Basking in healthy, cancer-free skin – Parents, doctors urged to counsel teens to avoid tanning
SAN FRANCISCO (MarketWatch) — With spring break, prom and wedding seasons getting under way, young people especially may long to get a head start on a tan as they strive for a sun-kissed look.
Bad idea, dermatologists warn. Limiting sun exposure and forgoing indoor tanning altogether is more important than ever as cases of melanoma, a potentially deadly skin cancer, rise.
“There is no such thing as safe tanning,” said Dr. Mandeep Kaur, a dermatologist and instructor at Wake Forest University in Winston-Salem, N.C “Right now our major concern is the teenagers because of their excessive use of tanning beds, indoor tanning facilities.”
Catching kids early is critical because people receive half of their total lifetime sun exposure before the age of 18, according to a review article published late last year in the journal Pediatric Dermatology.
Despite the need to counsel adolescents and their parents about the long-term health hazards of tanning, Kaur and her colleagues found that just 1% of pediatricians educated their patients about skin cancer and associated risky behavior during visits.
For kids taking antibiotics or other medicines who won’t admit to seeking ultraviolet rays, such conversations can save them from side effects they don’t know to ask about, said Dr. Joshua Fox, a dermatologist in Roslyn, NY, and a spokesman for the American Academy of Dermatology (AAD.)
“Many teenagers are on acne medications” such as tetracycline, he said. “That’s a photo-sensitizer. They could have severe blistering.”
The general population is well served by curbing the habit, too — and the earlier the better, Fox said. “A good percentage of our exposure — and for sure, sunburns — occur before 18, which is when the cells are perhaps at a more immature state and more prone toward developing cancers 20 to 30 years later.”
People interested in acquiring the tanned look without harming themselves by basking in UV light should spend their money on safer alternatives such as self-tanning lotions or sprays, experts said.
Skin cancer risk rising
Skin cancer is the most common of all cancers, accounting for more than 1 million cases each year and nearly half of cancers in the U.S., according to the American Cancer Society.
One in five Americans will develop a form of skin cancer in their lifetime. There are three types: basal cell, squamous cell and melanoma. Melanoma accounts for about 4% of skin cancer cases but causes 79% of skin cancer deaths.
Melanoma is the No. 1 cancer diagnosed in 20-something women. From 1950 to 2001, incidence of melanoma has increased 690%, with the death rate rising 165% in that time, according to the AAD. This year, melanoma will cause 7,910 deaths, killing 5,020 men and 2,890 women.
Skin cancer is neither painless nor cheap. In 2004, costs associated with treating non-melanoma skin cancer were $1.5 billion while melanoma treatment costs hit $291 million, the AAD said.
People are developing more skin cancers and at younger ages than previously seen for a number of reasons, said Dr. Craig Eichler, dermatologist for the Cleveland Clinic in Naples, Fla.
Depletion of the Earth’s protective ozone layer is allowing more harmful sun rays into the atmosphere just as people are living longer and pursuing active outdoor lifestyles such as playing golf for longer periods and more often, he said. Some also may be misusing sunscreen by thinking it gives them more protection or over more time than it actually does.
The idea that getting a “base tan” or “pre-tan” is helpful in preventing later sunburn, as some tanning parlors claim, is misleading, Eichler said.
“The reason skin tans is UV light causes damage to the DNA of the cells, which triggers an enzyme to produce tan so the skin can protect itself,” he said. “Rather than trying to do a pre-tan, we recommend [people] be very good with their sun-protective methods. By wearing hats and using sunscreens appropriately, people can still have an enjoyable vacation.”
Battle rages with industry
It’s hardly the first time dermatologists have clashed with the indoor tanning business. The Indoor Tanning Association (ITA), which represents the $5 billion industry of tanning-bed manufacturers, distributors and facilities, didn’t return repeated calls for comment. But its Web site says it promotes a “responsible message about moderate tanning and sunburn prevention.” The group criticized a recent AAD study for, it said, neglecting the majority of studies done in the past two decades that found “there is no link between indoor tanning and the likelihood of developing melanoma.” The ITA also accused the researchers of overestimating the number of sunbed users under 18, according to its Web site.
Dr. Barbara Gilchrest, professor and chair of the Dermatology Department at Boston University School of Medicine, said the industry’s latest tactic is using research that suggests vitamin D has health benefits like bone-strengthening to create misleading marketing campaigns.
“Teenagers aren’t going to tanning booths to get strong bones.”
— Dr. Barbara Gilchrest,Boston University School of Medicine
Vitamin D can be obtained through ultraviolet light, dietary supplements or food like milk. ”
If you have two ways of getting vitamin D, which is good for you, one which is harmless and one which is harmful, in an advanced society like ours I think it’s a disservice to suggest to people they shouldn’t do it the safe way,” Gilchrest said.
“I think [the indoor tanning industry has] very callously targeted an impressionable group to do something that is unquestionably going to be harmful to them down the line,” she said.
“It’s well known that teenagers cannot imagine being 30 years old or 50 years old,” Gilchrest added. “It’s very easy to convince a teenager what’s important is looking great for the prom. Teenagers aren’t going to tanning booths to get strong bones.”
Over the years, some states and counties have moved to oversee the tanning industry’s practices where minors are concerned. Twenty-two states place age restrictions on facilities, 27 require them to post a sign warning of health hazards and 25 require a warning statement to be signed by the user or a parent or guardian if the user is under a certain age, according to the American Academy of Dermatology Association, the health policy arm of the AAD.
In 2004, California strengthened a 1988 law by prohibiting children under 14 from using indoor tanning facilities, regardless of a parent’s consent. The new law also requires a written warning to customers, with fines for non-compliance as much as $2,500.
Still, dermatologists wanted prohibitions for kids up to age 18, and it’s unclear how well the law is enforced, said Karmi Ferguson, executive director of the California Society of Dermatology & Dermatologic Surgery.
That’s why parents and doctors have a major role to play in encouraging teens and young adults to seek safer alternatives to sunbathing and using tanning beds, Fox said.
Besides considerable industry influence, forces such as peer pressure and the relaxing feeling tanning can produce work against many teens in making smart long-term decisions, he said.
“Feeling good doesn’t mean it’s good for you,” Fox said. “That’s a hard concept for a teenager.”