Beach season is here, and the great summertime tanning debate is heating up once again.
Is tanning really so bad for us? What's wrong with wanting to get a little color? And if we're too busy to sunbathe outdoors, what harm could a few sessions in a tanning salon do?
This year, there's a new wrinkle in the tanning debate. Even before spring break, the Indoor Tanning Association launched an aggressive campaign with full-page advertisements in major newspapers. Among other claims, the campaign contends that the link between tanning and melanoma, the most deadly form of skin cancer, is hype. In response, two melanoma research organizations have issued a strong warning about the harmful effects of tanning.
With these two giants battling it out, the consumer may be left confused. What's true and what's spin?
Here, test your savvy on tanning myths:
True or False? Indoor Tanning Doesn't Cause Melanoma
The indoor tanning industry contends otherwise, saying in some ads that the link is "hype" and not proven.
"There are a lot of studies out there and a lot of conflicting evidence about what causes melanoma," says John Overstreet, the executive director of the Indoor Tanning Association in Washington, D.C., an industry trade group. "There are many factors involved with melanoma skin cancer," he says, adding that heredity is a major factor. For those with a family history of melanoma, he says, "we would certainly advise you not to tan indoors."
"You constantly hear indoor tanning causes melanoma," he says. "'Causes' means, if you do it, you have [melanoma]. Many millions of people do this [indoor tanning] and don't get skin cancer."
But researchers say that the link between ultraviolet exposure from the sun or tanning beds and melanoma is indisputable, counters David E. Fisher, MD, PhD, chairman of dermatology and director of the melanoma program at Massachusetts General Hospital at Harvard Medical School, Boston.
"There is no question that ultraviolet exposure is associated with an increased risk of melanoma," says Fisher, who is also the president of the Society for Melanoma Research. That group, along with the Melanoma Research Foundation, issued the strong anti-tanning statement.
Fisher points to a study published in the International Journal of Cancer in March 2007 that reviewed 19 published studies on the association of tanning beds and skin cancers. They found use of the tanning beds before age 35 boosted the risk of melanoma by 75%.
As for Overstreet's contention that most melanoma is associated with a family history, not so, says Fisher. "The vast majority are what we call sporadic melanomas."
"Most of the remaining risk factors [besides hereditary] are related to UV exposure," he says, such as being fair-skinned, not tanning easily, being a redhead who freckles easily, and having a history of blistering childhood sunburns.
True or False? Outdoor Tanning Causes Skin Cancer
True. The tanning industry's focus on melanoma only is misleading, says Fisher, noting that the link between non-melanoma skin cancer and UV exposure is solid.
Multiple studies have demonstrated a relationship between UV exposure and an increased risk of developing skin cancer, according to a report published in the May 2008 Journal of the American Academy of Dermatology, although the specifics of the association are different for melanoma and the non-melanoma skin cancers, squamous cell and basal cell.
True or False? You Need Sunlight to Get Enough Vitamin D
False. No one's disputing that exposure to sunlight produces vitamin D, "the sunshine vitamin," or that vitamin D isn't important. A spate of recent studies has found that adequate levels of vitamin D may lead to improved heart health and protect from breast cancer, among other long-known benefits such as bone health.
"I have no argument on the potential benefit of vitamin D," Fisher says.
Limited exposure to natural sun -- exposing skin to about 2 to 10 minutes a day without sunscreen -- is recommended by some experts as a way to produce enough vitamin D, but Fisher and others don't agree that's best. "There is no need to get your vitamin D from UV radiation," Fisher says. "You can get it from a pill." Many foods are also fortified with vitamin D such as milk.
Brandith Irwin, MD, a Seattle dermatologist and spokeswoman for the American Academy of Dermatology, agrees. "It's easy to supplement without tanning," Irwin says. Even with sunscreen on, she says, you may produce some vitamin D. "No sunscreen blocks all UV rays."
But depending on where you live, limited sun exposure won't always produce enough vitamin D, she says. "In many parts of the country, you could lay out without sunscreen for an hour and not get enough vitamin D production," Irwin says.
Irwin says vitamin D replacement can be easily obtained via an inexpensive supplement -- without risk to your skin.
Dietary sources include milk, cereal, yogurt, and orange juice fortified with vitamin D as well as salmon, mackerel, and tuna.
The Food and Nutrition Board of the Institute of Medicine recommends as an adequate vitamin D intake 200 IU for adults 19 to 50, 400 IU for adults 51 to 70, and 600 IU for those 71 and older.
But in 2007, a team of researchers published an editorial in the American Journal of Clinical Nutrition suggesting that daily intakes of about 1,700 IU would be better to ensure an adequate blood level of vitamin D.
True or False? Tanning Causes Premature Aging of the Skin
True. Whether the exposure is indoors or outdoors, ultraviolet exposure over time causes what doctors call "photo aging," or wrinkles and a leathery look.
German researchers evaluated 59 people who voluntarily started to use sun beds over a three-month period. Use of the sun bed induced a DNA mutation in the skin known to be linked with photo aging, they report in the Journal of Investigative Dermatology.
In another study, published in Aging Cell, ultraviolet radiation exposure from the sun was found to speed the accumulation of DNA mutations in human skin associated with premature aging.
To help prevent cancer and premature aging, experts recommend that you:
- Wear a broad spectrum sunscreen year-round of at least SPF 15 that protects against both UVA and UVB rays.
- Avoid sun exposure between the peak hours of 10 a.m. and 3 p.m.
- Wear protective clothing, such as a broad-brimmed hat and long sleeves.
- Apply sunscreen 30 minutes before going out in the sun and every two hours after while you are exposed.