Physician's Advice: The Tanning Wars
My license plates on my car are personalized, the say WEAR SPF. I thought it was an amusing plate for a dermatologist. Today, at the end of my day , I am walking to my car to go home and notice a business card on the window. It is a card for a free 15 minute session at a tanning salon. Well, it gives me the topic of today’s blog. The reason that we dermatologists know so much about the effects of tanning is that we used to use tanning booths quite extensively in the 50’s and 60’s for certain skin conditions. They were quite effective because ultraviolet light has the effect of depressing the immune system. That is why you are so tired after a day of sun exposure, your immune system is telling you to sleep so that it can recover. There are immune cells in the skin whose job it is control what it perceives to be an invader. The inflammation caused by doing their job sometimes causes a problem in certain skin diseases. So for years we effectively irradiated these conditions with ultraviolet light and noticed that 20 years later the exposed areas would have premature aging and skin cancers greater than the rest of the population. A case of we did not know for sure, what we did not know. So this is proven in dermatologists minds and in application. So much so we are typically very vocal about it. Apparently our message was getting through so the indoor tanning association launched an aggressive counter marketing campaign called "tanning causes melanoma HYPE." Reminiscent of conspiracy theory in application, its information is meant to promote tanning.
Even if not mentioned, like in my last post, they will introduce information that there is no solid evidence linking malignant melanoma to ultra violet radiation. This is true, there is no solid evidence for a melanoma link. Anyone want to volunteer for this study? It will not happen because it would be unethical. Regardless of that point, it is a fact, that ultraviolet radiation will induce other disfiguring types of skin cancer like Basal Cell and Squamous cell cancers, usually on your face. Another front is that of Sunlight induction of Vitamin D production. This is difficult to determine what is true, because we don't really know yet. Dermatologist will all agree Vitamin D is essential and necessary vitamin. Most physician's agree that this vitamin can be obtained through increasing dietary fish products and supplementation. My feeling is that between diet and what is coming through the sunscreen is probably sufficient. The osteoporosis prevalent in today’s society is not from people applying too much sunscreen. The only people I know who apply sunscreen and practice sun avoidance to that degree would be dermatologists. Most people barely apply enough to work. Osteoporosis etiology is probably more of a lifestyle, hormone, diuretic origin. The bone softening from vitamin D deficiency is a disease called Rickets, that was prevalent in the days before the advent sun screen and is the reason that milk now comes fortified with vitamin D.
Another point of contention is the The base tan argument. True, a base tan provides about an SPF of 4. That may be helpful to you while starting your vacation or it may be an unneeded extra dose of concentrated radiation. If you practice this behavior, be cautious not to burn yourself as there is general agreement that burning the skin increases your risk of neoplasm growth. We also know that ultraviolet light does cause premature aging and loss of elastic tissue cells within the skin.
Consequently, the scientific method requires that we argue both sides until the preponderance of evidence shows that someone wins. In most medical arenas this is done in medical journals and at annual meetings. Since tanning is good media copy and since it is an industry whom some peoples livelihood depends upon, the conflicting information is played out back and forth on the news and defended vehemently on the Internet. What happens is there is too much information and there is no certainty in the public's minds.
For me as a dermatologist, it is glaringly obvious. For you, it may be a bit more challenging. This is all your own personal decision to make. A good rule of thumb that Dr. Hogan taught me, if you are trying to evaluate your chances for success, Look at what similar people in similar situations did and see what their results were. Odds are yours will be the same. The bottom line for me in helping to make your skin more beautiful is to ask yourself, what will the cumulative effects of my habits have on my skin? When you start thinking that in ten years you will not care what your habits bring you, remember what George Burns said.