Melanoma and mommyhood: Is it safe to tan when pregant?

Even Snooki gave up tanning beds while
she was pregnant. Image: Twitter.

Last week, my friend Cher, a melanoma buddy and expecting mom, forwarded me her weekly pregnancy update: 

"Is it safe to use self-tanning lotions or tanning beds during pregnancy? Expert answer: Sandra Johnson, dermatologist: If you're not feeling attractive during pregnancy, the look of sun-kissed skin may do wonders for your self-esteem. The good news is that the ingredients in self-tanners are harmless, so it's fine to use them during pregnancy. These lotions and sprays are basically dyes that stay on the surface of your skin and won't harm your developing baby. Best of all, self-tanners have improved dramatically over the past few years, so you don't have to worry about looking like an extra from Willy Wonka and the Chocolate Factory. Tanning beds are a different story. There's no conclusive evidence that they're harmful to a developing fetus, but there's plenty of proof that they're dangerous to you. Tanning beds pose the same dangers as the sun: They emit ultraviolet (UV) radiation, which causes skin cancer. Don't believe anyone who tells you that because tanning booths emit only UVA rays, they're not hazardous to your health. One study suggests that visiting a tanning booth ten times in a year can double your chances of developing melanoma – one of the most deadly types of cancer. Melanoma is the only type of cancer that spreads to the placenta, which could be disastrous for both you and your baby. Lying in a tanning bed can also raise your body temperature to a level that may be hazardous to your baby, particularly during your first trimester. Having an elevated body temperature during pregnancy – that is, above 102 degrees Fahrenheit, which can happen in a tanning bed, hot tub, or sauna – has been associated with spinal malformations in developing babies. And then there's the concern that lying on your back too long could restrict blood flow to your heart and thus to your baby as well. (If this happens, you'll feel lightheaded.) Finally, yet one more downside to tanning: Pregnant women with sensitive skin who expose themselves to UV rays – whether from tanning beds or the sun – may be more prone to chloasma, those dark splotches that can appear on the face and occasionally the arms during pregnancy."

I was just as shocked as Cher to read this email. Do women really care that much about maintaining their tan that they'll continue using tanning beds throughout their pregnancy? On the same website, I did a quick search for "tanning," which pulled up a discussion board thread on the same topic. Some of the responses were quite remarkable.

smckeever371 said: "I work for a tanning salon and i am also pregnant. you do not want to over heat yourself when you are pregnant, however if you choose a tanning bed (lay-down or stand-up) with good fans there is no way for the uv light to cause any harm to your baby because it only penetrates the first two layers of your skin. If you feel that it is too hot in a tanning bed you can always use a spray tan. There is nothing wrong with tanning while pregnant. I wouldn't reccomend over-doing it. But all pregnant women like to feel beautiful and if that means hitting the tannng salon then by all means ladies go tanning! I have been tanning through my entire pregnancy using the stand up tanning bed and the spray tan once a week every week alternating and my baby boy is doing just fine and docs say he is healthy inside the womb waiting to come out."

cottonlily said: "My dr didn't say anything about tanning. However you must not overheat your own body whether from sun tanning, bed tanning, saunas, hot tubs, workouts, etc. He says (not specificially about tanning) that the baby is very well protected in the womb, inside your tissue, inside your skin. That's why you can continue to exercise, have sex, etc. We're not the delicate little flowers that some people believe we are while pregnant! While tanning may not be the healthiest thing to do for yourself, I challenge someone to find any medical evidence indicating it causes miscarriages. You can find someone in the world who would tell you anything - from raising your arms above your head to taking a bath - causes a remote chance of harming your baby... I'm choosing not to live out my pregnancy in a bunker afraid of the entire world and I'll be enjoying my tanning this summer!"

Daniellevi said: "I asked the same thing when I found out I was pregnant (with my first) and my Dr. said NO. Because you are still in the early first trimester, right now is a crucial developing time for the baby. Things like tanning beds or hot tubs are something you really want to avoid durring pregnancy. You'll hear of women who do tan in tanning beds (I know I did), but I really dont think a tan would be worth the potentially loosing your baby"

Amandatj1 said: "I'm so sick of seeing these questions and reading an answer like the one from bucalovsme. Some women don't lock themselves in a vault for nine months because they are expecting, I started tanning at 20 weeks, yes I did wait til after the danger zone, plus I wear a cover up over my belly just in case. Really if taming harmed a baby the it would harm our intestines, lungs, pancreas, stomach, heart etc. there are the normal doctor says no because of skin and we all know those issues. But come on, don't put us mothers down that feel more beautiful tanning, it has always made me feel better and trust me my husband likes me in a better mood. So if u have a crappy opinion keep it to yourself. This was an honest to goodness question. She didn't ask if she could take heroin."

Clearly I've been living in the dark. I didn't realize tanning bed use was such a hot topic among mothers-to-be. Heath issues aside, it really concerns me is this blasé attitude about tanning beds in general. If your more concerned about how you look during pregnancy, is that maybe some indication of how you'll take care of your child? Will you insist that your kids wear sunscreen, or will you let them burn their shoulders on vacation and drive them to the tanning salon before prom? What kind of example are you setting for your kids?

Stay tuned. Melanoma and Mommyhood Part 2 coming later this week!

A historian's take on sunscreen

Who knew that hippos were so
sun savvy? Image: Wildlife Photos

Did you know that hippos produce a natural "sweat" that protects them from the sun? Or that on an episode of Man vs. Wild, my man Bear Grylls uses mushroom coral mucus as a sunscreen? Thank goodness for Sarah Angleton, a writer/historian/blogger who I met at a conference earlier this summer. Sarah recently wrote a post on the history of sunscreen that's loaded with interesting facts like these. Here's a snippet:

"Historians think the Ancient Greeks used sand and oil to protect their skin from sun damage as early as 400 BC and quite a few years later, sun block gets another blurb when Christopher Columbus journals about the paint the natives use to protect their skin from the sun.

The first widely used chemical sunscreen was invented by Benjamin Green, whose 'Red Vet Pet' was worn by soldiers in the Pacific during WWII. Green’s early attempt would later become a Coppertone product. A handful of others invented basic sunscreens around the same time and they all had one thing in common: They didn’t work particularly well."

Read the full article. 

The other end of the spectrum: How pale is too pale?

Image: Sim Chi Yin for The New York Times

Every day, one million Americans crawl into an acrylic clam shell and bathe themselves in UV light. Actress Olivia Wilde joked: "In a thousand years archeologists will dig up tanning beds and think we fried people as punishment."

On the other side of the globe, women in Asia are going to opposite extremes, covering their faces with ghoulish masks to prevent their faces from tanning. According to a recent New York Times article, the rationale in China for protecting your skin is similar to American sentiment pre-1920: that women should have fair skin, otherwise you may get mistaken for a peasant. Not everyone in China wears these face masks--in fact, they're a bit of a novelty--but the cosmetics industry in China caters to women who want to lighten or preserve their fair complexion. This is reminiscent of 19th century Americans painting their faces with lead-based makeup and even resorting to blood letting (yes, you read that correctly), so that they looked more "beautiful."

Whether it's bleaching our skin with harsh chemicals or bronzing ourselves with a bottle of baby oil, women across the world seem to value beauty over their health. And what is it that defines beauty, anyway? Is pale skin intrinsically more beautiful than tan skin? In my opinion, it's not. As evidenced by evolving trends in beauty, there is no right or wrong way to be beautiful--it all depends on what our culture deems desirable at any given point in time. 

Would today's so-called tanorexics probably be trying to lighten their skin had they been born just a few decades earlier? Or if they'd been born in China? Perhaps. Why is it that no matter when or where we're born, so many of us feel the need to drastically alter our natural appearance, just so that we can fit in with societal norms? I sure don't have the answers, but when I saw these photos in the New York Times article, I couldn't help but see the similarities between these two very different but extreme behaviors (excessive tanning and excessive sun avoidance). It all just seems so silly, although I know--especially from previous personal experience--how real the peer pressure we often face to look a certain way can feel.

New skin cancer iPhone apps get rave reviews: Is it worth a try?

A screenshot of University of Michigan's
new skin self exam iPhone app.

Ever since I read this article on CNET about University of Michigan's new skin check app, I've been dying to try it. Trouble is, like most Americans, I am lazy, and sometimes things like "downloading a new iPhone app" fall to the bottom of my priority list.

Today, I saw a report claiming that "Digital Aids Boost Self-Exams for Melanoma." My curiosity once again piqued, I decided to disrobe and give the app a try for myself. After three months of gathering data, scientists found that patients using the app were more than twice as likely to perform self exams and almost three times as likely to feel more confident in detecting a melanoma on their own skin. After trying the app for myself, here are the pros and cons.

The review

First of all, how frickin' cool is it that there is an iPhone app to help us become more aware of potential problem spots on our skin? We live in an increasingly digital world, so being able to set up reminders to perform skin checks is awesome. The University of Michigan app was super easy to find in the iTunes store. Just search "skin cancer." It's free. As for features:

Risk Factors
Based on my age, number of moles on my body, and the region I lived in, the app told me I had a low risk for developing melanoma. Ironic, eh? I wish it would have asked a few more questions--like, do you have a personal or family history of the disease? Or what about number of lifetime sunburns? Or past tanning bed use? Overall impression: Great concept, needs some work.

Full-Body Survey
I was mistakenly under the impression that I would be able to do this myself. There's no way. You absolutely need a buddy to help you with this. You also need to make sure your OK with that buddy getting up close and personal to take 23 pictures of you. More convenient than getting this done in the doctor's office, but what about aging patients who live by themselves? Or 26-year-olds who live in studio apartments and are too embarrassed to ask their friends to take the pictures for them? Overall impression: Wish there was a way to make this a one-man operation.

Lesion Tracker
This feature lets you take photos of suspicious spots that you can refer back to later to see if the mole has been evolving in any way. When I go see my doc, they usually do this with a high resolution camera. Not sure if it was the lighting in my apartment or just the resolution of my iPhone, but when I tried to snap a few photos of my skin, it was really hard to see them. This might be a good tool for me to mentally be more aware of where my potential trouble spots are, but I wouldn't trust the camera to show me any significant changes. Overall impression: Needs higher quality images for this to provide valuable data.

Self Exam
I loved this feature! No photos necessary, it just walks you step-by-step through a self skin exam. If you come across anything suspicious, you can mark that spot on your "virtual body" and check back on it later. I'm all about the self exam and do it frequently. I think this is a great way to educate people how to do skin exams properly on their own. Overall impression: Great tool.

Info Section
Some of the images here are a little cheesy, but for someone who is unfamiliar with skin cancer, it's definitely helpful to have the information readily available. Overall impression: Not bad.

I have to admit, I'm a little disappointed by some of the feature on the app, but I think this is a great first step. I look forward to feature versions that take into account some of the problems I had with photos, as well as a more comprehensive risk assessment tool. If nothing else, apps like this one are raising awareness about the importance of skin exams. Getting to know your body and what's normal for you is so crucial. When you see something that's out of the ordinary, then it's time to make an appointment with your dermatologist.

Have you tried one of these self exam apps? I'd be curious to hear your thoughts.

I think I burnt my eyeballs

Oversized sunglasses aren't always
just for looks.

Last week, I complained to a handful of my friends: "It's August and I've worn my swimsuit only once this summer!" I know I don't purposefully lay out in the sun anymore, but a summer without swimming? It just doesn't feel like summer.

The weatherman forecasted it was going to be in the 90s on Sunday, so a small group of us decided to take a day trip to the Clackamas River. If you're from the Portland area, you probably know the Clackamas River. On hot summer days, it attracts a huge crowd of rowdy young adults (think frat party with water).You park one car at the top, float down the river on a tube, and drive back up to the top with your second car once you reach the bottom.

Even though I was swarmed by lots of tan bodies, I carefully applied my sunscreen to all exposed areas. I even spritzed my scalp and reapplied several times throughout the course of the float. By the time we were about three quarters of the way done, I started to feel an intense burning sensation in my eyes. At first I assumed it was just a little sunscreen that had run into my eye, but even after splashing clean water on my face, the burning persisted. I found myself needing to face away from the sun and shield my eyes from the glare with my hands--even though I had sunglasses on. By the time we reached the spot where our second car was parking, I was squinting like a pirate and could barely see a thing.

On Monday morning, it just so happened that I had a doctor's appointment scheduled, so while I was there, I politely asked her to inspect my eye.

"There are no scratches or anything," she said, "But it sure does look inflamed."

That was an understatement. My right eye was so puffy it looked like I'd been up half the night crying over a movie on Lifetime.

"You probably just got too much sun. Were you wearing sunglasses?"

Of course I was wearing sunglasses. My eyes have always been über sensitive. But maybe my sunglasses didn't provide full-spectrum UV protection. Or maybe a mysterious river-borne pathogen had somehow creeped its way into my eye. I didn't know, so I Googled.

Have you ever you've wondered: Can eyes get sunburned? Surprisingly, the answer (according to my doc and WebMD) is yes. In fact, symptoms include:

• Burning pain.
• A feeling that something is in your eye (foreign body sensation).
• Decreased vision.
• Excessive tearing.
• Hypersensitivity to light.

These symptoms, which can last for up to a few days, were sounding eerily familiar. Maybe I did burn my eyeballs. Scary, because excessive damage to your retina can cause vision problems later in life. So it remains a mystery whether I sunburned my eyes this weekend or not, but my love/hate relationship with the sun continues...

The man tan

Jake Gibb, Olympic beach volleyball player is
a melanoma and testicular cancer survivor.

When I was in college, still an avid tanning bed user, my girlfriends and I used to giggle every time we saw a guy at a tanning salon. Call me old fashioned, but I've always preferred my men to be more rugged and outdoorsy. If a guy is more high maintenance than me (think waxed chest and designer denim)--I'll pass.

Come to find out, many of my guy friends have been to a tanning salon. And many of the ones who haven't are notorious for shunning sunscreen when they spend time outdoors. While I spend most of my time educating young women about the dangers of UV radiation, I wanted to take a moment to remind you: guys get skin cancer, too. Men are actually more likely to be diagnosed with melanoma than women.

To quote a U.S. News article from a few years back:

"Why men? 'Part of it is because men tend to get more [ultraviolet] exposure because of their jobs, part of it is that they use sunscreen less, and part of it is later detection,' says Barbara Gilchrest, chair of the dermatology department at Boston University. Many of her male melanoma patients, she says, come in only after being nagged by family members. Forty-seven percent of men report they never use sunscreen, one survey found. That's part of the reason, no doubt, that researchers at the Centers for Disease Control and Prevention say men have higher rates of sunburn."

I hate, hate, HATE to stereotype, but so many guys I know are (a) too cool to wear sunscreen or (b) totally invincible and don't need to go see a dermatologist--or so they think. Even if you do stay out of the sun, be careful that you don't fall into the latter category. Make skin checks part of your regular routine, especially as you age. I imagine that checking your back in the mirror every so often is less of a pain than an annual colonoscopy. There are undoubtedly people in this world who care about you, so please take care of yourself.

Steve Hock, father of these two, passed
away from melanoma on July 16, 2012.
Men: You are not immune.

With age comes wisdom (and wrinkles if you forget your sunscreen)

Celebrating my birthday a few years ago.

As of 12 a.m. this morning, I am 26 years old. How did that happen? It feels like five minutes ago I was sipping my first legal beer. Birthdays have always been a huge stressor for me: Another milestone, another opportunity to over-analyze my life and criticize myself for not doing more. Because I still struggle with this feeling a little bit, I've decided to give myself (and you, my lovely readers!) the gift of motivation to live each day like it really counts. Yesterday, I contacted a few of my "mole mates" (a.k.a. my melanoma buddies) to ask if being diagnosed with cancer has changed the way they think about birthdays. The result? Poignant, useful advice that's worth a read whether your life has been touched by melanoma or not. Thank you to everyone for sharing!

How has melanoma changed the way you think about birthdays?

 

"I'm one of these that loves to celebrate every birthday, small and simply, but celebrate nonetheless. Until melanoma I celebrated on the day (Sept 3rd) and on my half birthday (yes, I celebrate March 3rd, too). NOW, everyday is my birthday. I just don't add a year to my age with each passing day though. I've become cognizant that I really am not guaranteed to see another Sept 3rd, so I relish each one I do see, but more than that, I've come to appreciate each new day like I never did BC. And every day is a new gift to be opened and enjoyed. So, I have lots of birthdays and lots of presents. Even on those days when they aren't the "best of days." I know a new day is coming. Melanoma changed my attitudes about a lot of things!" -Rev. Carol Taylor, Stage IIIb melanoma survivor from Attitude of Gratitude

"In August 2003, shortly after I turned 50, I was told I wouldn't see Christmas. Every subsequent birthday has been a gift. I turned 59 last month, and have every intention of becoming a Social Security and Medicare on the next generation. I've paid for the Social Security and Medicare benefits of the WW II generation. Now it's YOUR turn!" -Rich McDonald, Stage IIIc melanoma survivor from Welcome to The Hotel Melanoma

"Cancer has changed everything. At first my goals were 3 months at a time (of course I was told I had 6-12 months to live and I was told on my 50th birthday so it's even more special). Every birthday of my kids, and family was such a gift. Making it to my 51st was incredible, you appreciate everyday. There's a saying, "I look forward to getting old, so many of my friends did not have this opportunity," and its so true. I know how very blessed I am to be here. Really everyday is my birthday." -Mark Williams, Stage IV melanoma survivor

"Cancer has CERTAINLY change the way I feel about birthdays. I relish every one of them!!! I guess I've felt that way for a while because my brother died at 49 so I've had perspective since I was 34 but after cancer is totally different! Every birthday is a gift from GOD. I feel that way with not only my birthday but with my kids birthdays. They were on 12 and 14 when I was diagnosed so each birthday they reach is a huge achievement. I need to be here for them so every birthday they have is one more year I was blessed to be in their lives!!!!" -Diane Melius, melanoma survivor

"Cancer has definitely changed the way I view birthdays. I used to have a love/hate relationship with my birthday after my 18th. I felt like I wasn't where I needed to be at that particular moment. I was scared of becoming 'old' because I felt like life was rushing by! How was I really turning 23 when I wasn't engaged and entering the career I always wanted? Then I got that diagnosis and thought, 'I may not live to blow 30 candles off my cake.' Fear. That's what I felt in those moments (and still today!). I can't tell you how many people joke with me, 'Getting old is no fun!' or 'Don't get old!' Now, I politely smile and say, 'It's better than the alternative.' So many people do not have the privilege to grow older. I consider it a blessing. Truly." -Chelsea Price, Stage III melanoma survivor from Adventures With My Enemy... Melanoma

"I've always loved birthdays and have never dreaded getting a year older. I was happy to turn 30- I was married and pregnant with my first child, so life was great! My 33 birthday, however, was a blur. I had been diagnosed with Melanoma 3 months earlier and was living in a fog. I couldn't think about the future because I was not sure I would be in it. Thankfully, by my 34 birthday was much different. I had a new appreciation for the year that had passed and looked forward to the year ahead. I was once again planning for a future and living each day more joyfully because I knew it was a blessing. So, to sum it up, while I have always loved birthdays, I now treasure each one. Another year older? Heck yeah!!" -Anne Stokes Bowman, Stage Ib melanoma survivor


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