No Tan Is a Safe Tan

(HealthDay News) -- Evidence is accumulating that there is no such thing as a "safe tan."

Ultraviolet rays, no matter where you get them from, cause skin cancer, and the purported health benefits of UV rays, such as vitamin D production, are overstated, if not downright wrong.

So say a trio of papers published in the October issue of Pigment Cell & Melanoma Research.

"There's a lot of money to be made, and the tanning industry has been quite successful even in places like New Mexico and South America selling tanning as a safe alternative to outdoor sun. We're trying to point out that it's not the case," said Marianne Berwick, author of one of the papers and a professor of internal medicine at the University of New Mexico Health Sciences Center in Albuquerque.

"We wanted to counter the marketing and a response to the misperception of the true cost/benefit analysis of UV radiation," said Dr. David Fisher, director of the Melanoma Program in Medical Oncology at Massachusetts General Hospital in Boston, president of the Society of Melanoma Research, and author of one of the other papers in the journal.

Skin cancer is the most common malignancy in the United States, with 1 million new cases in 2008, and an estimated one in five people developing some type of skin cancer during their lifetime. Ultraviolet radiation is a major risk factor for all types of skin cancer.

Yet, the tanning industry continues to grow, with revenues increasing fivefold since 1992, according to background information in the journal.

But there is rampant evidence that tanning of any kind is not safe and carries few, if any, health benefits.

"The first step [to both skin cancer and a tan] is DNA damage. That tells us that there's one common initiating event, and it is a carcinogenic event through which you get your tan, so the concept of a safe tan becomes essentially impossible," Fisher said.

Moreover, claims that tanning may not lead to melanoma, as opposed to other forms of skin cancer, are based on cleverly skewed interpretations of complex molecular phenomenon, Fisher added.

"There is no controversy whatsoever about the presence of UV signature mutations in squamous cell carcinoma. You can see that the genes have been mutated in a way that UV directly caused it," he explained. "The melanoma connection to UV is probably indirect, so you wouldn't see the mutation directly in the melanoma cell even though the UV caused it."

"The tanning industry has seized on that complexity."

A representative for the tanning industry refuted the findings using that exact argument.

"Here are three more studies that make irresponsible assertions without providing any concrete link between indoor tanning and melanoma," said John Overstreet, executive director of the Indoor Tanning Association. "The fact is, UV light provides vitamin D, which helps the body ward off many types of diseases, and the rewards that come with moderate and responsible exposure to UV light far outweigh the consequences of not getting enough of it."

But Fisher noted vitamin D can come from other, safer sources.

"We know that vitamin D is synthesized in the skin after ultraviolet radiation hits the skin. It's how you couch the discussion when the indoor tanning association took out a full-page ad in The New York Times right before prom season and lists all the good things about vitamin D," Fisher said. "Basically, you're getting vitamin D from a carcinogen."

Not only can vitamin D be obtained from supplements, a simple blood test can tell a person if he or she is actually deficient in the vitamin.

The World Health Organization and other organizations have called for a ban on sunbed use by individuals under the age of 18. According to the papers in the journal, the industry has lobbied against such a ban.

More information
Learn more about skin cancer at the American Academy of Dermatology.

Are You Getting Burned by Your Sunscreen?

(HealthDay News) -- Sunscreens are one of the most popular protections people use as the summer sun rises high and threatens to burn their skin with harmful ultraviolet rays.

Sunburns are not only painful, they can lead to skin cancer, the most prevalent form of cancer in the United States.

But, new research has led some to question the effectiveness of many sunscreens.

A recent study by the Environmental Working Group found that one in every eight name-brand sunscreens did not protect against ultraviolet A rays. These UVA rays have traditionally been linked to tanning, but doctors now know they can cause long-term damage and skin cancer. The SPF -- or sun protection factor -- rating currently placed on all sunscreens only reflects the lotion's effectiveness in blocking ultraviolet B rays.

As a result of such research, the U.S. Food and Drug Administration is the process of approving a new regulation that would set standards for testing and labeling sunscreens for UVA protection as well as for UVB.

The incidence of sunburns has increased in the United States, a sign the many people aren't using proper sun protection. A recent study by the U.S. Centers for Disease Control and Prevention found that sunburn rates increased from 31.8 percent to 33.7 percent from 1999 to 2004.

Sunburn damage to the skin is a direct cause of skin cancer, said Dr. Martin Weinstock, a professor of dermatology at Brown University Medical School.

"Most cancers in the United States are skin cancer, and incidences are rising, while the incidences of most other types of cancer are remaining stable or going down," Weinstock said. "The most important avoidable cause we know about is exposure to ultraviolet radiation."

Sunlight is composed of the visible light that we can see, and ultraviolet (UV) light that we can not. There are two types of UV light -- UVA and UVB. While UVA rays are responsible for tanning and UVB for sunburn, both can damage the skin and increase the risk of skin cancer.

Most skin cancers form in older people, on parts of their bodies that have experienced more exposure to the sun, or in people who have weakened immune systems.

The most deadly form of skin cancer is melanoma, which forms in the skin cells that make the pigment melanin -- often as a mole. The National Cancer Institute estimates there will be 62,480 new cases of melanoma in the United States in 2008, and about 8,420 deaths caused by the disease. By comparison, there will be more than 1 million new cases of non-melanoma skin cancers in 2008, with fewer than 1,000 deaths.

Experts recommend a multiple approach to protecting yourself against harmful rays.

"The American Cancer Society has a slogan -- 'Slip, Slop, Slap,' " Weinstock said. "Slip on a shirt, slop on some sunscreen, and slap on a hat."

But Kristan Markey, a research analyst with the Environmental Working Group, a nonprofit organization that works to protect public health and the environment, said the effectiveness of sunscreens isn't as strong as one might think.

"We found that most sunscreens are not effective in filtering out ultraviolet radiation or have problems with toxic hazards," Markey said.

Not only do many sunscreens fail to protect against UV radiation, but they also break down over normal usage and develop toxic components, the group's study found.

Markey noted that sunscreen makers also make claims that can't stand up to the light of day. For example, even sunscreens that boast "all-day protection" must be regularly reapplied to avoid skin damage, he said.

"You can't say 'all-day protection,' because the recommendation is you have to reapply every two hours," Markey said. "It's still very much the wild west in the industry."

The FDA's recommended new rules for sunscreens would assign a star rating system -- from one to four stars -- to gauge the lotions' effectiveness in blocking UVA rays. Ratings for UVA would be based on two tests, one to measure the sunscreen's ability to reduce the amount of UVA radiation passing through it, and a second to measure the product's ability to prevent tanning and potential long-term skin damage.

Given the mandatory approval process, any new labeling featuring the UVA ratings alongside the current SPF rating won't appear on store shelves until 2009 at the earliest.

Until then, Weinstock said people need to continue to check themselves often for changes in skin blemishes or moles, as a precaution.

"We do recommend that people do a thorough examination of their own skin once a month, top and bottom, front and back," he said. "If they see spots that are changing, ask for some advice from a medical professional.

"Early detection is important in the treatment of skin Cancer, and it's right out there to see," he added.

More information
To learn more about sunscreens, visit the American Academy of Dermatology.