Editor's note: Updated June 3, 2015, to add new research presented at the American Society for Clinical Oncology meeting and CDC report on melanoma.
April 14, 2015 -- As a teen, Danielle Russo of Boston loved the tanned look, so she turned to indoor tanning beds to give her what she thought was a ''healthy glow.'' For several years, she went every day to tan, usually for 10 minutes. She cut back in her twenties but still went a couple times each month.
At 27, just months after Danielle got married, she gave in to her husband Derek’s pleas to get a troublesome mole on her stomach checked out. The mole had been there for years, and her family was also concerned about it. "It would peel off and flake off and bleed," she says.
Her doctor diagnosed her with the most deadly of skin cancers: melanoma. Even worse, it had spread to her lymph nodes. "Our first year of marriage was spent in hospitals, doctors' offices, The Cancer Center, at chemo treatments, and having numerous surgeries," she says.
She’s now in remission, but she has to go back to her oncologist every 3 months and to her doctor for skin checks every 6 months.
"You always think it can't happen to you, but it does," says Danielle, now 29. "I wish someone had told me when I was younger that tanning is not cute."
A Troubling Trend
Skin cancer, especially melanoma, is on the rise among young adults in the U.S.
While parents often warn their teens about the dangers of drinking and driving and having unsafe sex, the message about getting too much sun is often overlooked, experts say. Teenagers and young adults tend to think skin cancer is something that happens only to their parents or grandparents, says Anne Chapas, MD, a Manhattan dermatologist.
But she says doctors are finding that it doesn’t take these diseases a long time to show up.
Melanoma is one of the most common cancers in young adults, especially young women, according to the American Cancer Society (ACS). It’s the leading cause of cancer death in women ages 25 to 30, according to the Melanoma Research Foundation.
In 2015, about 74,000 new cases of melanoma will be diagnosed in the U.S., according to the ACS. About 9,900 people will die from it.
About 7% of melanoma cases diagnosed in 2014 happened in people 34 and younger, the society says.
Overall, rates of melanoma have risen 1.8% a year from 2002 through 2011, the ACS says.
Since the 1970s, cases of melanoma have increased 250% in children and young adults, according to a study presented in June at the American Society of Clinical Oncology meeting. Two-thirds of melanomas diagnosed in 2011 were in women, according to researchers.
The CDC, in a June report, says melanoma rates doubled between 1982 and 2011.
Basal cell and squamous cell skin cancers are less deadly, but they’re much more common than melanomas. More than 3.5 million cases are diagnosed each year in the U.S., according to the ACS, and the number of cases has risen for many years -- probably due to more sun exposure, better testing by doctors, and people's longer life-spans.
Typically, these two skin cancer types are highly curable, yet about 2,000 people in the U.S. die from them each year, according to the cancer society.
It’s common for young adults to be their own worst enemies. In a study of people 18 to 29, half said they’d gotten at least one sunburn in the past year, according to a report published by the CDC in 2012. The risk of melanoma doubles with five or more sunburns, according to the Skin Cancer Foundation.
The most common sun-safe habit women 18 to 29 said they practiced was using sunscreen, the CDC says -- but only 37% did so. Men 18 to 29 were most likely to report wearing long clothing to be sun-safe, but just 33% did that.
Indoor tanning also contributes to skin cancer, experts say. In the CDC survey, white women 18 to 21 were most likely to use tanning booths. Many college students do so to get a ''base tan," so they won't be as pale when they go to the beach. These facilities are easy to find, too. About half of 125 campuses surveyed in a recent study either had indoor tanning services on campus or nearby.
But tanning beds are a bad idea, says Elizabeth Hale, MD, a dermatologist in New York. "Indoor tanning is directly linked to melanoma, basal cell, and squamous cell cancer," she says.
And people who use tanning beds are more likely to report getting a sunburn when they go out in the sun, according to the CDC. A “base tan” does not protect your skin from UV damage, the agency says.
Research shows that people who used indoor tanning even once were more likely to get skin cancers, both squamous and basal cell, according to a study that looked only at these two types. The risk was highest for people who used tanning beds before age 25. Their odds of getting squamous cell cancer were twice as high as the odds of those who never used indoor tanning, and their risk of basal cell 40% higher.
Using a tanning bed before age 30 boosts melanoma risk by 75%, according to the Melanoma Research Foundation.
Indoor Tanning Industry Responds
"The risks of getting skin cancer from indoor tanning are clearly exaggerated,” says John Overstreet, spokesman for the Indoor Tanning Association, an industry group. Blistering sunburns raise the risk of skin cancer, he says, and those are more likely to occur outdoors.
Staff members at indoor tanning facilities suggest customers limit how long they tan to avoid burning, he says, and staff also take into account the fairness of someone’s skin when giving that advice.
How to Teach Safe Habits
If you're close with someone who tans, and you'd like to boost their sun smarts, Hale and Chapas offer these tips:
- Focus on the cosmetic downside of sunning. "The reason people are tanning is they think it makes them look better," Hale says. They think they look healthier and even thinner, she says. Hale tells sunbathers that it causes premature skin aging and age spots. "I try to convince them that a tan is temporary, but the damage lasts forever."
- Make sun-safe habits easy to remember. "People at the beach drinking are less likely to apply [and reapply] sunscreen," Chapas says. She recommends using apps that remind you when to put on more screen. Search ''sunscreen reminder apps'' to find them. Or just set your watch or phone alarm to go off every 80 minutes, or more often if you’re sweating or swimming, Chapas says.
- Suggest healthier bronzing options, like sunless tanning sprays and other products. "I'm all for sunless tanning," Hale says. Still, those don't protect you from burns either, she says, so it's just as important to use sunscreen.
Danielle Russo, the melanoma survivor, says she’d tell teens and young adults to forget about tanning. "I would tell them to pay attention to their skin and protect their skin."