I left the country, and went to a tanning bed, both for the first time while in 5th grade. I was 10 years old. Circa 1984, my parents had planned a trip to Mexico and my mom had been poorly-advised that it was a good idea to have my brother and me ready with a “base tan” prior to travel to prevent sunburn. This was unlikely to have come from a doctor, but who knows. It was the 80′s after all.

My mom took us to the local strip mall where I spent multiple 1/2 hour sessions in that warm, sweaty, purple glow encased between 2 rows of light bulbs, the grocery store to my left and the new VHS video store to my right. I remember the stomach sticker I used to obscure the UV light during tanning that marked the progress of our sessions. I remember how excited I got about traveling. I remember how this formed an initial groundwork for my skewed idea that getting a tan marked some sort of achievement. I remember how I used to get praised for my ability to tan when we’d return home to Minnesota.

I also remember that I got the only blistering sun burn in my life from a tanning bed while still under the age of 18. Not good.

I share this because tanning is a misinformation issue. Children and teens may have no idea what risk they take when getting a tan (or a burn) and some parents often have no idea the danger of these tanning beds pose. The argument for “this may cause cancer” often doesn’t resonate with a teen. It’s simply too remote, too far off, or too “grown up” a concern. I’ve found talking about the truth behind wrinkles may be a better angle…

This week the Academy of Pediatrics (AAP) stepped up. The AAP published a policy statement describing the effects of UV light exposure in children while pushing for a ban on tanning in children under age 18. The statement starts off by articulating that “sunlight sustains life on earth.” This time of year here in Seattle we’re particularly aware of this…

The Policy Statement outlines the risks of ultraviolet radiation (UVR) and the hazards of tanning beds among other risks like sunbathing without sunscreen/UV protection. Tanning beds (and sunshine) increase the risk of cancer because they provide UV light radiation which ultimately damages our skin and proliferates/stimulates growth of moles. The more moles you have, the more likely one can develop into a melanoma, basal cell, or squamous cell cancer. As the AAP states,

Public awareness of the risk [of tanning beds] is not optimal, overall compliance with sun protection is inconsistent, and melanoma rates continue to rise. The risk of skin cancer increases when people overexpose themselves to sun and intentionally expose themselves to artificial sources of UVR. Yet, people continue to sunburn, and teenagers and adults alike remain frequent visitors to tanning parlors.

So what can we do? Arm ourselves with facts both about tanning beds, and UV radiation, in general. I learned a lot from the AAP statement. Here’s 10 take away tips from their statement we can all use to help our children enjoy being outside in the sun while acknowledging how to protect them from the ill effects of natural and artificial UVR.

10 Tips on Tanning:

  1. UVR, Radiation Effects: Loving the sun is not the problem. It’s sensible to crave sunlight; the sun promotes feelings of well-being while sunlight is essential for vitamin D synthesis in our skin which can mediate mood amongst all sorts of other goodness-es. The sun provides ultraviolet radiation however, so we need to balance the benefits of sunlight with the risks of UVR, particularly in children. UVR is harmful because damages skin and evidence supports a strong causal relationship between sunlight exposure and skin cancer. In particular, there is a heightened risk of melanoma for those with increased childhood sun-exposure. UVR is made up of UVA and UVB waves of light. This is handy: UVB light is the light that Burns, and UVA light is the light that causes your skin to Age (wrinkle).
  2. Minimizing UVR: Ways to minimize UVR in life include not allowing your skin to burn, avoiding suntanning, and avoiding tanning beds altogether. Things you already know are true: wearing hats and long sleeves, sunglasses, and sunscreen in addition to sitting in the shade reduce your exposure. Yet, one thing to keep in mind: sand, snow, concrete and water can reflect up to 85% of sunlight, thus intensifying its effects, and ultimately our exposure to radiation. Midday (10am to 2-3pm) is most intense. UVR ultimately causes our skin to get red with excessive exposure (sunburn). How easy this burn happens depends on what time of year it is, what time of day it is, and ultimately what type of skin you have (the paler you are, of course, the higher the risk). Tanning is a protective response to sun exposure from our skin cells, but any tanning still reflects damage to the skin. And ultimately, the more tanning, burning and UVR our skin gets, the weaker our skin’s elasticity becomes. Translation: aging. Repeated tanning and sunburn results in sagging cheeks, deeper facial wrinkles and skin discoloration. Explaining this to your teen is a great way to help them understand why you don’t want to have a tan on your face if you can avoid it. Help them minimize their UVR.
  3. Risk of Cancer Increasing: The risks of sun exposure and artificial UV light (like tanning beds) has proved to contribute to risk of cancer. Melanoma incidence has been increasing for the last 30 years, with young white women rising dramatically (3% increase yearly since 1992!). The rise in melanoma is attributed to the earth’s decrease in ozone, clothing with more skin exposure, and increased exposure to artificial UVR for tanning purposes (tanning beds). Although melanoma (the most deadly kind of skin cancer) represents less than 5% of all skin cancers, it causes by far the most deaths. This isn’t just old people; melanoma can occur in teenagers and young adults. Melanoma skin cancer is the second most common cancer of women in their 20′s, and the 3rd most common cancer of men in their 20′s. Kids/adults at highest risk for melanoma are those with family members with melanoma, light skin, those with lots of moles and freckling.
  4. Tanning Bed Use:Tanning beds and sunlamps are the main sources of artificial UVR. The intensity of the UVA radiation by powerful tanning units may be 10-15 times higher than that of the midday sun! Ten to 15 times higher. About 1/4 of all teenagers with white skin have stated they used tanning facility in their lives. In another survey, 10% of t(w)eens age 11 to 18 had used indoor tanning in the last year. So this may not be as rare as you think. Furthermore, side effects to tanning in addition to sunburn are dryness, nausea, photo-drug reactions (reactions to sun exposure because of acne medication, for example), and disease flares (like patients with lupus).
  5. Sunscreen Recommendations: I wrote an entire blog about using sunscreen, but the skinny here: you need sunscreen with UVA and UVB coverage (read the bottle). It’s ideal to apply sunscreen 20 minutes before in the sun, and reapply it to body every 2 hours or so while in the sun. More often if playing in sand and water. You need 1 oz (a shot glass) to cover your entire body. The number of SPF for sunscreen is less important than how you use it. Further, using UV swimsuits and clothing may be an even better way to protect young children.
  6. Getting Vitamin D: Sunshine/sunlight exposure and vitamin D are intertwined. You get vitamin D two ways: from your diet (egg yolks, fortified milk/daily, fatty fish) or from the sun. If your child is not getting UV exposure, they will still get necessary vitamin D by taking supplements (400 IU daily) or by altering their diet. Children living in the north (above 35 degree) may be at higher risk as there is limited UV exposure in the winter. Talk with your pediatrician about vitamin D supplementation.
  7. Myth of The Pre-vacation Tan: Many people believe a pre-vacation tan will protect them from a dangerous burn. The reality is the opposite. Pre-tanning before a tropical vacation lead to extra radiation due to exposure before vacation (tanning bed) and also on vacation because people tend to use fewer protection precautions during the vacation thinking their tan will protect them. Studies suggest a prevacation tan only provides the equivalent of a SPF of 3.
  8. Supporting ban on tanning beds for minors: Nobody likes to be told what to do. However, there is concern that teens simply don’t understand and aren’t aware of real risks to tanning. Many states have laws that require parental permission, but most are not up to age 18 years. The AAP joins the WHO, AMA and the American Academy of Dermatology in supporting legislation to ban use of artificial tanning by people under age 18.  No need to have an MD to take this stand, of course. As a parent, you can support this too. From activism and advocacy in your own home (banning use) to community involvement.
  9. You Can Get Warm Other Ways: Some teens suggest tanning beds elevate their mood and serve as a “warm up” during winter months. Find sincere alternatives for teens like “hot yoga,” exercise, and time with friends. Time and money can be spent other ways. If your teen has already been tanning, don’t just take away tanning, Chose a plan where you substitute activities and put the same amount money into another desirable activity. Consider spray tans and tanning lotions as the main motivation for tanning is coloring the skin. There are many safe and affordable products available.
  10. Teach Teens Not To Be Fooled By Temperature/Trees: Shade can be deceiving. “A fair-skinned person sitting under a tree can burn in less than an hour.” Don’t let teens be fooled by temperature. You can get a gnarly sunburn while skiing in the mountains (snow is reflective, the sun can be intensified) or on a cold day in the sun. Sun and heat are not the same. We need to ensure teens understand that the sun and UVR are strongest particularly near equator and during summer. And that temperature bears no connection to the sun’s ability to burn our skin.

What’s your story? You been stuck between those purple lights, too? What do you think about the ban; does it irritate your sense of liberty?