Monday, November 12, 2012

A melanoma survivor walks into a tanning salon

National Health Blog Post Month Day 12: Call BS on Something 


Starting on #12! What a fantastic idea.
Walking into a tanning salon after being diagnosed with melanoma feels a bit like being a hippie-liberal at a tea party convention. This was about a year and a half ago. I was there because even after my run-in with skin cancer, I was still a little self-conscious about wearing a bikini in public. I was also curious to try spray tanning, which temporarily darkens the skin using a chemical called DHA instead of UV radiation.

I hadn’t been to this tanning salon before, so the gentleman at the front desk asked me to fill out a new member questionnaire. Every salon’s questionnaire is a bit different, but they all ask about your natural hair and eye color, as well as if you tan easily, so that if you ever decide to UV tan, operators can recommend an appropriate UV dosage.

“Have you ever tried UV tanning before?” he asked. “You could do what we call a tanning cocktail. Lay in a UV bed for a few minutes, open your pores up, and then head on in for your spray tan.”

“Yes, and no thank you.”

Meanwhile, a woman who was just nine days away from her wedding had come in for her first ever indoor tanning experience. She’d received a full tour of the facilities from a friendly female employee and was deciding which package to buy. Sensing a bit of hesitancy in the bride-to-be, the man at the front desk walked over to the waiting area and grabbed a newspaper that was sitting on the table.

“This here is gold,” he said, pointing to the cover story. “Researchers at Oregon Health & Science University right here in Portland say that we need more vitamin D. In a climate like Portland where it rains eight months of the year, the only way you’re going to get enough vitamin D is by using an indoor tanning bed. Plus, tanning beds have improved so much in the past few years. They won’t fry your skin and burn you like they used to. Our beds are so high tech. They use 98% UVA rays—hardly any of the burning rays at all. So we don’t even have to worry about the c-word anymore.”

As he finished his sentence, I felt like I’d been punched in the gut. Research by doctors at the university where I worked was being manipulated to sell tanning beds to innocent consumers. And him blatantly saying that tanning beds won’t cause cancer? Do you think he would have been offended had I pulled up my shirt and showed them the scar on my chest? I didn’t want to start a scene, nor start a fight that I knew I wasn’t going to win, so I kept my mouth shut.

Despite this salon operator’s promises that today’s tanning beds won’t cause the “c-word,” in the scientific community, UV radiation is well known to be the primary cause of most skin cancers. Even the Indoor Tanning Association, a lobbying organization for the indoor tanning industry, admits that their products can lead to skin cancer, stating clearly on their website: “You do not need to become tan for your skin to make Vitamin D. Exposure to ultraviolet radiation may increase the likelihood of developing skin cancer and can cause serious eye injury [1].”

When the skin is exposed to UV radiation from the sun or from an artificial light source, it triggers a molecular reaction within skin cells, specifically between the keratinocyte cells in the top layer and the melanocyte cells in the bottom layer. UV rays cause the pigment-containing melanocytes at the bottom layer of the epidermis to travel upwards, where the pigment creates a protective cover for the top layer cells [2]. According to a report by the American Academy of Dermatology, the molecular mechanism that is responsible for creating a tan appearance is the exact same mechanism that leads to skin cancer [3].

Although the Indoor Tanning Association has acknowledged that exposure to UV rays may increase a person’s risk for developing skin cancers like basal and sqaumous cell carcinoma, they are adamant that there is no correlation between melanoma (the most deadly type of skin cancer) and UV exposure from tanning beds.

In contrast, the World Health Organization, a global authority on health research, has found not one or two, but 19 studies that linked sunbed use with an increased risk for melanoma. The same group also came to the conclusion that using tanning beds before the age of 30 increases a person’s risk of developing melanoma by 75% [4]. An American’s risk of developing melanoma has increased 2000% over the past 75 years [2], signifying that a change in human behavior over the last century is likely responsible for this increase. And what has changed that dramatically in the last 75 years? The use of tanning beds.

Admittedly, we have more epidemiological evidence than biological evidence that tanning beds increase a person's risk for developing melanoma. But why risk it? Tanning salon owners are more concerned about making a profit than taking care of your health.

Next time you try to tell me tanning beds don't cause cancer, I will call bullshit.


This post was inspired by the Day 12 prompt for National Health Blog Post Month.
View posts by other participants.

[1]The Indoor Tanning Association. Accessed June 5, 2011. 
[2] Tran TT, Schulman J, Fisher DE. “UV and pigmentation: molecular mechanisms and social controversies.” Pigment Cell Melanoma Res. 2008 Oct;21(5):509-16.  
[3] Lim HW, James WD, Rigel DS, Maloney ME, Spencer JM, Bhushan R. “Adverse effects of ultraviolet radiation from the use of indoor tanning equipment: time to ban the tan.” J Am Acad Dermatol. 2011 May;64(5):893-902. 
[4] “The association of use of sunbeds with cutaneous malignant melanoma and other skin cancers: A systematic review.” Int J Cancer. 2007 Mar 1;120(5):1116-22.