Tanning beds and young adults
Today was interesting, I had a 22 year old female patient come see me and she incidentally mentioned that she was using a tanning bed. Now this is a little of a bit of dilemma to a dermatologist. At this age group, if I give unrequested information about the risks of tanning; the patient will typically look at me while dazedly nodding their head in agreement. Inside they are really thinking that this information does not apply to them and why is he lecturing me. . If I say nothing then I lose the chance to plant the seed of realization of the most important skin fact of her life. Of course by age 40, they will listen but the damage is already been done by then.
So, the conversation began. Lets hypothetically say her name is Tammy. “How often do you tan?,” I asked. Tammy grudgingly replied, knowing what was probably coming, “Once or twice a week at my tanning salon.” I pondered how I could get through to her and then said, “I would rather you tan at the beach.” She looked at me in disbelief, “you would rather I tan at the beach?” “Yes,” I replied. She asked, “Why?” “Because in the tanning booth you will get a weeks worth of sunlight in 6 minutes, if you go to the beach you may only get a day in.” I discussed that only cream proven to prevent wrinkles is sunscreen. She said, “Oh I use that on my face, I just tan my body.”
My explanation to that was to look at women in their 40’s who have followed that idea. They look like someone pasted their younger looking heads on an older person’s body because the color difference is so dramatic. To go further,” of course you look good with a tan. You have young skin. Young skin is the most beautiful thing you will ever see.” I continued, “ look at a babies skin sometime, no freckles, smooth, perfect.” Kids will often begin their life long enamoration with sunlight because association with independence they experience at the beach for the first time in their lives. Their friends are running around in bikini’s, the boys all have muscles. Compliments are given for perhaps the first time. Romance is in the air. Remember most of your hangups and beliefs about ourselves are created during early teens and adolescence. So is the desire for a tan/compliments/freedom. Well, at least she was wearing sunscreen on her face. I said to her, “I understand why you like to tan, you feel your skin looks better with a tan now, but what about later?” I explained that there is a major change in the body and brain from age 12 to age 22. Not so big of change in the brain from age 22 to 32 but a slight change in the body. Even less change of the brain from age 32 to 42 and a major change in the body. Your brain with all the desires that you have today will be in a 42 year old body someday and you will wish that you did not do the damage that you are doing right now. Please eliminate the tanning bed.
She actually looked at me and honestly thanked me and said
she would do her best to not tan.
Doctors can often tell when patients are lying, or saying something that
they will not do. We learn this through daily
experience of advising people and following up with them. I think that I honestly got through to
her. This is a rarity for this type of
interaction. Usually the patient will
never come back because at this age it sounds too much like unasked for parental
advice. Of course at some point in their life, they remember that dermatologist that said....
Comments
All the best,
April Braswell
Romance Coach, Online Dating Coach
making your skin more beautiful
Scott A Bell
I've never been to a tanning booth. They scare me! But I remember when I was living in Sweden that was one thing that many, many Swedish girls/women did...regularily. I wonder if it is still the thing to do over there?
Jennifer Skinner
Wardrobe Planning, Style Development
Thanks for the advice, now if I can get my daughter to accept it, I'll be go to go!
John
"Because in the tanning booth you will get a weeks worth of sunlight in 6 minutes, if you go to the beach you may only get a day in."
I find it disturbing that you would simply make up statistics in order to prove a point. Wouldn't it be more appropriate to be honest and to counsel her on moderation, whether at the beach or in a tanning bed?
Tanning beds do destroy your skin, but eventually our skin will be destroyed by something anyway. Rarely do I see an 80 year old with skin I envy.
The history of tanning is interesting as well. Prior to WWII, people never considered a tan sexy, (You mean you "want" to look like a field hand?"), but all the men returning with a tan from the South Pacific after kicking Japan's ass made it a fashion statement.
And another thing, salespeople develop a great lie detection system as well, since they get lied to all the time.
Steve Chambers
Sales Training Expert
Dr Helton provides NO scientic data to support his claim concerning indoor tanning verses sun tanning. In fact, there is NO such data to support his claim. This type of public information is dangerious since most people believe everything a doctors tells them. Dr Helton knows or should know that the human body requires sufficient amounts of Vitamin D3 to remain health and the ONLY way for the body to product sufficient amount is through u.v. light exposure and that supplements or food will NOT provide enough Vitamin D3.
90 percent of skin cancers are non-melanoma cancers. The most common forms are basal and squamous cell carcinomas, which are much less serious. They're benign and are easily cured by simple outpatient surgery. These are the ones caused by solar radiation. Melanomas, on the other hand, are most likely caused by lack of sunlight and excess artificial light.
"UCSD's Moores Cancer Center found that people with high blood levels of vitamin D had half the risk of breast and colon cancer of those with low levels. "
"In a Harvard School of Public Health study in 2006, researchers found that people who took in the highest amounts of vitamin D cut their risk of pancreatic cancer almost in half compared with those with the lowest intakes."
The best way to get your vitamin D is to get regular, moderate UV exposure. A sensible amount would be to get 1/4 the amount of exposure that it would take to get pink. That amount will vary based on latitude, time of day, season, altitude, cloud cover, as well as skin color. Someone that is fair skinned, but has a tan will require more exposure time than if they had no tan. A tan acts as an SPF and could block as much as 90% to 99% of the vitamin D producing UVB radiation*.
N Engl J Med 2007;357:266-81.*Dr. Holick's article Vitamin D deficiency,
Copyright © 2007 Massachusetts Medical Society.)
Doctors know or should know that most sunscreens are toxic. Simply Google "sunscreen toxic". Doctors who suggest that applying sunscreen is safe is like when doctors said smoking cigarettes was good for stress.
Is there any way to do early skin cancer detection? And can cancer occur from the result of one or a few bad burns?
Aaron
However you didn't address the point that Dr. Helton was making about artificial tanning. Would you advise your client to go and sit in a tanning bed until they were pink as your article suggests?
I also have my hang ups about sunscreen something that I admit I don't use at all.
Focus Your Energy
Matthew Shields
I like the sun and I hate sunscreen. But I know I should use it. Kind of like a lot of things. This is great advice though and it would be better if the habit were established at an early age to protect.
Rob Northrup
Is Your Corporation Protecting You?
Dr. Helton, I do so love your posts even when I'm guilty of the crime! Yes, I use tanning beds, and I know this sounds stupid, but I use them because I don't like to get sunburns. I tan gradually in the bed then at the beach I never burn. I live in a seaside town - we go to the beach here, that's what you do in the warm weather. And there's no way in *&%$ I'm going to the beach in my bikini looking like casper! I know that I'm starting to pay the price, but heck I'm in my 40's, in a few more years it won't matter if I'm brown, white, plaid, wrinkled, spotted whatever so I might as well look good while I still have the option.
I think I can feel you wanting to grab me by the hair and yell "Hello!" in my ear right through my computer screen.
Good post Peter. It's always difficult to influence people to change their habits when the consequences aren't obvious for over a decade. Few people think that far.
Yann
Yann Vernier - Personal Coach UK
Interesting this post has brought some tanning bed advocates out of the woodwork. As far a weeks worth of tanning in 6 minutes, that all depends on the person. Because most average people work 40 hours a week, I would argue that the average person does get a weeks worth of sunlight in 6 min of a tanning machine,
As far as the studies that are being quoted, Agreed, Vitamin D is essential. That is why it is a vitamin. Dr. Michael Holick is the foremost researcher on Vitamin D. Yes he makes some interesting claims. I am not a researcher. I am speaking from my experience with everyday patients and their feelings about the effect of sunlight and aging. Claims regarding disease resulting from Vitamin D deficiency pale in comparison facts of people who are having their noses removed due to skin cancer. Basal cell cancers do not result in death, but squamous cell can. Both are induced by UV rays. Consequently to label these conditions as benign is a spin that anyone with a good conscience cannot agree with. Of course there are no scientific studies comparing the actual verses UV light. Based on what we know, that would be an unethical experiment.
Moreover, to say melanoma results from lack of sun exposure? Preposterous. The melanoma capital of the world would disagree with you. Go to Australia and make that claim.
As far as sunscreens blocking all vitamin D production. This is untrue as well as noted that many people still tan though their sunscreen.
Lastly,has anyone ever read the consent form that must be signed prior to using a tanning facility? It pretty much summarizes everything the things we have just mentioned. Bottom line, it is your life and people need to make their own decisions. Dont take my word for this, ask your doctor what they think. I am just one guy trying to make peoples skin more beautiful
Or everyone could hole up in their basement for some internet marketing work. See you in a few years.
Sheridan
"...nearly three decades of efforts using a variety of in vitro and in vivo models of human skin and mouse genetic models have produced conflicting data. Epidemiologic studies have also failed to establish a definitive association between UV exposure and risk of melanoma." --Role of UV in cutaneous melanoma. Maddodi N, Setaluri V. Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA. January 29, 2008.
Intermittent UV exposure (I read this as pale, then burning) has an increased risk of melanoma, but heavy occupational UV exposure correlates with a reduced risk of developing melanoma.
http://www.ncbi.nlm.nih.gov/pubmed/9335442
(Parenthetical comment is mine, not part of the original quote.)
Again Dr Helton, you provide NO data to substantiate your claim that 6 minutes of tanning bed exposure equates to a weeks worth of sun light exposure. What are you suggesting a "weeks worth" of sun exposure is? Further, what tanning bed are you referring to? In order to make a valid claim, usually one needs to provide all the details of the comparison.
No comment about the well known and well published FACT that most sunscreens contain toxic chemicals?
WASHINGTON, March 25 – The bodies of nearly all Americans are contaminated with a sunscreen chemical that has been linked to allergies, hormone disruption, and cell damage, according to a new study from the Centers for Disease Control (CDC). A companion study from the Mt. Sinai School of Medicine found that the same chemical is linked to low birth weight in baby girls whose mothers are exposed during pregnancy.
The chemical, oxybenzone, is widely used in sunscreens. Environmental Working Group's (EWG) analysis of ingredient labels found that nearly 600 sunscreens sold in the U.S. contain oxybenzone, including products by Hawaiian Tropic, Coppertone, and Banana Boat. Although oxybenzone is most common in sunscreen, companies also use the toxic chemical in at least 567 other personal care products, including lip balm, lipstick, moisturizers and fragrance for women. http://www.ewg.org/node/26217
The high rate of natural production of vitamin D3 cholecalciferol in the skin is the single most important fact every person should know about vitamin D because it has such profound implications for the natural human condition.
Vitamin D is a steroid hormone precursor that has recently been found to play a role in a wide variety of diseases. Current research indicates vitamin D deficiency plays a role in causing seventeen varieties of cancer as well as heart disease, stroke, hypertension, autoimmune diseases, diabetes, depression, chronic pain, osteoarthritis, osteoporosis, muscle weakness, muscle wasting, birth defects, and periodontal disease.
This does not mean that vitamin D deficiency is the only cause of these diseases, or that you will not get them if you take vitamin D. What it does mean is that vitamin D, and the many ways in which it affects a person's health, can no longer be overlooked by the health care industry nor by individuals striving to achieve and maintain a greater state of health. http://www.vitamindcouncil.org/
It is well known that the ONLY way humans naturally produce Vitamin D3 is by exposing the skin to u.v. ligh.
They found that since 1986, skin biopsies have risen by 250 percent, a figure nearly the same as the rise in the incidence of early stage melanoma. But there was no change in the melanoma death rate. And the incidence of advanced disease also did not change, the researchers found. It makes sense for a doctor to look at your skin during a regular physical exam, Dr. Ackerman said, but screening programs have led to an excessive zeal for skin biopsies and for diagnosing melanoma. "There has been a mania for taking off these moles that are of no consequence," Dr. Ackerman said. "We're talking about billions and billions of dollars being spent, based on hype."
http://www.nytimes.com/2005/08/09/he...gewanted=print This article is very interesting and worth reading Dr Helton.
In fact Matt, there is NO difference in the wave length light energy (uva & uvb) produced by a tanning bed as compared to the sun. The real diiference is that a tanning bed produces a known quantity of uva & uvb in a specific amount of time. Almost impossible to determine that from the sun while at the beach.
As for me suggesting that I "advise your client to go and sit in a tanning bed until they were pink as your article suggests?" Where did you get that from? I'll be happy to engage you in responsible debate but not when people just make up accusations that are pulled out of the sky.
I did revist your last posting and have to retract my last statement about your advice to clients, I did mis read your post.
I also have the same opnion as you as far as sunscreen being comprised primarily of chemicals which is why I choose not to use them.
My problem with tanning beds is based on the same principal. It would appear that you are an advocate of the usage of the beds as long as the usage is kept to an imaginary bench mark.. Is that correct?
My problem with the technology is that as you mention everyone is different. Tanning salons are run by uneducated, uninformed individuals. The difference of just one minute can make a huge difference in the out come of your session. An employee of a tanning salon has no way to determine a safe exposure time is going to be from one client to the next.
Again I am taking this from the context of your posts but I am under the assumption that you are an advocate of tanning. If this is the case then I would like your opnion on how to determine the proper exposure time for each client. A figure of a 1/4 of the time it takes to get pink in my way of thinking is not a viable calculation.
Focus Your Energy
Matthew Shields
"Tanning salons are run by uneducated, uninformed individuals. "
Should I be offended by this? Do I sound uneducated and uninformed?
In my opinion, a person that insists on blogging on a subject they know nothing about qualifies as the poster child for the uneducated and uninformed.
The amount of UVB exposure required to turn you pink is a minimal erythemal dose (MED). This amount of irradiance will vary based on skin type. Skin types are graded from I to VI. Each tanning unit, by law, has an exposure schedule based on skin type. It will tell you how long to stay each visit and how often you should visit. The first visit should be limited to 1/4 MED and can be buiilt up to a maximum session of 4 MEDs over the period of 4 weeks. This is the maximum mandated by the FDA.
Many states require training for salon workers, many don't. If you go to a salon that can't explain skin typing and exposure schedules, find one that can.
"has anyone ever read the consent form that must be signed prior to using a tanning facility? It pretty much summarizes everything the things we have just mentioned. Bottom line, it is your life and people need to make their own decisions. Dont take my word for this, ask your doctor what they think. I am just one guy trying to"
I'm sure EVERYONE has read a copy of the consent forms required at a doctors office or hospital. That also pretty much sumerizes everything being discussed here. I do agree with Dr Helton on his point that, "is your life and people need to make their own decisions". People should do their own research and find out for themselves what's going on and not always run to a doctor for simple advice. To advise humans to stay out of the sun and apply toxic chemicals to their skin, the same sun that has nourished mankind for eons, seems to be morally unacceptable. I've had the pleasure however, of reading a few other posts by Dr Helton and find them to be very informative and in the spirit of good health.