Science is on the brink of discovery that would enable skin color changes, as in white to black or black to white. Or so promises an article that appeared recently in both Next, a science magazine, and Flair, a black beauty magazine.
The article refers to research into improved treatment for vitiligo, a little understood disease that develops without warning and robs the skin of its color. A four-year research project is being carried out through a $2 million National Institutes of Health grant to six facilities, including the Howard University School of Medicine, Yale University, University of Pennsylvania, Bryn Mawr College, University of Massachusetts and Massachusetts Eye and Ear Infirmary.
The researchers are disturbed by the article's suggestion, calling it a "misrepresentation" of their attempt to find a substance that will augment traditional treatments for restoring natural skin color.
While the magazines played down the problems of the disease and sensationalized the research, vitiligo -- although it has few known effects on a person's health -- can be psychologically debilitating.
One patient here, for example, refuses to undress in front of her husband; another woman carefully applies makeup so no one knows -- except her husband. Even in summer's heat, one man dons long pants, a turtleneck, a hat and large sunglasses before going out in public.
These three individuals, all black, are hiding what they feel are unsightly patches of pinkish-white skin.
Vitiligo is estimated to affect between 2 and 4 percent of the population. It does not discriminate between sex, age or race, and is not contagious. The ghostly patches are often mistaken for scars from a burn. Because the disease causes a marked lightening of the skin, it is often more noticeable in blacks than in whites. But, regardless of color, it is disturbing.
"They see themselves as hideous monsters, some are recluses," says Dr. Pearl E. Grimes, who runs the Tuesday-Thursday witiligo clinic at Howard University Hospital. "It's important that they see they are not unique in having this problem," she says, adding that too few people realize the condition is treatable. Grimes notes that the need for support is great and "the friendships the patients develop among themselves (at the clinic) are very important."
Under the tutelage of Dr. John A. Kenney, whom Grimes calls "the most renowned black dermatologist in the country," and with the help of the NIH grant, Grimes has been able to expand services significantly at the vitiligo clinic, offered at Howard for about 10 years. Because of the research grant, the clinic is now open two days a week instead of once every two weeks. The staff spends more time educating and counseling patients about the disease, associated psychological problems and types of treatment. Clinic staffers even offer makeup samples.
The clinic has treated 180 patients since January, six times the number treated during that same period last year.
Crude treatment for the condition was discovered by ancient Egyptians with vitiligo, who ate psoralea berries, then sunned themselves on the banks of the Nile to coax their natural color back. Psoralen lotion and pills still are used in conjunction with ultraviolet light and are significantly effective for about 40 percent of the patients, Grimes said.
"If they are conscientious about taking their medications, they'll get some response," adds Grimes. "We have no panacea," she adds. "I don't try to paint an overly optimistic picture; I tell my patients to anticipate therapy for a minimum of a year." If results aren't satisfactory, there's always makeup -- an option she offers to men as well as women.
In vitiligo, the pigment cells, called melanocytes, are destroyed or disappear, and without medication, the body does not replace them. No one knows what causes this, but Kenney suggests that the cells might be attacked by the body's immune system.
Psoralen promotes the growth of new melanocytes, and with the help of real or artificial sunlight, these new cells migrate to the areas that lost pigmentation.
Researchers at Howard are studying the patterns of the disease -- what age groups it strikes most frequently, how quickly it progresses, and whether its presence is related to other physical problems, such as diabetes or loss of pigmentation in the eye.
Researchers at Yale are looking for ways to improve treatment. Scientists now are able to synthesize a melanocyte-stimulating hormone which, in preliminary testing, has improved the effectiveness of psoralen in some cases.
The problem with this approach, according to Dr. Aaron B. Lerner, head of dermatology at Yale, is that this hormone is extremely expensive, and the process requires refinement.
As for the business of changing skin color, that's not very new, Lerner points out.
"You can turn a black person with vitiligo white -- it's no big task," says Lerner.
Washington dermatologist Robert Stolar has been doing this since the 1940s. In patients who are "unsightly," Stolar explains, "I take the brown out and make them all one color." He says this can be done very effectively with a bleaching cream called monobenzyl ether of hydroquinone.However, this treatment will not turn a healthy black person white, according to Lerner. "You're in for a big mess," he says. The color would be uneven and blotchy because vitiligo patients' skin responds differently to drugs like hydroquinone and psoralen.
For example, a healthy white person taking psoralen would look very tan, but the color would eventually fade unless treatment were continued. Two white authors -- Grace Halsell ("Soul Sister") and John H. Griffin ("Black Like Me") used psoralen to change their complexions to black to gather research for their books.
Grimes says that in her experience, turning white is usually a "last resort" option for black patients. As far as changing races is concerned, Grimes says, "You can't change your background and how you relate . . ."