Facts on Tanning, Sun, Aging and Skin Cancer

Having a blog requires keeping it up to date and therefore most bloggers are continually looking for relevant topics.  I recently read a fantastic journal article in a journal called Dermatologic Surgery.  Tanning and Cutaneous Malignancy by Sheffif F. Ibrahim, M.D. and Mark Brown, M.D. is one of the best written and most comprehensive articles on the subject I have ever read.  I thought it would be interesting to summarize the important points of the article as well as some of my own facts.  I believe each bullett point is self explanatory and they are in no particular order.  After reading these, one should have a good idea that tanning (whether indoors or outdoors) and especially sunburn is dangerous and puts patients at a greater risk of melanoma and nonmelanoma skin cancers.  There is  no safe tan!  Although many doctors recommend no direct sun, ever, I believe that most  patients will not do that, so I am a believer in moderation.  I realize that all sun causes damage, but I also believe that you cannot control behavior.

1. Every civilization has had an unwavering reverence for the sun

2. Before the industrial revolution a tan was a sign of lower class field workers and “porcelain paleness was the epitome of high society” and after that workers went into factories and those with leisure became tanned.

3. Fashion Icon Coco Chanel  sparked the tanning craze in the western world  proclaiming “a 1929 girl must be tanned….A golden tan is the index of chic”

4. Bikini’s were introduced in 1946 and the “California Beach Culture” of the 1960’s further exposed the skin and increased sun exposure.

5. A 1907 study in France noted the grape pickers developed increased numbers of cancers on sun exposed areas.

6. Over the past 40 years, the association between sun exposure, prematurely aged skin, and cutaneous malignancy has become indisputable.

7. However the desire to tan is higher than ever before.

8. In a survey of 8,000 Americans 94%  were concerned that exposure to UV light could lead to skin cancer, yet 68% felt they looked better with a tan.

9. The first ad for a sun lamp appeared in Vogue in 1923 and there are up to 50,000 indoor tanning facilities in the USA.

10. There is little sound evidence for any medical benefit from recreational tanning.

11. We are currently experiencing a skin cancer epidemic and exposure to UVR remains the single most modifiable risk factor for the prevention of skin cancers.

12. Sunlight is 95% UVA and 5% UVB.  UVB is a complete carcinogen and are largerly responsible for sunburn, tanning and carcinogenesis.

13. Tanning is a response to DNA damage.

14. Cancer Stats

a. The WHO estimated in the year 2000 up to 70,000 deaths worldwide were attributable to excessive UV exposure.

b. In the USA skin cancer represents for more that 50% of all malignancies

c. Mortality from melanoma in the USA occurs at the rate of approximately one life per hour or more that 8,000 deaths annually.

d. Although melanoma only represents 3% of total skin cancers, they are responsible for over of 80% of skin cancer deaths.

e. Skin cancer incidence is rising faster than any other cancer and the lifetime risk of an American to develop melanoma has increased 2,000% in the last 75 years.

f. Melanoma is currently the second most common cancer (after thyroid) form women in their 20’s.

g. Residents of New Zealand and Australia have the highest melanoma rates in the world due to largely fair skin and live close to the equator.

h. Caucasians have 23 times higher incidence of melanoma than blacks.

15. Red heads, fair skinned people and light eye color are at more risk, as is excessive sun exposure before the age of 18, and sunburn at any age have been repeatedly shown to increase one’s lifetime risk for development of melanoma.

16. “A single severe in childhood may double the risk of melanoma” (ref 77 in article).

17. The tanning industry generates $5 billion annually, up from 1 billion in 1992.  1 million people tan daily and 70% are Caucasian females form 16-49.  30% of teens between 13 and 19 are tanning with girls 2-3X over boys.

18. Indoor Tanners are

a. More likely to tan outdoors

b. Less likely to use sun protection

c. Less knowledgeable about skin cancer risks

d. More influenced by social factors

e. More concerned about weight

f. More likely to smoke

g. More likely to binge drink

h. More likely to use recreational drugs

i. More likely to have parents who tan

19. 20 minutes in a tanning bed is equal to 2-3 hours in the noon day sun.

20. Evidence shows several positive associations between indoor tanning and melanoma, particular with exposure before age 35.

21. Patients that use indoor tanning think they are protected and hence spend more time in outdoor sun, which is bad.

22. Studies show that up to 88% of tanning salons allowed minors to tan without parental permission and 75% provided reassurance of the safety of tanning.

23. Sun is not necessary for Vit. D which is in many foods, 5 minutes at noon in the June Boston sun is adequate for maximal cutaneous production.  2 glasses of milk or orange juice cover it, as does incidental exposure of face and back of hands.

24. Tanning can produce endorphins and contribute to “tanner’s high”

25. The link between natural and artificial sun and skin cancer is becoming much like cigarettes and lung disease or alcohol abuse and liver damage.