Young Adults and the Threat of Skin Cancer

For most young adults, getting a tan is as common as getting a haircut or a manicure. Investing time in their appearance in order to look their best is a rite of passage that no generation has circumvented.  Today, more than ever, teens and young adults are bombarded with warnings that tanning is the most avoidable risk factor in the prevention of skin cancer.  Unfortunately, studies confirm that America's youth forego this advice in favor of the bronzed look.

This year, more than 1 million new cases of skin cancer will be diagnosed in the United States – exceeding the incidence of all other cancers combined. It is estimated that there will be nearly 125,000 new cases of melanoma diagnosed in the US in 2011.

While many health issues are complex and involve multiple factors, in the case of skin cancer we know that ultraviolet light is the culprit and that avoiding excessive exposure is the cure.  Yet despite this knowledge, the number of skin cancers continues to rise each year. Even more disheartening is the fact that young adults continue to tan both by natural sunlight and in tanning beds despite the known health risks.

A national study published in the September 2003 issue of Archives of Pediatric Adolescent Medicine found that among 6,903 non-Hispanic white adolescents between the ages of 13 and 19 indoor tanning is not only prevalent, but influenced by demographic factors such as the use of controlled substances (e.g., alcohol, tobacco and marijuana), appearance-related factors (e.g., dieting), and psychosocial factors (e.g., cognitive ability).

Overall, when taking the national population into consideration, the number of young women who reported using a tanning booth at least once far outweighed the number of young men who engaged in this activity (36.8 percent vs. 11.2 percent, respectively). The number of young women who reported using tanning booths also increased with age. The study found that 47 percent of young women aged 18 to 19 years old reported using a tanning booth three or more times, compared with 11.2 percent of 13- to 14-year-old girls.

Geographic region greatly influenced the likelihood of using an indoor tanning facility, with adolescents in the Midwest and South being two to three times more likely to use tanning booths than the rest of the country. In addition, teens that attended a rural high school were more likely to report using an indoor tanning facility than their counterparts at urban high schools.

This study confirms that despite the risk, indoor tanning seems to be increasingly popular with young people – and particularly young women.  It's unfortunate that the pressure these teens face to conform to cosmetic ideals presented in popular culture and advertising is so powerful, even with all we know about the dangers of tanning.

Indoor tanning is a booming business in the United States, generating estimated revenues in excess of $5 billion dollars a year. Most salons use bulbs in their tanning beds that emit a significant amount of UVB and UVA radiation – both of which are associated with the development of skin cancer and premature aging. In fact, the Department of Health and Human Services has added UV radiation from the sun or artificial light sources such as tanning beds and sun lamps to the government's list of known carcinogens.

The manufacturers of indoor tanning equipment are regulated at the federal level. Once manufacturers sell the equipment to a tanning salon, it is generally up to the states to regulate their operations. While 29 states regulate tanning salon operators, the legislation varies in severity and there is limited enforcement. While some states go so far as to prohibit access to tanning booths by minors without parental consent, some require salon owners to post warning signs in a visible location in the salon, and others may only establish educational and training standards for tanning salon operators.

The American Academy of Dermatology Association (AADA) issued a new position statement on indoor tanning, encouraging states to aggressively pursue legislation that protects children and urging the Food and Drug Administration (FDA) to take action that will ban the sale and use of tanning equipment for non-medical purposes. Specifically, the AADA supports the following requirements for indoor tanning facilities:

• No minor should be permitted to use tanning devices.
• A Surgeon General's warning should be placed on all tanning devices.
• No person or facility should advertise the use of any Ultraviolet A or Ultraviolet B tanning device using wording such as "safe," "safe tanning," "no harmful rays," "no adverse effect," or similar wording or concepts.

Research has shown that indoor tanning is dangerous, and there should be laws to protect children from engaging in this activity as there are from other unhealthy behaviors such as drinking or smoking.

The reality of skin cancer:

• Skin cancer (melanoma) is one of the fastest-growing cancers.
• Cases in young people have doubled in the past 20 years.
• Skin cancer accounts for one in 10 of all cancers in 20 to 24-year-olds.
• Skin damage in early years can lead to skin cancer later on.

What you can do, advice from the Teenage Cancer Trust:

1. Wear a high-factor sun cream of SPF15 or higher.
2. Cover up. If you're out in the sun, wear a T-shirt, hat and sunglasses.
3. Seek shade between 11am and 3pm.
4. Avoid sunbeds as they they expose your skin to harmful UV rays which increase your risk of skin cancer. Using a sunbed once a month can increase your risk by more than 50 per cent.

Ross A. Clevens, MD

Melbourne Florida Facial Plastic Surgeon