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Tanning beds & death beds. Tell me the difference again …

BFT readers are well aware of the relationship between sun exposure and skin damage. UVA and UVB exposure from the sun accounts for 80% or more of skin aging and increases the odds of developing the common types of skin cancer. Is it any surprise then that “artificial” sun exposure from tanning beds might carry similar risks? At least as far as basal cell carcinoma goes, that relationship has now been confirmed by researchers from the Yale School of Public Health who recently published their finding online in the Journal of the American Academy of Dermatology.

Compared to those who have never used it, young people who use indoor tanning have a 69% higher risk of developing basal cell carcinoma (BCC). The risk is strongest among women, the gender most likely to use tanning devices, and goes up with every year of use. The study found that 27% of early-onset BBC could be prevented when genders are combined if indoor tanning is avoided. For females as a group that rate of reduction leaps up to 43%.

BCC is the most common type of skin cancer, it rarely spreads or kills, but it can invade surrounding tissue and cause unsightly disfigurement. Most occur on parts of the body that are repeatedly exposed to the sun, such as the head and neck, but there appears to be an increase in cases of them appearing on the torso.

For the study, researchers interviewed 376 patients diagnosed with BCC and 390 controls without BCC who had been diagnosed with minor, benign, skin conditions. All subjects were under 40 years of age. They answered questions about whether they had ever used indoor tanning, and if so, at what age they started, how often they used it, how long did sessions last, the number of burns received as a result of tanning, and the type of tanning machine.

The analysis showed that:
• Ever using an indoor tanning machine was linked to a 69% higher risk of early-onset BCC
• This link was stronger among young women, for those who developed more than one BCC, and for those whose BCCs appeared on the torso or extremities
• The risk went up in a “dose-dependent” fashion for each of 3 variables: each year of indoor tanning, number of overall burns, and burns to biopsy site

The researchers conclude: “Indoor tanning was a strong risk factor for early-onset BCC, particularly among females. Indoor tanning should continue to be targeted by both policy-based and behavioral interventions, as the impact on BCC-associated morbidity may be substantial.”

Indoor tanning is already linked to melanoma, a less common but much deadlier form of skin cancer that is also increasing among young women. Estimates suggest around 30 million Americans use indoor tanning beds every year, with young women being the most common users.

Again, BFT wants to ask “just how important is that suntan?” Why not opt for the safer, faster “spray-a-tan?”

BFT is a strong advocate of sun protection whenever outdoors. For those who are determined to continue using tanning beds, we now suggest sun protection indoors as well. No one wants wrinkles but we bet most people want skin cancer even less.

PS: As you regular readers know, we are deep into the world of cytokines (cellular messenger molecules) and their role in aging. There are within your skin melanocyte stimulating cytokines. This cytokine family is secreted by skin fibroblasts (in response to UVB exposure) and keratinocytes (in response to UVA exposure). Tanning is an adaptive response whereby melanin (dark pigment) is produced by melanocytes, a third cell type in skin. The trigger is just light, right? Kind of like photosynthesis in a plant, but brown instead of green? Nice, natural, harmless? NO! ~ The trigger seems to be DNA damage (ouch!). DNA within skin cells are able to sense damage from UV light. In response, several cytokines are released that act both on the cell in which they are produced, and other cells in the area, to counteract the effects of DNA damage. The altered cytokine profile results in inflammation through attraction and activation of immune system cells, activation of collagen degrading enzymes, dilatation of blood vessels, etc. This inflammation is what ultimately results in fine lines, wrinkles, and dyspigmentation (color change). The older you get, the more healing becomes this inflammatory type. Over-expression of melanogenic (and related inflammatory) cytokines is responsible for age-related pigmentary changes. Like “age spots”.

So, every time you are tempted to go unexposed into the sun or tanning bed, remember that your primary defense signaling system is damage to your skin’s very precious DNA — the very stuff that when damaged can lead to mutation and then on to many types of cancer, as this post demonstrates.

4 Comments

  1. Anna says:

    Great site, lots of good information.

    I have one question about tanning beds: Is it accetable to use tanning beds as a “cure” for atopic skin? I have very atopic skin and also eczema. I have noticed that solarium helps my skin a lot. I dont use tanning beds for the tanning purposes, only to treat my skin. What is your opinion about this kind of use? I think I also have to mention that I live in Scandinavia, where we have very short summers, and I use tanning beds only winter times, when the skin is at its worse condition.

  2. Drgeorge says:

    Great question, Anna, and an important one. Atopic dermatitis has indeed been treated with varying success with UV light for quite a long time. The first link below will take you to an an abstract from a 1985 article (from Scandinavia) that discusses this very issue.You will note that a relatively common side effect of UV treatment is 2nd degree “sunburn” It is provided as background as this 1985 article is not indicative of current thinking. For that I suggest you visit the second link below which is the atopic dermatitis section on the National Arthiritis and Musculaoskelatal, and Skin Disorders website (a division of the United States National Institute of Health.).

    There are immunomodulation approaches using new drugs that are based on much more current understanding and knowledge about cellular signalingi.(i.e. cytokines.) You are no doubt aware of the role streroid tratment, both topical and systemic, has historically had in treating this condition. You are also probably aware of the numerous side effects steroid therapy can cause, some quite serious. A more focused and targeted pharacologic approach is preferred – a rifle approach vs a blunderbuss. The newer tharapies target the source of the problem at a specific cellular level.

    You will notice in the discussion about UV treatment of atopic dermatitis on the NAIMS website that concern remains about the possible UV complications of skin aging and carcinogenesis (cancer). Judicious use of the minimal exposure to control the condition seems prudent to say the least.

    http://www.ncbi.nlm.nih.gov/pubmed/3859162

    http://www.niams.nih.gov/Health_Info/Atopic_Dermatitis/#i

    An additional in-depth review of atopic dermatitis can be found at the link below from the Journal of Clinical Investigation – well worth the read albeit highly detailed.

    http://www.jci.org/articles/view/21060

  3. Kristina says:

    Hi Docs,
    Speaking about UV radiation, is it true that vitamin A is a photo carcinogen or leads to more free radicals when exposed to sunlight? I have always worn sunscreen but recently read that most sunscreens contain vitamin A, which doesn’t seem healthy if exposing vitamin A to sunlight ends up damaging your skin further. So I switched to mineral sunscreens that use Zinc and Titanium Dioxide as the UV-blocking agent, but I am wondering if they are as affective?

  4. Drgeorge says:

    Kristina, your question is a great one and will be the subject of two future topics – one on sunscreens and another on vitamin A in skincare – so stay tuned.
    The short answer is certain animal studies (hairless mice) showed one form of Vitamin A (retinyl palmitate) and UV light exposure resulted in increased skin cancer rates. The data was mixed on treninoin (Retin-A), and so-far unknown for retinol, which is known to have potential to increase sensitivity to UV light. On the other hand, retinoids (the vitamin A analogs) have proved value in overall skin health and anti-aging effects.
    Vitamin A, in one its form or another, is an ingredient in many skin care products. It is reasonable to avoid products intended for sun exposure i.e. sunscreens with vitamin A and seek it out for nighttime moisturizers. Use of particulate dispersion sunscreens that diffuse and scatter light with solid particles (e.g. zinc and titanium oxide) is an effective way to block UV exposure and is an old technology.

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