“When I look back on the things I did when I was younger,” says 49-year-old Kylee Baumle, a former sun goddess whose father and husband were recently diagnosed with skin cancer, “all those hours I spent working on my tan by the pool — I have to wonder, ‘What was I thinking?’”
It’s a good question — and one that many are asking today’s teens and twentysomethings, who, despite repeated warnings about harmful UV rays, continue to flock to beaches and tanning booths.
Melanoma is currently the second most common cancer among 20- to 29-year-old women, yet many continue to spend long hours “working on their tans,” like the now-remorseful Baumle once did. According to the American Academy of Dermatology, the incidence of melanoma has increased 690 percent from 1950 to 2001, and the overall mortality rate has increased 165 percent during this same period.
With that kind of disconnect, it’s no surprise researchers and health care professionals are racking their brains trying to figure out what speaks to this seemingly deaf and decidedly looks-conscious crowd.
Oddly enough, the answer may be vanity.
“Sitting in the sun definitely ages you,” says 16-year-old Claire Nelson, who uses sunblock every day, even in not-so-sunny Seattle. “I know I’m going to get wrinkles some day, but I don’t want to end up with wrinkles at age 20 from tanning.”
“Wrinkles are definitely more of a concern than skin cancer,” echoes Alex Doniach, a 23-year-old California native who recently moved to Memphis, Tenn. “When you’re in your 20s, you’re not thinking about the consequences of skin cancer. But I do think about that scary neighbor lady in ‘There’s Something About Mary,’ the one whose skin was completely fried and wrinkled and saggy. It’s like, ‘OK, let’s avoid that.’”
According to Dr. Heike Mahler, a professor of psychology who focuses on cancer prevention at the University of California, San Diego, these thoughts are very much in sync with those of the 2,000 or so college students she’s conducted tanning studies on over the last decade.
Wrinkles scarier than cancer?
“With health-based approaches, people learned about the dangers of sun exposure and UV exposure, but there was very little evidence of actual behavioral change, especially with younger people,” she says. “The threats were probabilistic and in the distant future so they weren’t all that threatening, especially with the strong motivations for tanning behavior. There’s a real cultural pressure to be attractive and a tan is perceived as part of that attractiveness.”
So Mahler decided to hit today’s sun gods and goddesses where it hurts — right in their self-image. She and her researchers started showing college students images of people with heavy wrinkling and age spots, then followed up with Polaroids of their own sun-damaged skin, captured with a ultraviolet camera, which reveals age spots and uneven pigmentation not yet visible to the naked eye.
“We show them what their skin looks like just below the surface,” she says. “Most of these individuals already have quite significant sun damage. People are visibly shocked when they see the photos and it seems to have a strong, immediate impact.”
In a 2006 study published in Basic and Applied Social Psychology, Mahler and her colleagues used these “appearance-based interventions” on 244 Southern California beach patrons ranging in age from 18 to 67 at the very start of summer, then followed up with interviews three months later. Results showed the message sunk in: Test subjects not only talked the sunblock talk, they walked the sunblock walk.
A new study in this month’s Health Psychology involving 133 UCSD students shows Mahler’s “in your face” intervention actually resulted in sun-smart behavior for a full year.
“This latest study shows it’s not just them trying to make us happy by saying, ‘Yes, I’ve used more sun protection,’” says Mahler. “We can document that their skin is less tan.”
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Tanorexics: Hooked on UV
But just as researchers are finding new ways to curb tanning habits, other evidence suggests that even those who want to quit may not be able to because tanning is addictive. Two recent studies at Wake Forest University Baptist Medical Center in North Carolina have shown that UV light produces a “relaxing” effect and that “frequent tanning may be driven in part by a mild dependence on opioids, most likely endorphins.”
In March, the Journal of the American Academy of Dermatology published a study involving 385 students at the University of Washington that found 12 percent had developed a dependence on UV light in the same way people exhibit a dependence on alcohol or drugs. Students who purposefully tanned were given a questionnaire used to identify substance-related disorders with questions such as “Have you ever felt you ought to cut down on your tanning?” and “Have you ever thought about tanning first thing in the morning?”
While 12 percent of all the students indicated a substance-related disorder with regard to UV light, 18 percent of outdoor tanners and 28 percent of indoor tanners seemed to be hooked. What’s more, even participants with a family history of skin cancer engaged in tanning — 77 percent purposefully tanned outdoors and 45 percent used indoor tanning beds.
“The fact that tanning may be addictive for some individuals should strengthen the argument for stricter regulations on the indoor tanning industry,” says Dr. Robin Hornung, chief of dermatology at Children’s Hospital & Regional Medical Center in Seattle and author of the study. “Education alone is not enough to stop high-risk tanning behavior, and skin cancer rates will continue to increase markedly without proper intervention.”
Are “tan bans” the answer?
“No one is implying that people should never be outside or participate in sports or outdoor activities; they just need to do it in a sensible way,” says Dr. Arielle Kauvar, clinical associate professor of dermatology at New York University School of Medicine.
“But since it is addictive, tanning behavior needs to be approached in much the same way that alcohol, cigarette smoking or drug addiction is approached. Short of banning tanning lamps altogether, we could at least try to prevent minors from having access to indoor tanning and post medical warnings about the hazards of indoor tanning,” she says. “And if we can protect people from ever starting, we’re better off than trying to modify their behavior once it exists.”
Unfortunately, there are a few roadblocks. You may know them as Paris, Lindsay and Jessica.
“If celebrities would take up the cause, that would help tremendously,” says UCSD’s Mahler. “If we could show college students images of beautiful models who are not tan, or celebrities would come forth and acknowledge that they’re getting spray-on tans rather than subjecting themselves to harmful UV rays, it would have a huge impact.”
As would, perhaps, a few former tanners owning up to the long-term effects of their habit.
“I’ve got a lot of crinkly wrinkles under my eyes and I know it’s from what I did when I was a teenager,” says Kylee Baumle, who now covers up before she heads out to work in the gardens surrounding her rural Ohio home. “Old habits are hard to break, but you just have to change your ways.”
Diane Mapes is a Seattle freelance writer and author of "How to Date in a Post-Dating World."
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