The Medical Minute: Protect your skin, outdoors and in

By Dr. Rogerio Izar Neves

This year, like every year, more than one-third of Americans will get at least one sunburn. According to the Skin Cancer Foundation, the risk of melanoma, the deadliest type of skin cancer, more than doubles with just one severe sunburn in childhood or adolescence or from five such overexposures in a lifetime.

Skin cancer, including melanoma, is the most common of all cancer types. More than 2 million skin cancers are diagnosed each year in the United States. That's more than all other cancers combined. But, skin cancer is largely preventable by avoiding overexposure to harmful UV-A and UV-B rays -- outdoors and in -- and skin cancer is extremely treatable if caught early.

With the summer approaching, how do you play it safe in the sun? Avoid outdoor athletics between the peak sun hours of 10 a.m. and 4 p.m.; wear protective clothing, hats, and UV-blocking sunglasses; and use a broad spectrum, sweat-resistant, SPF 15+ sunscreen with UV-A and UV-B protection, being careful to cover often-missed exposed spots, such as the hands and the back of the neck, and reapply frequently.

But the sun isn’t the only culprit when it comes to the increasing number of skin cancer cases each year. Another way to protect your skin this summer and year-round is to not use tanning beds.

Evidence that indoor tanning is associated with malignant melanoma and nonmelanoma skin cancer is mounting. The use of tanning beds accelerates ultraviolet exposure. One recent analysis of numerous published studies on this topic found that there is a 75 percent increased risk of melanoma associated with indoor tanning bed use before age 35, and a 225 percent increased risk of squamous cell carcinoma associated with indoor tanning regardless of age.

Although knowledge of these harmful effects has become more widespread over the past decade, the use of indoor tanning facilities is more popular than ever, especially among young adults.

Despite the tanning industry’s efforts to portray indoor tanning as a “safe” alternative to outdoor tanning, the intense UV rays in tanning beds can cause permanent skin damage, higher incidence of melanoma and other skin cancers, premature aging, weakened immune systems and eye damage. The International Agency for Research on Cancer, part of the World Health Organization, listed ultraviolet radiation-emitting beds as “carcinogenic to humans,” its highest category of cancer risks.

The tanning industry has argued that cutaneous production of Vitamin D outweighs the risks of UV exposure to skin. This argument is deeply flawed because oral supplements of vitamin D produce identical (and more predictable) vitamin D supplementation, without carcinogenic risk.

Recently, research has shown that indoor tanning also is likely to be addictive. Several studies have suggested this, via a series of measurable criteria of addiction. This year, a study published at Archives of Dermatology presented compelling evidence that, for a significant subset of young adults, indoor tanning may indeed be more of an addiction than a choice. In fact, the authors found a greater proclivity to substance abuse, depression and anxiety, suggesting that habitual tanning may be a predictor of other addictive behaviors, such as alcoholism and cigarette smoking.

Armed with this new knowledge, physicians and their patients should view habitual indoor tanning for what it is -- a risky, potentially addictive behavior that is reinforced by a wide range of cultural, social, and psychological factors. In this context, conquering this popular and growing addiction will require more than a few stern words of warning delivered at the end of a routine skin examination.

Rogerio Izar Neves, M.D., Ph.D., is an associate professor of surgery, dermatology, pharmacology, and medicine at Penn State Milton S. Hershey Medical Center and deputy director of Penn State Hershey Melanoma Center.

 

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Last Updated May 19, 2011