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Unsafe Sun Exposure and Tanning

Angela Oswalt Morelli , MSW, edited by C. E. Zupanick, Psy.D.

For decades, teens have enjoyed lounging around in their bathing suits by the pool, lake, ocean, or even their own backyard, soaking up the sun's rays, and relishing their dark tan. Next came tanning beds at the local hair salons, gyms, or tanning salons where one could achieve a perfect, all-over bronze glow, all year around. Many people seem to prefer their skins' appearance when it's tanned: some think it makes them look more attractive, some think it makes them look thinner, and some think it makes them look healthier. However, we now know the health risks of sun exposure or other ultraviolet (UV) light rays, far exceed the temporary enjoyment of a "nice" tan.

teen girl outsideYouth need to remain vigilant about protecting their skin from sun damage during their adolescent years, as skin damage that occurs during adolescence can turn into serious health problems when they become adults. When people spend time in the sun, their skin absorbs ultraviolet (UV) light rays from the sun. These UV light rays can damage and burn skin within minutes. The skin becomes tan from exposure to UV light because the body creates melanin, a tan pigment, in an effort to protect itself from this burning process. However, melanin is insufficient protection, and people of all skin tones from light to dark are at risk for skin damage from UV exposure. This skin damage can trigger abnormal cell growth and replication. Skin cancers are deadly diseases in which abnormal skin growth and cell replication becomes out of control and risks spreading the abnormal growth to other cells in the body. In fact, even one sunburn can significantly raise a person's risk for skin cancer. Beyond the risk of deadly cancer, repeated sun exposure can also cause unsightly wrinkling and premature aging. Most youth who care about their appearance will agree that they do not want to appear older than they actually are and that wrinkles are unattractive. Still, many misperceptions and myths about tanning persist and parents should ensure their youth have accurate information about tanning risks. One such myth is that tanning beds are beneficial because the use of tanning beds will help to prevent the skin from burning in the sun. Another myth is that tanning is beneficial because it provides the body with Vitamin D, and therefore is healthy. However, the facts are that regardless of how a tan is achieved, it is never safe or healthy. Whether youth lie in the sun for hours, or lie on a tanning bed for just a few minutes, the UV light rays from the sun and tanning lamps can cause deep tissue skin damage that can lead to serious and fatal cancers. Moreover, for tanners who believe tanning makes them more attractive, the fact is even small amounts of UV light damages the skin, causing premature wrinkles and a leathery appearance to the skin.

Unfortunately, teens and young adults are at greater risk for permanent skin damage from UV rays than are older adults. This is because teens' skin cells grow and change more rapidly than older adults. Thus, there are more opportunities for normal cellular growth to become altered and damaged by UV ray exposure. In fact, by definition cancer is a malignant growth that is caused by abnormal and uncontrolled cell division. However, it often takes many years for this damage to become evident so it is unlikely youth will detect any problem until after they become adults. When doctors detect these abnormal skin lesions or cancer cells, patients may require unpleasant treatments including repeated surgical procedures to remove cancerous lesions and the tissue around them, radiation therapy, and chemotherapy. However, youth who have already exposed their skin to UV damage because of tanning should be educated to understand that the earlier skin changes are detected, the easier it is to treat or to remove the cancerous cells entirely. These youth should regularly monitor any changes to their skin throughout the course of their lives and should immediately report any changes to their health care provider. Their health care provider may also advise routine screening for abnormal growth.

Because the practice of tanning is so unsafe, many states, territories and provinces have passed laws restricting teens' access to light-bulb tanning bed systems. Some prohibit teens from using tanning beds without a doctor's prescription. Others require teens to obtain written parental consent to tan, or require parents to be present during their youths' tanning bed sessions. These laws can provide parents a springboard for discussion about tanning to provide youth the education they need to make wise decisions for themselves. While these laws are helpful, if parents simply refuse to provide consent to tan, this does not provide their youth any lasting protection. Youth will probably just get upset, proclaim the decision is unfair, and decide tan in earnest once they turn 18. Instead, parents can help their youth become better informed about medical dangers UV light exposure, and can explore and correct any myths or misperceptions their youth hold about tanning. There is a lot of material on the Internet and in the media these days about the risks of tanning and sun overexposure, even in teens' and women's fashion magazines. If a family lives in a state that requires a doctor's note for tanning, parents can schedule an appointment with the family doctor or dermatologist, so that the medical professional can discuss the teens' desire to tan, and explain the medical risks.

Even if youth insist they want their skin tanned, there are other options to achieve these results without UV exposure; e.g., spray tans, tanning crèmes, and tanning lotions. Many of these over-the-counter products are available at the local drug store or grocery store, and many tanning salons now offer the spray tans as well as light-bulb tanning beds. Youth can use these products safely as long as they use the products as directed on the packaging. Users should keep the products away from their eyes and be careful not to inhale or to ingest the product directly. At this time, there are no safe tanning pills, and youth should avoid any drug that offers that tanning benefit.

Even when teens are not attempting to intentionally tan, many teens and older adolescents often spend a lot of time in the sun without considering the need for sun protection. Developing a sun safety plan that is part of a daily habit is the best way that youth can protect themselves from the dangers of the sun. In general, youth can prevent sun damage by staying out of the sun during peak hours for sunlight intensity, generally 10:00am to 4:00pm. However, this can be extremely difficult, as youth like to spend time outdoors, and it's extremely important that youth get plenty of exercise daily, which often occurs outside. Furthermore, the ultraviolet rays in the sun can still penetrate skin during other hours of the day and even when it's cloudy or overcast outside. Youth should be vigilant in protecting their skin when they are outside in the sunlight. Youth should wear a sunscreen that has at least a level 15 Sun Protective Factor (SPF) at all times. There are many different types of sunscreens available that youth can use. Most are creams or lotions topically rubbed into the skin, but others can be easily sprayed on, which helps youth apply it to hard-to-reach body parts. As well, there are cosmetics such as face lotions and body moisturizers that have sunscreen built in, so that youth can apply those daily cosmetics and get the benefits of the sunscreen automatically. Other sunscreens are developed to be more resistant to moisture such as sweat or to not sting the eyes if a youth sweats heavily.

It's extremely important that youth read the directions on the back of the sunscreen container to make sure they are applying it and using it correctly. Most people do not use enough sun screen to protect themselves adequately. It takes about an ounce of sunscreen, or the amount it would take to fill a shot glass, to cover the skin normally exposed outside of clothing. If youth only wear a bathing suit or exercise without a shirt, it will take even more protection to adequately cover the skin. Moreover, sunscreen should be applied at least 30 minutes before going into the sun, as it takes that long for the main ingredients to activate. In general, sunscreen needs to be re-applied repeatedly throughout the day or outdoor activity, as it wears off over time. As well, even water-resistant sunscreens can wash off within time, and sunscreen can also be rubbed off, such as with a beach towel. Youth should re-apply sunscreen every two hours when exercising heavily or swimming and also re-apply it every time they towel off.

Ultraviolet rays can also cause damage to the scalp, lips, and eyes, which cannot be easily protected with regular sunscreen. Instead, youth should be sure to wear wide-brimmed hats or other head coverings to protect their scalps and eyes from the sun's rays. As well, youth should regularly wear protective eyewear that is designed to block out 99% of all UVA and UVB sun rays, such as sunglasses, goggles, or ski masks. To protect the sensitive skin on the lips, youth should repeatedly apply a lip balm with an SPF of 15 or more as well.