctors even administering glutathione drips?
Domingo said this is more of an "ethical" and "practice" issue, as under off-label drug use, doctors are allowed to prescribe a drug for a different purpose other than what the FDA has approved--if he or she thinks that it can be beneficial for the patient.
"Ang ating mga gamot kasi binibigyan iyan ng permiso ng ating Food and Drug Administration. Tawag doon is Certificate of Product Registration (CPR). Nakalagay sa CPR kung para saan ang isang gamot, iyon ang tinatawag na indication. Ngayon kung wala doon sa indication iyong gamit para saan siya nirereseta, inaako ng doctor ang responsibilidad kung ito ay makabubuti o hindi para sa pasyente," he explained.
"Maraming mga iba ibang klase ng off-label drug use. Hindi lang iyong paggamit ng isang gamot para sa hindi niya dahilan. Pwede rin iniba iyong dosage, meaning nilakasan ng kaunti o hininaan, o kaya mas madalas iyong pagbigay. Nangyayari kunwari sa ating mga pasyente na may lagnat. Kung kailangan dalasan iyong pagbigay, pwede nating dalasan iyon. Kung kailangan nating taasan iyong dosage, pwede rin po," he added.
The said practice is not illegal, but patients must be informed of the drug's benefits and risks.
"Hindi siya illegal. It is up to the doctor to decide kung siya ay may benefit o hindi. Kaya may lisensya rin ang doktor. At meron din kaming sinusumpuan, iyong ating Hippocratic Oath na the main consideration is the patient. Ibig sabihin, hindi kami dapat basta basta umaarangkada. Kung tingin namin mas maraming masama kesa makabubuti na epekto, hindi namin dapat ginagawa ito para sa isang pasyente," Domingo shared.
Can doctors be held liable for administering glutathione products for skin whitening?
Domingo explained DOH can help patients who file complaints against doctors when problems occur from the use of glutathione.
"Hindi namin pwedeng hulihin pero kung may maling mangyari or may masamang mangyari, ang pasyente ang pwedeng magreklamo at pwede namin siyang tulungan para mahanapan ng lunas iyong sitwasyon na nangyari," he said.
"Paano kung hindi doctor ang nagbigay? Meron tayong tinatawag na illegal practice of medicine. Ayon sa ating Philippine Medical Act, ang pag-alam kung anong sakit at ang pagbigay ng lunas ay tanging doktor lamang ang lisensyadong pwedeng gumawa. Kaya nga may board exam kami at ingat na ingat kami sa lisensya namin. Kasi pag may mali kaming ginawa, tanggal ang lisensya," he added.
The official said patients may also complain about erring clinics to their respective local government units, where business permits go through.
SKIN CARE REGIMEN
Domingo, who is also a doctor, stressed there is no need for drips, capsules, and the like to have a more fair complexion.
Simply avoiding the sun is a good step.
"Umiwas sa araw. Gumamit ng payong, gumamit ng long sleeves na damit. Sa lilim tayo maglakad, lalo na sa panahon ngayon, napakalakas na ng araw, papasok na ang tag-init. Huwag tayong magpaaraw. Pwede tayong gumamit ng sunscreen. Tingnan natin ang tinatawag na SPF factor, typically ang habol natin 25 pataas," he said.
Domingo said licensed dermatologists should also be consulted for any skin care routine.
"May mga sabon din, tulad ng papaya soap, marami namang iba ibang brand iyan. Pero may caution tayo doon kasi pag gumamit kayo ng papaya soap, nagkakaroon siya ng exfoliating effect. Mabilis iyong pagpalit ng balat. Hindi lahat ng tao hiyang sa papaya soap... Ask your dermatologist kung hiyang kayo doon sa mga ibang gamot at procedure para magpaputi," he shared.
"But then again, bakit kailangan natin magpaputi? We should be proud of our genetics, kung anuman ang kulay ng balat natin, ipagmalaki natin," he added.
The official said eating a balanced diet with fruits and vegetables, having complete sleep, and avoiding stress also contribute to healthy skin.
Roxanne Reyes, a beautician, admitted she takes glutathione capsules with Vitamin C to maintain her fair complexion.
She also uses several products for her face and body.
"Sa face ko, ginagamit ko sabon. Sunod po noon, toner or cleanser tapos serum, then iyong sunscreen. Pag gabi naman, night cream. Pag sa katawan sabon na pang whitening then lotion ko na may SPF," Reyes shared.
"Nagta-take ako ng capsule na gluta, feeling ko, nag-glow lalo na pag pagod, pag puyat. Nakakatulong sa katawan," she added.
Meantime, OFW Angeli Tariman has learned to embrace her current complexion, as she cannot afford to buy skin-whitening products.
"Noong mga nakaraang buwan, busy kasi ako sa papers ko. Wala akong panahon mag-take ng mga pampaputi... Busy iyong budget ko sa paglakad ng papers ko," she said.
"Depende siguro sa mga babae. Minsan black beauty ang gusto nila. Ako naman gusto ko white," she added.
"In general, nakakaputi pa rin siya. Pero it will really depend on how your body responds to it. Iyong iba, mas mabilis iyong pagputi, iyong iba hindi ganoon kabilis ang pagputi. But again hindi talaga siya pamputi. Hindi dapat siya ginagamit for that," he added.
Discussions on the use of glutathione came to light anew when TV host Mariel Rodriguez-Padilla was criticized for her drip session in the office of husband Sen. Robin Padilla.
Rodriguez-Padilla later on clarified that what was injected to her was not glutathione, but vitamin C.
Both vitamin C and glutathione drips are not recommended by the DOH.
"DOH categorically states that there are no published clinical trials that have evaluated the use of injectable glutathione for skin lightening. There are also no published guidelines for appropriate dosing regimens and duration of treatment. Injectable glutathione is approved by FDA Philippines as an adjunct treatment in cisplatin chemotherapy. The [Food and Drug Administration] has not approved any injectable products for skin lightening," the agency said in a statement on Feb. 24.
Domingo said liver, kidney, and skin problems may arise from the use of glutathione as skin whitening, while intravenous vitamin C may cause kidney problems.
Meanwhile, the official explained that only manufacturers--not the FDA or DOH--can initiate clinical trials for glutathione as a skin-whitening drug.
"Ang gumagawa po niyan ay ang manufacturer ng gamot. Kunwari meron tayong bagong gamot o kasalukuyang gamot na gusto nating palisensyahan ng bagong gamit... Maraming manufacturers ng glutathione, sila iyong mag-clinical trial at may proseso iyan. May apat na phases - Phase 1, 2, 3, 4 - tapos lahat iyan may kaukulang dami ng tao. Sa Phase 1, nagsisimula iyan sa kaunting tao, mga 10 lang. Phase 2, dadami, mga 100 to 500, parami nang parami. Phase 3, tens of thousands. Phase 4, ibig sabihin, pinayagan na iyon pero may post-marketing surveillance," Domingo said.
"It is up to the manufacturer (to start a clinical trial or not). Pero as I hinted, magastos din kasi. Kung nakikita ng manufactuter na hindi naman talaga iyon ang pakay nila, kunwari iyong gumawa ng glutathione as an intravenous drug. Kung para sa cancer talaga ang pakay niya, doon sila nagpa-register. It's up to them to decide if they want to register it for other indications or not," he added.
AN 'ETHICAL' CONCERN
Still, a number of clinics offer such products, promising fairer skin to their customers.
Why does glutathione use for skin whitening remain prevalent, with some doctors even administering glutathione drips?
Domingo said this is more of an "ethical" and "practice" issue, as under off-label drug use, doctors are allowed to prescribe a drug for a different purpose other than what the FDA has approved--if he or she thinks that it can be beneficial for the patient.
"Ang ating mga gamot kasi binibigyan iyan ng permiso ng ating Food and Drug Administration. Tawag doon is Certificate of Product Registration (CPR). Nakalagay sa CPR kung para saan ang isang gamot, iyon ang tinatawag na indication. Ngayon kung wala doon sa indication iyong gamit para saan siya nirereseta, inaako ng doctor ang responsibilidad kung ito ay makabubuti o hindi para sa pasyente," he explained.
"Maraming mga iba ibang klase ng off-label drug use. Hindi lang iyong paggamit ng isang gamot para sa hindi niya dahilan. Pwede rin iniba iyong dosage, meaning nilakasan ng kaunti o hininaan, o kaya mas madalas iyong pagbigay. Nangyayari kunwari sa ating mga pasyente na may lagnat. Kung kailangan dalasan iyong pagbigay, pwede nating dalasan iyon. Kung kailangan nating taasan iyong dosage, pwede rin po," he added.
The said practice is not illegal, but patients must be informed of the drug's benefits and risks.
"Hindi siya illegal. It is up to the doctor to decide kung siya ay may benefit o hindi. Kaya may lisensya rin ang doktor. At meron din kaming sinusumpuan, iyong ating Hippocratic Oath na the main consideration is the patient. Ibig sabihin, hindi kami dapat basta basta umaarangkada. Kung tingin namin mas maraming masama kesa makabubuti na epekto, hindi namin dapat ginagawa ito para sa isang pasyente," Domingo shared.
Can doctors be held liable for administering glutathione products for skin whitening?
Domingo explained DOH can help patients who file complaints against doctors when problems occur from the use of glutathione.
"Hindi namin pwedeng hulihin pero kung may maling mangyari or may masamang mangyari, ang pasyente ang pwedeng magreklamo at pwede namin siyang tulungan para mahanapan ng lunas iyong sitwasyon na nangyari," he said.
"Paano kung hindi doctor ang nagbigay? Meron tayong tinatawag na illegal practice of medicine. Ayon sa ating Philippine Medical Act, ang pag-alam kung anong sakit at ang pagbigay ng lunas ay tanging doktor lamang ang lisensyadong pwedeng gumawa. Kaya nga may board exam kami at ingat na ingat kami sa lisensya namin. Kasi pag may mali kaming ginawa, tanggal ang lisensya," he added.
The official said patients may also complain about erring clinics to their respective local government units, where business permits go through.
SKIN CARE REGIMEN
Domingo, who is also a doctor, stressed there is no need for drips, capsules, and the like to have a more fair complexion.
Simply avoiding the sun is a good step.
"Umiwas sa araw. Gumamit ng payong, gumamit ng long sleeves na damit. Sa lilim tayo maglakad, lalo na sa panahon ngayon, napakalakas na ng araw, papasok na ang tag-init. Huwag tayong magpaaraw. Pwede tayong gumamit ng sunscreen. Tingnan natin ang tinatawag na SPF factor, typically ang habol natin 25 pataas," he said.
Domingo said licensed dermatologists should also be consulted for any skin care routine.
"May mga sabon din, tulad ng papaya soap, marami namang iba ibang brand iyan. Pero may caution tayo doon kasi pag gumamit kayo ng papaya soap, nagkakaroon siya ng exfoliating effect. Mabilis iyong pagpalit ng balat. Hindi lahat ng tao hiyang sa papaya soap... Ask your dermatologist kung hiyang kayo doon sa mga ibang gamot at procedure para magpaputi," he shared.
"But then again, bakit kailangan natin magpaputi? We should be proud of our genetics, kung anuman ang kulay ng balat natin, ipagmalaki natin," he added.
The official said eating a balanced diet with fruits and vegetables, having complete sleep, and avoiding stress also contribute to healthy skin.
Roxanne Reyes, a beautician, admitted she takes glutathione capsules with Vitamin C to maintain her fair complexion.
She also uses several products for her face and body.
"Sa face ko, ginagamit ko sabon. Sunod po noon, toner or cleanser tapos serum, then iyong sunscreen. Pag gabi naman, night cream. Pag sa katawan sabon na pang whitening then lotion ko na may SPF," Reyes shared.
"Nagta-take ako ng capsule na gluta, feeling ko, nag-glow lalo na pag pagod, pag puyat. Nakakatulong sa katawan," she added.
Meantime, OFW Angeli Tariman has learned to embrace her current complexion, as she cannot afford to buy skin-whitening products.
"Noong mga nakaraang buwan, busy kasi ako sa papers ko. Wala akong panahon mag-take ng mga pampaputi... Busy iyong budget ko sa paglakad ng papers ko," she said.
"Depende siguro sa mga babae. Minsan black beauty ang gusto nila. Ako naman gusto ko white," she added.
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