Ira Skolnik, MD, PhD, dermatologist, shares insights on young women, tanning and the health risk associated with tanning booths.
Skin cancer is being diagnosed in younger people. Why is that?
Over the past few decades, people gradually have worn less and less clothing, including at the beach. We used to see basal cell carcinoma, the most common form of skin cancer, only in people over the age of 70. But since I began practicing 20 years ago, we increasingly diagnose it, as well as melanoma — which is far more serious — in younger people.
It is worth noting that, for the average person, skin cancer is caused by a combination of sun exposure (about 75-80 percent) and genes (the remaining 20-25 percent). You need to know your family history; if a first-degree relative had skin cancer, you are at greater risk for it.
What do you observe in your own dermatology practice?
Today, it is not uncommon for me to see patients in their late 20s with basal cell carcinoma. I always ask if they think they've gotten an excessive amount of sun in their lifetimes, and the answer is almost always yes, they went tanning or to the beach without sunscreen or other protection. More than 50 percent of my patients are female, but that's because they take better care of their skin than men and are more likely to come in if they see a change. In women, melanoma typically develops on their arms or legs; in men, it tends to be on their backs.
What about teenaged girls, who are known to frequent tanning booths?
They admit to going to tanning booths, and they're usually not proud of it. What I hear from teenaged girls is that they want to look good at the prom, and they feel that a tan is healthy-looking. I explain to them that it's actually the exact opposite — a tan is not healthy at all. And artificial tanning, where you get extra ultraviolet light, is a no-no.
All you have to do is turn on the TV, and you can see that, more than ever, we are living in a society that values appearance over character. It's unfortunate, but young people think they need to live up to that standard. I try to emphasize being yourself and being healthy. It doesn't mean you can't go out in the summertime and have fun. But you have to use common sense and protect yourself.
Do you have advice for parents?
I sometimes show parents and teenagers photos of what skin cancer looks like and what the skin looks like after surgery. Teenagers can understand the consequences of something; both the child and the parent need to know that tanning is another one of those risky behaviors that need to be discontinued. And I provide information, including that there are no excuses, such as needing a visit to a tanning booth to get a "base tan" before a vacation or to get sufficient vitamin D. People who go tanning are trading one problem — vitamin D deficiency — for a problem that is ten times more serious: skin cancer. Everyone should wear a sunscreen with an SPF of at least 30. If there is a family history of skin cancer, I suggest SPF 45 or 60.
Will the recent Massachusetts legislation banning individuals younger than 18 from tanning booths help?
Absolutely, because it provides legal support for what I tell my patients. That is why the Massachusetts Academy of Dermatology, for which I serve as president, worked for the past ten years to get the legislation passed. Other organizations, such as The Melanoma Foundation of New England, were instrumental in convincing the state legislature that we need to prevent tanning in children under age 18. I am proud that Massachusetts and a few other states are leading the country on this important public health issue.
