A tan, whether you get it on the beach, in a bed, or through incidental exposure, is unhealthy. Tans are caused by harmful ultraviolet (UV) radiation from the sun or tanning lamps, and if you have one, you’ve sustained skin cell damage. The cumulative damage caused by UV radiation can lead to premature skin aging (wrinkles, lax skin, brown spots), as well as skin cancer. In fact, people who first use a tanning bed before age 35 increase their risk for melanoma by 75 percent.
JAMA Dermatology has released a study, “International Prevalence of Indoor Tanning — A Systematic Review and Meta-Analysis.” In the US, 35% of adults and 55% of college students have tanned, and the study found there are more than 419,000 new skin cancer cases attributable to indoor tanning each year. Worldwide, there are more skin cancer cases due to indoor tanning than there are lung cancer cases due to smoking.
The Skin Cancer Foundation recommends that people of all ages, genders, and ethnic backgrounds avoid indoor tanning and take precautions in the sun by limiting outdoor time between 10 am and 4 pm, seeking the shade when outdoors, using a broad spectrum SPF 15+ sunscreen (SPF 30+ sunscreen for extended stays outdoors), and wearing protective clothing, including wide-brimmed hats and UV-blocking sunglasses.
Sunburn, also called erythema, is one of the most obvious signs of UV exposure and skin damage. Often marked by redness and peeling (usually after a few days), sunburn is a form of short-term skin damage. When UV rays reach your skin, they damage cells in the epidermis. In response, your immune system increases blood flow to the affected areas. The increased blood flow is what gives sunburn its characteristic redness and makes the skin feel warm to the touch. At the same time, the damaged skin cells release chemicals that send messages through the body until they are translated as a painful burning sensation by the brain. White blood cells, which help protect you from infection and disease, attack and remove the damaged skin cells. It is this process of removing damaged cells that can cause sunburned skin to itch and peel. The earliest signs of sunburn are skin that looks flushed, is tender or painful, or gives off more heat than normal. Unfortunately, if your skin tone is medium to dark you may not notice any obvious physical signs until several hours later. It can take 6 – 48 hours for the full effects of sunburn to appear. The American Academy of Dermatology (AAD) recommends treating mild sunburn with cool baths, over-the-counter hydrocortisone creams, and aspirin to ease pain and swelling. Severe sunburn should be treated as a medical emergency and examined by a doctor right away. Severe sunburn is often characterized by a large area of red, blistered skin with a headache, fever, or chills. Sunburn can be a very painful effect of UV exposure. Studies have shown a link between severe sunburn and melanoma, the deadliest form of skin cancer. Pay careful attention to protecting yourself from UV rays.
There is no such thing as a safe tan. The increase in skin pigment, called melanin, which causes the tan color change in your skin is a sign of damage. Once skin is exposed to UV radiation, it increases the production of melanin in an attempt to protect the skin from further damage. Melanin is the same pigment that colors your hair, eyes, and skin. The increase in melanin may cause your skin tone to darken over the next 48 hours. Skin tones that are capable of developing a tan, typically skin types II through V, will probably darken in tone within two days. Evidence suggests that tanning greatly increases your risk of developing skin cancer. And, contrary to popular belief, getting a tan will not protect your skin from sunburn or other skin damage. The extra melanin in tanned skin provides a Sun Protection Factor (SPF) of about 2 to 4; far below the minimum recommended SPF of 15.
Sometimes referred to as “photoaging,” premature aging is the result of unprotected UV exposure. It takes the form of leathery, wrinkled skin, and dark spots. Although the causes of premature aging are not always clear, unprotected exposure to harmful UV rays break down the collagen and elastin fibers in healthy young skin, and cause wrinkles and loosened folds. Frequent sunburns or hours spent tanning can result in a permanent darkening of the skin, dark spots, and a leathery texture. A dermatologist or plastic surgeon can develop a treatment plan based on your needs. Treatments can include chemical peels, dermabrasion, and skin fillers. Premature aging is a long-term side effect of UV exposure, meaning it may not show on your skin until many years after you have had a sunburn or suntan. Avoiding UV exposure is essential to maintaining healthy skin.
There are two main types of skin cancer: melanoma and non-melanoma. Melanoma is the less common, but more dangerous form of skin cancer, and accounts for most of the deaths due to skin cancer each year. Melanoma is cancer that begins in the epidermal cells that produce melanin (melanocytes). According to the American Cancer Society (ACS) melanoma is almost always curable when detected in its early stages. Non-melanomas (basal cell and squamous cell carcinomas) occur in the basal or squamous cells located at the base of the epidermis, both inside and outside the body. Non-melanomas often develop in sun-exposed areas of the body, including the face, ears, neck, lips, and the backs of the hands. Predisposition to skin cancer can be hereditary, meaning it is passed through the generations of a family through genes. There is also strong evidence suggesting that exposure to UV rays, both UVA and UVB, can cause skin cancer. UV radiation may promote skin cancer in two different ways:
- By damaging the DNA in skin cells, causing the skin to grow abnormally and develop benign or malignant growths.
- By weakening the immune system and compromising the body’s natural defenses against aggressive cancer cells.
Performing regular self skin cancer exams is a good way to protect yourself against skin cancer. The following are possible signs of skin cancer, and should be checked by a doctor.
- Any changes on the skin, especially in the size or color of a mole, birthmark, or other dark pigmentation
- Unexplained scaliness, oozing, or bleeding on the skin’s surface
- A spot on the skin that suddenly feels itchy, tender, or painful
Skin cancer treatment varies depending on the type and severity of the cancer. Your doctor will develop a treatment plan based on your needs. According to the American Cancer Society, most of the more than one million skin cancers diagnosed each year in the U.S. are considered sun-related. Skin cancer occurs in people of all skin tones, though it is less common in those with darker skin tones. Assessing your risk with the help of your doctor, protecting your skin, and performing regular skin cancer checks are the best methods of prevention.
Actinic or Solar Keratoses
A fourth type of growth, actinic or solar keratoses, is a concern because it can progress into cancer. Actinic keratoses are considered the earliest stage in the development of skin cancer, and are caused by long-term exposure to sunlight. They are the most common pre-malignant skin condition, occurring in more than 5 million Americans each year. Actinic or solar keratoses share some of the symptoms of skin cancer. Look for raised, rough-textured, or scaly bumps that occur in areas that have been sunburned or tanned. Most cases of actinic keratoses are easily treated in a dermatologist’s office by removing them with liquid nitrogen or chemical peels. Actinic or solar keratoses are the most common pre-malignant skin condition. Check with your doctor if you find any suspicious-looking bumps.
Eye Damage – Photokeratitis
Photokeratitis can be thought of as a sunburn of the cornea. It is caused by intense UVC/UVB exposure of the eye. Photokeratitis is also called “snow blindness” because many people develop this condition at high altitudes in a snowy environment where the reflections of UVB are high. This condition can also be produced by exposure to intense artificial sources of UVC/UVB, like broken mercury vapor lamps, or certain types of tanning lamps. Symptoms include tearing, pain, swollen eyelids, a feeling of sand in the eye, and hazy or decreased vision. Consult your doctor if you have any of these symptoms. Your doctor can prescribe a topical solution which will aid your cornea in healing. Since the cornea usually heals in 24 to 48 hours, the symptoms are not long-lasting.
Eye Damage – Cataracts
Cataracts are one form of eye damage that research has shown may increase with UV exposure. Clouding of the natural lens of the eye causing decreased vision and possible blindness are all effects of cataracts. Other types of eye damage include cancer around the eyes, macular degeneration, and irregular tissue growth that can block vision (pterygium). Consult your doctor if you experience any of the following symptoms.
- Clouded or spotty vision
- Pain or soreness in and around the eyes
Cataracts can be surgically removed. Wearing sun protection gear such as a wide-brimmed hat and sunglasses with 100% UV protection can help decrease the risks of eye damage.
Immune System Suppression
According to the World Health Organization (WHO), all people, regardless of skin color, are vulnerable to the effects of immune suppression. Overexposure to UV radiation may suppress proper functioning of the body’s immune system and the skin’s natural defenses, increasing sensitivity to sunlight, diminishing the effects of immunizations or causing reactions to certain medications. In people who have been treated for an infection of the Herpes simplex virus, sun exposure can weaken the immune system so that it can no longer keep the virus under control. This results in reactivation of the infection and recurring cold sores.