FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

SUNTAN PARLOR LEGACY - UGLY WRINKLED SKIN, POSSIBLE EARLY DEATH

Question: The campus newspaper in our college town recently published a front page story with the headline, "Tanning has health benefits." In the story it said that "those who tan are 57 percent less likely to sunburn and less likely to contract melanoma." Is it true that maintaining a suntan decreases your chances of getting this type of skin cancer? That's just the opposite of what I've heard other places.

Answer: Incomplete knowledge often leads to incorrect conclusions, and personal bias always plays a role in the way each of us interprets any information. The reporter who wrote this misleading story undoubtedly did not interview the most knowledgeable sources, and then the information gathered was filtered by past experience and attitude toward the subject. I'll try to set the record straight.

As I'm sure you know, the body needs sunlight to make vitamin D. If one were faced with the limited options of either living in constant total darkness or using a tanning bed on a regular basis, then exposure to this form of artificial sunlight would clearly be a "health benefit" as your newspaper article suggested. In the real world, however, the patrons of tanning parlors are clearly harming, not improving, their health.

Exposure to ultraviolet light, whether from the sun or from lights in the tanning booth, damages the skin. The immediate sign of mild damage is a suntan. The skin reacts to the injury by producing pigment which makes the skin darker. This extra pigment helps block ultraviolet rays from reaching the deeper skin layers where more serious damage is possible. About 20 years or more after tanning, the skin becomes wrinkled, thickened and leather-like. Sun exposure may also produce rough, irregular skin lesions that are not particularly dangerous from a health standpoint, but they surely are cosmetically unpleasant.

The greatest health risk produced by sun exposure is an increase in the chance of developing skin cancer. There are about 700,000 skin cancers reported each year, and 7,000 cases of the most deadly form, melanoma. Melanoma occurs 10 times more frequently in Caucasians than it does in African-Americans. This difference is primarily due to the protection from sun-caused skin damage provided by inherited, not sun-induced, skin pigment.

The risk of skin cancer increases as the amount of sun exposure increases, and this is particularly true for individuals with fair skin. Those with skin that burns easily instead of tanning are at greatest risk. Those who have several sunburns each year are at a greater risk than those who are constantly in the sun but do not burn. This occurs because repeated sunburn injury causes a marked increase in the risk of cancer, while constant exposure, with resultant tanning, provides some protection to the deep skin layers. This would seem to support the claim in the article you cite that maintaining a tan is beneficial. And it is, in about the same sense as setting fire to one's house with matches is less destructive than using gasoline and matches.

There is no such thing as a "healthy" tan. All tanning contributes to skin damage, and the damage is cumulative over the years. In the best case, tanning just makes you appear "old and leathery" by the time you're in your 30s or 40s. In the worst case, it makes you die prematurely from skin cancer.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.