Danger: Teens and
tanning.
by Jessica J. Krant, M.D., MPH
PARENTGUIDE News April 2006
Would you knowingly paint a chemical on your
skin that causes cancer?
What about lying in a box while ultraviolet
radiation causes skin damage
that leads to premature aging, cancer and
possibly death?
In spite of growing evidence in recent years
that clearly shows the dangers of attempting
to achieve a tan, or “just a little
color,” about ten percent of teens between
the ages of 12 and 18 have used an artificial
tanning booth in the past year. In some areas,
up to 30 percent of teens use artificial ultraviolet
tanning, and one in four young people up to
age 25 across the country have tanned artificially
in the past year. This is particularly significant
because artificial tanning with ultraviolet
radiation is pursued solely for cosmetic purposes.
Many first time artificial tanners are young
people who want to appear tan for prom or
spring break. They are often sold on the idea
by classmates or marketing campaigns, but
once started, artificial tanning can become
somewhat “addictive,” according
to one young tanner. Unfortunately, artificial
tanning adds to the risks inherent in natural
sun exposure. Despite rising public awareness
of the dangers of sun exposure, warnings are
not taken seriously and are sometimes ignored.
But what exactly is so wrong with tanning?
Skin Cancer and Other Consequences
Tanning, both with natural sunlight and in
artificial ultraviolet tanning booths, has
been proven to lead to skin cancer. Nearly
half of all new cancers in the United States
are skin cancers, and more than one million
new cases of skin cancer will be diagnosed
this year alone. One in five Americans will
develop skin cancer during his or her lifetime.
There are three main types of skin cancer:
basal cell carcinoma, squamous cell carcinoma
and malignant melanoma. Basal cell carcinoma
(BCC) is the most common type, comprising
about 80 percent of skin cancers. BCC is increasingly
common in young people in their teens and
20s. Squamous cell carcinoma (SCC) has an
even higher risk of spreading and death, contributing
to the about 2,820 non-melanoma skin cancer
deaths in 2005. Malignant melanoma (MM) has
been diagnosed in over 100,000 Americans 2005,
and has caused about 7,700 deaths. Melanoma
is the most common type of any cancer overall,
including non-skin cancers, in young people
between the ages of 25 and 29, and is the
fastest growing type of cancer in young people.
In addition to the clear risks of skin cancer,
ultraviolet radiation has also been shown
to lead to wrinkling and premature aging,
eye damage including melanoma of the retina,
and an increase in skin infection outbreaks
such as herpes or cold sores. Tanning booths
have also been shown to contribute to the
spread of skin fungal infections. There truly
is no such thing as a “healthy tan.”
Teens at Risk
While artificial tanning rates increase with
age into adulthood, and lifetime cumulative
and additive sun exposure contribute to skin
cancer and aging, teenagers are particularly
vulnerable to tanning. Young skin is more
easily damaged by sun exposure, and early
childhood burns and tanning contribute to
a large proportion of cancer-related damage.
In addition, children and teens are still
developing in terms of health-related judgment.
Like some adults, children and teens often
do not fully understand the long-term consequences
of their choices.
While all teens are at great risk, young women
ages 15 to 29 are the most loyal customers
of artificial tanning parlors, as well as
the fastest growing group of skin cancer patients
for all types of skin cancer. Such young women
have shown a 60 percent increase in melanoma
rates since the mid 1970s. Probably not coincidentally,
this is also the same time period over which
the artificial tanning industry has boomed
in the United States. The tanning industry
itself reports that the largest group of customers
now using its equipment is comprised of young
women ages 20 to 39, and tanning industry
seminars teach parlors to recruit employees
and customers attending high schools.
New Laws
There is currently no federal legislation
regarding teens and tanning booths despite
pressure from dermatologists and the World
Health Organization, among other medical groups.
However, the increasing awareness of the clear
dangers of tanning, combined with teens’
still-developing judgment, has prompted many
state and local legislatures to adopt a patchwork
of regulations that are gaining momentum around
the country. In 2004, Nassau County adopted
regulations preventing anyone under the age
of 16 from tanning unless accompanied by a
parent. Recently, Westchester County has debated
adopting even stricter regulations, which
would prevent anyone under age 16 from tanning
artificially at all, and require parental
consent for minors ages 16 and 17.
While the American Academy of Dermatology
and the American Society for Dermatologic
Surgery prefer that no one use artificial
tanning equipment at all, the prevailing hope
is that federal legislation may be enacted
that will prohibit all minors from using the
equipment without exception, thus sending
a clear message about the dangers to teens
and parents alike.
Sun Safety and Prevention
What can be done to truly minimize the risks
associated with tanning? First, do not seek
a tan. Society’s adoption of the tan
as a “healthy” look in past decades
has led to a dangerous increase in cancer.
Avoid excessive sun exposure by attempting
to limit outdoor activities to the cooler
hours of the day, when the sun is less direct.
Wear sunscreen daily, not just at the beach.
An effective sunblock should be at least SPF
15 (for casual exposure) and SPF 30 or higher
for stronger exposure. Sunblocks should be
applied generously, and reapplied every two
hours, or sooner after swimming or perspiring.
Ideally, sun-protective clothing should become
a habit, such as hats with wide brims that
protect the ears and neck and long-sleeved
shirts with dark or dense fabric.
Of course, all of these practices prevent
the look your teen may be seeking. So while
tweens and teens gradually learn new behaviors
and learn to value actual healthy skin rather
than tan skin, teach them that using self-tanning
creams and spray-on artificial tans are far
safer than ultraviolet exposure. Just remember
that a tan look is NOT protected from damage,
so sunblock is still necessary. With practice,
good habits can replace dangerous ones, and
the rewards of looking younger longer and
avoiding skin cancer surgery will prove well
worth it.
Malignant melanoma (MM) is expected
to be diagnosed in over 100,000 Americans
this year, and to cause 7,770 deaths. Melanoma
is the most common type of any cancer overall,
including non-skin cancers, in people between
the ages of 25 and 29, and is the fastest
growing type of cancer in young people.
Jessica J. Krant, M.D., MPH, is clinical
assistant professor of dermatology at SUNY
Downstate in Brooklyn, a Mohs skin cancer
surgeon and dermatologist in Westchester County,
and a delegate to the American Medical Association
for the American Society for Dermatologic
Surgery. Find Dr. Krant at www.NYskindocs.com.
For more information on skin cancer, go to
www.asds.net.
