Dangers of Tanning
My 15-year-old daughter, Wende, has a friend who goes to the tanning parlor three times a week with her mother. The mom works full time, so they started doing this last fall as a little outing that didn't take much time or money. Naturally, my daughter thinks that's the coolest thing on earth and would give anything to do the same with me – as she has told me on many occasions. What I won't let her give is her life.
You see, a couple of years ago at the urging of our family doctor who didn't like the look of a couple of her many moles, Wende had her first visit to the dermatologist. The dermatologist removed the moles, which were thankfully benign, and let us go with a chilling lecture. It turns out that Wende is at an unusually high risk for melanoma. She's a blue-eyed blonde, has fair skin and has more than her share of moles. She also has a family history of both squamous and basal cell cancers – on both sides of the family.
Although the lecture fell on Wende's deaf ears, it scared the heck out of me. I subsequently banned Wende from sunbathing, using tanning beds, going outside without sunscreen and even rolling down her socks when she was sitting on the bench waiting to bat. Does she obey? She does when I'm there. When I'm not, well, let me just say that I've noticed a few light tan lines already this spring. I don't punish her, but I do let her know that I see them and I reiterate that melanoma is a very bad thing that she doesn't want to get. There is no doubt that she is a lot more careful than she used to be, although whether that's out of true agreement or fear of lecture, I don't know. Frankly, I don't much care as long as it's working.
An Unhealthy Tan
Alan Geller, MPH, R.N., is an associate professor of dermatology at Boston University and a member of the American Cancer Society skin cancer advisory board. The rise in the use of tanning beds among teens disturbs him a great deal, particularly the mother/daughter tanning bed trend.
"This is not a case of a girl who is going to her junior prom, going in for one quick hit," says Geller. "These girls are going over and over throughout the year. The tanning industry is very good at creating cheap tanning packages that are very attractive to young girls."
The reality is that 7 percent of 14-year-old girls use tanning beds. At age 15, that number doubles. At 17, it doubles again, so by that age, 35 percent of girls are using tanning beds on a regular basis. Since the 14- and 15-year-olds don't drive, someone has to be taking them to these tanning parlors. More and more it seems to be Mom, who then checks into the booth next door.
Tan Now, Pay Later
Part of the problem is that what people do know about melanoma isn't nearly enough. The danger of sunburn has been well broadcast and has resulted in a phenomenal increase in the use of products to block the sun. What Geller doesn't feel has been as well explained is the fact that it's not just sunburns that are the problem, it's any tanning at all. Any change in the color of the skin means that the skin has been damaged. This damage may not be a problem when they're in their teens, but 10 years down the road it can become a life-threatening condition.
"The number of teens being diagnosed with melanoma is still very rare, but the sun damage they get in their teenage years can cause problems in a relatively short time," says Geller. "At age 25 to 29, melanoma is one of the two or three most commonly diagnosed skin cancers. What we need to get across to teens is that this isn't that far down the road for them."
In addition, in females the most likely spot for melanoma to develop is on the backs of the legs, which are often exposed to the sun. In males, it's their backs because of the habit many boys and men have of taking off their shirt when they're working or playing outside.
Mary Eversole of Hazard, Ky., had a melanoma removed from her leg in 1998. She had stopped using tanning beds years before after her doctor warned her about their danger, but that didn't stop the melanoma from forming in the exact spot where Eversole's leg would press against the glass of the tanning booth. Although her visible spot was tiny, about the size of a pencil point, she had to have a huge chunk taken out of her leg because of what is called the "iceberg" effect of melanoma. Just as only the tip of an iceberg actually shows through the water, melanoma can penetrate a great deal more of the body than the bit of itself that shows on the surface.
Dr. Joseph Germino, associate professor of oncology at the Cancer Institute of New Jersey, said this vertical growth phase is what separates melanoma from other skin cancers, such as basal cell or squamous cell.
"Melanoma has two kinds of growth phases: horizontal and vertical. The vertical growth phase is when it starts to penetrate deep into the skin and into the other layers of the body," says Dr. Germino. "Ideally, the horizontal growth phase lasts long enough for the melanoma to be detected and removed early. Some melanomas can get very aggressive and have a vertical growth phase early on."
As a result, a person can have a spot almost too small to be seen with the naked eye, while the cancer is silently, aggressively spreading through the body. This is why regular yearly checkups by a dermatologist who is skilled in detecting skin cancers is extremely important for those who may be at risk for melanoma.
Sun and Fun
Geller doesn't want to advocate that no one ever go in the sun. What he does want to do is make people more aware of how to block the sun as completely as possible while not giving up activities to do so. The Centers for Disease Control and Prevention has just started a movement to encourage schools to provide more shaded areas for play for children, such as more trees and awnings on playgrounds. Geller's group is starting a nationwide program to educate Little League and other athletic organizations on the importance of proper clothing for games played in the direct sun.
I'm jumping on the "proper clothing" bandwagon myself. A few years ago Wende's softball league went from wearing knee length pants and three quarter sleeve shirts to shorts and sleeveless jerseys. As a result, she has an ever-darkening tan where her shorts end and her socks begin – everywhere except on the scar where she had a suspicious mole removed last summer. It may seem like a step forward in fashion to the girls, but it's a big step backward for the health of their skin.