tanning booths

Beauty is Only Skin Deep – Tanning Basics

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This week marks spring season’s jump back into our lives (YAY!), and I celebrated by wearing a dress to work on Monday. Office mate said, “Nice legs, but you could use some sun.” I laughed and had to explain that I don’t tan because I avoid sun damage. I would rather look pale versus tan; appear sickly versus healthy. Think about that word play irony. The way to get that “healthy” tan is primarily via exposure to the sun, tanning beds or artificial topical tanning treatments, all of which are lower on the healthy totem pole by comparison to simply leaving our skin alone.

The amount of misinformation available online is hilarious. A simple Google search for “how do you get a tan?” revealed the answer, “what makes you tan is melon that works hard in your skin and gets a darker color.” Melon, eh? The mass majority know this is false. What is not hilarious is there are many who flock to tanning salons for what they believe is the safe alternative to baking in the sun.

What is Tanning?

A tan is basically injury to the skin’s DNA. The skin reacts to UVA exposure by darkening in an attempt to prevent further DNA damage. The darker the tan, the more the mutations, and with enough mutations come skin cancer. Here’s how it works.

Ultraviolet (UV) rays damage the skin’s cellular DNA, and excessive UV radiation produces genetic mutations that can lead to skin cancer. UV radiation is considered the main cause of nonmelanoma skin cancers (NMSC), including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). More than a million worldwide and 250,000 Americans are affected by skin cancer each year. Despite our wealth of knowledge as it relates to protecting our skin from the sun, many still seek that “healthy tan.”

UVB rays cause surface sunburns and vary by season, location and time of day. They are most intense in the U.S. between 10:00 AM and 4:00 PM from April to October. While intensity varies, they can still burn and damage skin year-round, especially at high altitudes and on reflective surface. Snow or ice can reflect up to 80 percent of the ray. What does this mean? You get hit twice with the rays even during winter. One bit of good news is UVB rays do not significantly penetrate glass.

UVA rays are a different beast. They attack deeper connective tissue and trigger long-term damage such as skin cancer, wrinkles and sunspots. According to the Skin Cancer Foundation, they are present with relatively equal intensity during all daylight hours year-round, and can penetrate clouds and glass. Recent studies show that UVA rays damage skin cells called keratinocytes in the basal layer of the epidermis, where most skin cancers occur.

What about Tanning Booths?

Tanning booths primarily emit UVA rays. The high-pressure sunlamps used in tanning salons emit doses of UVA as much as 12 times that of the sun. Statistically tanning salon users are 2.5 times more likely to develop squamous cell carcinoma, and 1.5 times more likely to develop basal cell carcinoma. According to recent research, first exposure to tanning beds in youth increases melanoma risk by 75 percent.

Alarmingly, a recent congressional report exposes the tanning industry’s misleading messaging to teens. Specifically, Committee investigators found:

  • Nearly all salons denied the known risks of indoor tanning
  • 90% stated that indoor tanning did not pose a health risk
  • 51% denied that indoor tanning would increase a fair-skinned teenager’s risk of developing skin cancer
  • Salons thought the link between indoor tanning and skin cancer as “a big myth,” rumor,” and “hype”
  • 80% claimed that indoor tanning was beneficial to a young person’s health
  • Several salons even said that tanning would PREVENT cancer

Other health benefit claims included:

      • Vitamin D production
      • Treatment of depression and low self-esteem
      • Prevention of and treatment for arthritis
      • Weight loss
      • Prevention of osteoporosis
      • Reduction of cellulite

The report suggested that salons used a variety of approaches to minimize the health risks of indoor tanning, especially when marketing to young girls. Consequently, the general perception of teenaged girls was that “it’s got to be safe, or else they wouldn’t let us do it.”

The Skin Cancer Foundation is currently campaigning to generate letters of support urging the FDA to regulate tanning beds and ban those under 18 from using them. The Foundation feels the tanning salon industry’s misleading practices for the sake of revenue are putting the lives of people, particularly young women, at risk.

My feeling is we all make choices in our lives by weighing the risks involved, however, we deserve to be properly informed. I definitely partake in my share of risks, but I learned and chose early on to avoid skin damage by using SPF products in lieu of makeup (see here for all natural sunscreen products) or a “healthy tan.” For me, pale trumps skin damage or cancer any day. I shudder to think how many young women have already been affected by the myth that tanning beds are a healthy choice. Be proactive in staying informed. I can’t preach this enough. Beauty is only skin deep, and our true colors – tan or lack thereof – reveal the truth of what lies beneath it all.

Blame Coco Chanel

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It was she, after all, who stepped off a friend’s yacht in Cannes looking fabulous, free-spirited, and tan in a sea of the pale and repressed. It was she who designed freer, arm and leg-baring fashions, leading women to bob their tresses and dance with abandon down the aisle of jazz and liquor. Society, which had scorned a hint of bronze just a decade earlier, embraced it with increasing abandon.

Before Ms Chanel’s noteworthy disembarkation, tan skin was a sign of the lower class; of laboring in fields and living rough on the streets. Nobility, on the other hand, lived a life of leisure spent indoors. To tan was to toil and that was something the betters did not do. In fact, instead they pioneered the Michael Jackson trail of applying bleach to the skin, often using lead and arsenic-based face paint.

Yes, these women suffered premature death, but they looked darn good in the process.

With the dawn of the Industrial Revolution, which kept workers indoors more than out, a tan became the 20th century’s status symbol. Those who had the means for Mediterranean, island, and beach vacations were the bronzed beautiful jet set, once again distinguishable from the proletariat.

Enter Gidget and Moon Doggie, Frankie and Annette, Coppertone and Iodine-laced baby oil; by the fifties, we all aspired to a healthy, beautiful tan.

Now, a little sun is good for you, necessary actually. Without the Vitamin D the sun provides, we develop rickets and bone deformities. The first tanning beds, in fact, were a medical invention to counteract sunlight deprivation and vitamin D deficiency. Yet, on average, fifteen minutes a day, three days a week provides the Vitamin D we as humans need. We do not need to bake under the sun for hours and we especially do not need to lie in carcinogenic capsules of UV rays.

Rates of malignant melanoma have more than quadrupled in the past 30 years. It is the most common form of cancer among those aged 15-34. The World Health Organization has found that people who have been using tanning devices before age 30 are 75% more likely to develop melanoma.

We still tan. And it is killing us.

Educating the public, and particularly teenagers, about the dangers of tanning is a personal cause for me. My own father died of melanoma at 52. He only sunned himself on vacation, which was not often. He was a lifeguard in high school and during summers home from college. He never used a tanning bed. I got my olive complexion from him. Other than his pale blue-gray eyes, he did not fit the mold of a skin cancer susceptible being. He died all the same.

I see teenagers on the news tanning for prom, people still slathering themselves and lying like meat cooking in the sun, a baseball mitt brown mother taking her child to the tanning salon. With the exception of that last example, tanning is still a very accepted activity. Humans view themselves as immortal, until they don’t. Until they find a strange mole on their head or under their arm and the doctor estimates a year of life left, a year of surgeries and chemotherapy and radiation until his body gives up the fight. Until a wife and grown daughter are left bereft, and three beautiful grandchildren will never know their amazing grandfather. It’s got to stop. We are killing ourselves.

I, for one, am all for bringing pale skin back in fashion, hold the lead and arsenic please.

Avoiding Melanoma and Other Skin Cancers

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I worship the sun. Perhaps it has to do with my astrological sign (Leo), or the fact I was born on a hot humid day in August, or, since I also love the humidity, perhaps it’s a carryover from having been a Southern Belle in a previous life? Whatever the reason I’m happy when the sun is out and I’m generally out when it’s out. Nevertheless, I’ve had to learn the hard way to change my relationship with the sun.

Lesson I: Sun Poisoning & Suntanning

My earliest memory of the sun’s potent effects was a on a trip to Acapulco when I was seven. I got so sunburned the first day of the vacation that I spent the remaining six days in bed, violently ill and in pain with sun poisoning. I could have been the Coppertone poster child except I was too sick to stand up.

The summer I was fifteen, my best friend and I went to the beach near our homes in Southern California every single day. We slathered ourselves with Johnson’s baby oil and tried to look busy reading our Kathleen E. Woodiwiss novels while lying on our beach towels, all the while hoping some handsome young studs would notice what bronzed goddesses we were.

The following two summers I was a life guard at our community pool. I burned my nose so many times the first summer that it became bulbous and my supervisor finally purchased a tube of zinc oxide cream for me and insisted I apply it religiously. This was before the days of SPF lotions, and was my introduction to protecting myself from the harmful effects of UV rays.

However, I still wasn’t fully on board with the idea of sun protection. It didn’t help that when I arrived to college on the east coast in late summer 1980, I was on just about every boy’s radar because of my deep tan and sun-bleached hair.

Lesson II: Basal Cell Carcinoma

The risk I was putting myself at didn’t truly begin to sink in until 1989 when my brother had a biopsy of a small polyp on the bridge of his nose and learned he had malignant basal cell carcinoma. Basal cell is a non-melanoma skin cancer that arises from small round cells found in the lower part of the epidermis. In order to remove all the malignant cells, his surgeon had to carve up his face like a Thanksgiving turkey leaving him permanently scarred and disfigured. Fortunately, the margins came back clear and he’s lived cancer-free ever since.

Shortly after the incident with my brother, I had my first child. I became a religious applier of sunscreen to my baby’s skin, if not always my own. As the years passed and I began to notice crow’s feet and sun spots taking their rightful places on my skin, I took more precautions. For me, it took vanity, not my brother’s skin cancer, to become a full-on sunscreen aficionado.

Lesson III: Dysplastic Nevi (Atypical Melanoma)

In 2007, my son, who’d been the primary benefactor of my brother’s misfortune, and who had always, like me, had a lot of moles, had one removed from the base of his thumb. The biopsy report indicated dysplastic nevi, a benign mole that resembles and may predict single or multiple melanomas. The higher the number of these moles someone has, the higher the risk of cancer. Those who have dysplastic nevi, plus a family history of melanoma (two or more close blood relatives with the disease) have an extremely high risk of developing melanoma. Individuals who have dysplastic nevi, but no family history of melanoma, still face a 7 to 27 times higher risk of developing melanoma compared to the general population.

My son returned to the dermatologist who dug out a large chunk of skin from my son’s hand. Yet, this brush with melanoma occurred during an inconvenient time. My son had recently been diagnosed with a brain malformation and was awaiting surgery. An atypical melanoma seemed the least of our worries.

Lesson IV: Acral Lentiginous  Melanoma

Fast forward three years to 2010. My 81-year old father, also a sun worshiper, took my stepmother to a dermatology appointment. At the end of the appointment, as he helped my step mom slip into her sweater, the dermatologist stopped him and said, “let me see your thumb there.” My dad told the doctor that the black vertical streak on the inside of the thumbnail had been there for a few years. Concerned, the doctor scheduled a biopsy. Sure enough, it came back positive for acral lentiginous  melanoma.

Lentigenous-type melanoma is the most commonly diagnosed melenoma in Asian and black populations, however, it is extremely rare among Caucasians. Bob Marley had acral lentiginous melanoma. Similar to my dad, Marley’s melanoma presented itself as a macule, or spot, on his big toenail. These spots can look like the type of black and blue spot you might get if you caught your fingers in a door, and frequently they are neglected. Bob Marley’s melanoma eventually metasticized and into the brain tumor that eventually took his life.

My dad was more, or less fortunate. He submitted to exploratory surgery, and since his melanoma was detected relatively early, the surgeon only needed to amputate half his thumb.

Lesson Learned

There’s an adage that a lesson will be repeated to you in various forms and at various turns until you learn it. Then you can go onto the next lesson. Even though acral lentiginous melanoma does not appear to be linked to sun exposure, rarely occurs in Caucasians, and the average age at diagnosis is between sixty and seventy years, and I was adopted so I have no reason to think I have a genetic predisposition, I finally learned my lesson. After these several wake up calls, I now understand that the risk at which my genes and my mistakes have placed me warrant monthly self-examination, regular professional skin exams and daily sun protection. No exceptions.

If you, like me, are thick skinned due to sun exposure and thick sculled due to a stubborn nature, and have yet to learn your lesson, then you may want to consider a few salient facts:

Here are some prevention tips that I follow:

What are your tips? What were your lessons? We’d like to hear from you.

 

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