UC Irvine Health dermatologist Dr. Janellen Smith has a message for young women who are eagerly prepping for swimsuit season: Protect your skin from the sun’s ultraviolet rays with a strong sunblock. And, above all, avoid tanning beds.
“We know that ultraviolet light is a carcinogen, so it’s really not safe to tan at all,” said Smith, a skin cancer expert and professor at UC Irvine School of Medicine’s Department of Dermatology.
“But at tanning salons, you are getting way more intense ultraviolet light, the kind that penetrates deeply into the skin.”
Indoor tanning ups melanoma risk
In fact, women who tan indoors are six times more likely to develop melanoma, the deadliest of skin cancers, and at a younger age, according to a study published in January by the Journal of the American Medical Association. Women are far more likely to frequent tanning salons than men, the study showed.
“We know that about 30 percent of young girls, ages 16 or 17, have been to a tanning salon at least once, and a number of them reported going once a week,” said Smith, who is co-director of the Pigmented Lesion Clinic at the UC Irvine Health Chao Family Comprehensive Cancer Center.
These are worrisome statistics because melanoma — once the province of the elderly — already claims more than 10,000 lives each year. The numbers give impetus to the American Academy of Dermatology’s efforts to promote regular skin self-exams on “Melanoma Monday,” the first Monday in May, which is Melanoma Awareness Month.
Stronger than the sun
Why are tanning beds more dangerous? Experts say the high-pressure lamps used in most tanning salons can generate 12 times more ultraviolet A (UVA) waves — the most damaging kind — than the sun.
UVA waves trigger melanocytes to produce more protective pigment, hence the darkening skin. “We also know that UVA waves interfere with the DNA of melanocytes, so instead of living and dying, the cells just keep replicating at a fast rate,” Smith said.
Unchecked, these damaged melanocytes can spread through the body’s blood vessels and lymph channels to distant parts of the body.
When a melanoma is caught early and is confined to the first layer of skin, removal can be relatively simple, Smith said. Deeper melanomas may require a larger scar because the surgeon must create a safety margin around the cancer.
The World Health Organization declared tanning devices carcinogenic to human health in 2009. Since then, indoor tanning has been banned in Brazil and Australia. Several states, including California, ban the use of tanning beds by anyone under age 18. The U.S. Food and Drug Administration has proposed a similar restriction. Smith, however, believes the ban should at least apply to anyone under age 21.
Some of Smith's patients have foresworn sunbathing and tanning beds and adopted her recommended regimen: religious application of a broad spectrum sunscreen rated at least 30 SPF every two hours — if exposed to the sun. She also advises protective clothing during the sunniest part of the day, between 10 a.m. and 4 p.m.
Tanning, a way of life for some
For a few people, though, even a small brush with melanoma doesn’t change behavior, Smith said. “We have been examining the addictive nature of tanning. We think it gives people a feeling of self-worth, a sense that it makes them more beautiful.”
That’s one reason she tries to counsel children and teens she is treating for other skin conditions. She’ll show them photos of people who been in the sun most of their lives and others who haven’t.
“It’s hard to say you shouldn’t tan. So tell them, ‘We know that everybody is going to age, but do you really want to look 60 when your girlfriends look 40?’”
The idea behind "Melanoma Monday" was to encourage at least annual skin checks. Scheduling them more frequently is even better to stay abreast of this fast-growing disease.
“It’s a great idea to pick a day once a month to look over your body,” Smith said. “If you see something of concern, get it checked out.”
What to look for
Normal moles are usually oval or round growths and uniform in color — tan, brown or black. They are often about the size of a pencil eraser with distinct borders.
New or changing new moles should be evaluated according to the A-B-C-D-E checklist.
“Remember,” Smith said, “melanoma can develop anywhere on or inside your body. Fortunately, the skin can be examined regularly — with your own eyes or those of your partner.”
Learn more about melanoma and how to spot it ›