Getting “Some Color”

That is how I used to refer to tanning.

Although I think skin cancer, particularly melanoma, merits significantly more attention than it gets in the media and in primary care offices, I would say that the vast majority of people, at least in this country, realize that the UV radiation is the number one culprit. So, why do so many of us shake off a sunburn like it is no big deal?

Burning is a Big Deal

Many of my patients knew that sunburning was “not good” for their skin – the pain lets you know – but they underestimated just how damaging burning is to the skin. But the reality is that a history of five or more sunburns or a single blistering sunburn at any point in life more than doubles one’s risk of developing melanoma. Ouch. And melanoma is just one of three types of skin cancer. The others, basal and squamous, although rarely life-threatening, occur more readily than melanoma and at increasingly high rates.

Tanning is a Big Deal, Too

Equally pressing, why do so many of us – myself included until I started working in derm – go out of our way to get a great tan?  I do not think there is as much awareness about the cumulative effects of sun. Years of UV exposure and tanning puts us at risk for skin cancer, as well. But it is less obvious because our skin is not scorched. UVA rays cause the skin to tan, and they also cause the skin to sag, wrinkle, and discolor over time. The more tan the skin at present, the more aged it will look in years to come. In practice, I would ask patients about their incidence of sunburns, and I would follow with a question about tanning practices. A history of either is a red flag.

Tan = Prom Ready

I would try to allow as much skin as possible to bask in the sun. In fact, I would increase my vulnerability by applying tanning or baby oil – begging the sun to darken me. I know I am not alone in this. And I did not think twice when my skin turned red, even peeled, because that meant I would be “bronzed” in the next day or two. That was the point. In 1998 and 1999, I vividly remember lying in a tanning bed (burning is a better descriptor) several times in preparation for my junior and senior proms. I recall listening to the buzzing of the almost green and exceptionally bright bulbs and thinking, “This can’t possibly be good for me,” like it happened yesterday. Regrettably, my desire to be immediately tanned outweighed my skepticism of the safety of tanning beds. I figured a few tanning bed sessions would not really make a difference. This naiveté and notion of adolescent invincibility may sound familiar to you. Unfortunately, the beautification of tanned skin continues. Despite the evidence against it, the tan image still translates as sexy and desirable – and safe.

Check Yourself Out

Take a look at the inner part of your forearm. Better yet, take a peek at your butt in the mirror. Really! That lighter-colored, freckle-free, and softer skin is unexposed skin in its natural, undamaged state. Even the slightest tan means some UV damage has occurred.

So, Find a Cave?

As I would tell patients, I am not suggesting that you run from tree-to-tree, avoid the beach, or drive yourself and those around absolutely nuts with sun paranoia and sun protective neuroses. Even the most diligent among us get some color. It is inevitable. Sunscreens, though effective if applied appropriately, do not provide 100% UV protection. But we can do things like wear long-sleeves, shades, and hats at all times when outdoors. And, although I, too, love how good it feels, we really should avoid tanning. More importantly, we should absolutely avoid tanning beds, which emit predominantly UVA rays – the factor most linked to melanoma – and at higher levels than the sun.