Not all skin sections are created equal. The skin underneath the eyes is thinner than the rest of the body. Feet tend to be rougher and thicker. Due to sun exposure, there are tan lines where shirts end. Despite applying lotions, creams and scrubs, the skin on the elbows and knees tends to be darker.

While we are still on modified quarantine, we can get into the nitty-gritty of the skin issue with Dr. Anna Palabyab-Rufino, a dermatologist.

Why are elbows and knees prone to darkening more than other areas of our skin? Melanin is responsible for giving our skin its color. But sun exposure, certain skin conditions causing postinflammatory hyperpigmentation, such as skin asthma or eczema, friction and dryness can all stimulate an increase in its production in certain areas of our bodies. The elbows and knees are constantly bending and rubbing against surfaces. They are prone to thickening and drying due to friction, as well. Irritation can also lead to postinflammatory hyperpigmentation.

What daily habits do people have that make these skin areas darker? Rubbing or scrubbing these areas vigorously while bathing may actually do more harm than good, since as a defense mechanism, the skin tends to become thicker, appearing darker when you do this. Darkening in these areas does not mean that they are dirty. People with darker skin tones have more melanin, and are just more prone to hyperpigmentation. Putting your elbows on your desks or tables, doing exercises that require you to kneel, or putting your elbows on the floor without protection can aggravate this, as well. Another important thing is forgetting to put sunblock when you go out in the sun.

What are derma-approved ways to lighten these areas? Are there habits that people can integrate to lighten them naturally? The best thing to do is to avoid the things mentioned above. Moisturizing the area to prevent dryness and mild exfoliation can prevent the accumulation of dead skin cells. Treatment and prevention of certain conditions such as skin asthma and eczema are also important. Using some chemical peels or exfoliants is effective, as well as laser procedures that target pigmentation.

How safe are common lightening products and soaps found in the drugstore/over the counter? Over-the-counter products are usually safe, but not all have the same level of efficacy. If you have very dry or sensitive skin, use products with caution.

There are lightening soaps that have ingredients that gently exfoliate the skin. There are also creams and lotions containing ingredients such as hydroquinone, kojic acid, arbutin, niacinamide and vitamin C that can help lighten these areas. Lotions applied on the whole arm or leg are preferred over spot treatment to avoid creating a lighter halo on the area surrounding the elbows and knees.

Other products that can help peel off the upper layers of the skin, containing AHAs (alpha-hydroxy acids, like glycolic acid) or BHAs (beta hydroxy acid, like salicylic acid) are also recommended but should be used with caution.

Sunblock should be applied when these areas are going to be exposed to the sun. A broad-spectrum sunblock of at least SPF (sun protection factor) 30 and a PA++ (sun protection efficacy) is recommended. INQAnna Palabyab-Rufino, MD, FPDS, holds clinic at BeautiqueMD, 8th Floor, MDI Corporate Center, 10th Ave. and 39th St., Bonifacio Global City, Taguig, tel. 0917-5142879,

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