Monday, 28 May 2012

1 in 5 Americans Will Get Skin Cancer. Here's How To Protect Yourself

By Chai Woodham, for U.S. News

You know you've reached the zenith of pop culture zaniness when Saturday Night Live parodies you. That's exactly what happened to Patricia Krentcil, the overly bronzed New Jersey mom facing second-degree child endangerment charges for allegedly allowing her then five-year-old daughter into a tanning booth. Audiences across America may have laughed at an Oompa-Loompa orange Kristin Wiig spoofing the infamous "Tanning Mom," but doctors say that this is no laughing matter.

A new study conducted by the Centers for Disease Control and Prevention (CDC) and the National Cancer Institute (NCI) reveals that 50 percent of young adults ages 18 through 29 say they've had at least one sunburn in the past year. "A sunburn is a form of sickness or poisoning," says Cynthia Bailey, a dermatologist practicing in Sebastopol, Calif. "Both a sunburn and a suntan indicate that ultraviolet rays have caused free radicals to form within the skin and DNA damage has occurred." And this, in turn, can lead to skin cancer, the most common form of cancer in the United States.


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Sun seekers aren't the only ones putting themselves at risk. The American Academy of Dermatology estimates that some 28 million Americans tan indoors each year, and the age of frequent users is getting younger and younger. A study also conducted by the CDC and NCI found that nearly a third of white women ages 18 to 21 regularly use tanning beds, averaging about 28 visits in 2010. "Ultraviolet radiation from tanning devices [and the sun] is just as carcinogenic to humans as tobacco smoking," says Delphine Lee, a dermatologist and director of translational immunology at the John Wayne Cancer Institute in Santa Monica, Calif. "Studies found a 75 percent increase in the risk of melanoma in those who had been exposed to UV radiation from indoor tanning before the age of 35."

Mention melanoma, the most deadly form of skin cancer, and John McCain might come to mind -- the 75-year-old senator who has endured numerous removals of melanoma from his upper body and face. Recent studies, though, show that it's not an older person's disease. Rather than the likes of McCain, people should really remember reggae musician Bob Marley, who died at age 36 from a metastatic melanoma found on his toe. A Mayo Clinic survey of patients published in April revealed that for people under 40, incidences of melanoma have increased eightfold among women and fourfold among men from 1979 to 2009. This rise in cases may be due to the popularity of indoor tanning, researchers speculate. "Fifteen to 30 minutes in a tanning booth is equal to an entire day at the beach, and the UV [rays] absorbed during a session is 20 times stronger than the rays of the sun," says Howard Murad, a dermatologist and associate clinical professor of medicine at the University of California--Los Angeles.

So why do people keep tanning? Surely the thought of thinning skin, fine lines and wrinkles, liver spots, skin rashes from the interaction between UV rays and certain medications, aggravation of autoimmune diseases, and cataracts -- not to mention cancers of the eye and skin -- would deter most folks. New research published in the May issue of Addiction Biology suggests that for some people, tanning is not that easy to resist.

Scientists measured the brain activity and blood flow of study participants subjected to ultraviolet radiation in a tanning bed. What they discovered was that the UV rays stimulated several parts of the brain involved in addiction. Quite simply, tanning could be just as habit-forming as drugs or alcohol. Despite all the awareness of the health hazards of tanning, it appears that some people just can't say no when they should.

The Skin Cancer Foundation reports that more than two million people are diagnosed with skin cancer each year, and one person dies from melanoma every hour. "It would be unrealistic to expect the average person not to get some color by the end of the summer," says Lawrence Mark, a dermatologist at the Indiana University Simon Cancer Center in Indianapolis. "But there is always some risk with tanning. The question is whether the benefit is worth the risk."

To minimize that risk, here's what you can do:

Slather on sunscreen. "I often tell my patients to use an SPF 30 and to reapply their sunscreen every two hours," says Erin Gilbert, a dermatologist and spokesperson for the American Academy of Dermatology. Some products boast a sun protection factor as high as 80. That isn't necessary, says Gilbert, as there is no good evidence that an SPF higher than 30 provides greater protection. What you really need to do, she advises, is "apply a shot glass worth of sunscreen daily to exposed areas like the face, neck, hands, and chest to achieve adequate coverage." Applying too thinly lowers the protection factor of the product.

With the wide array of sun protection products on shelves today, the Food and Drug Administration is implementing new regulations to help consumers determine the best sunscreen for them. Prior standards only addressed protection against UVB rays -- UVB-shielding products just help protect against sunburns. Starting in December, manufacturers will be required to label those sunscreens that protect against both UVB and UVA rays as "broad spectrum." Those that carry the "broad spectrum" designation and have an SPF 15 or higher will show wording indicating they reduce the risk of sunburn, skin cancer, and premature aging with proper sun protection behaviors like limited sun exposure and use of protective clothing. Those that are not labeled "broad spectrum" or that have an SPF value between 2 and 14 only prevent sunburn and will carry a "skin cancer/skin aging alert." Other changes include the rule that manufacturers will no longer be able to call their product a "sunblock" or describe their sunscreen as "sweatproof" or "waterproof." And those sunscreens with an SPF value higher than 50 will simply be labeled as "SPF 50+."

Cover up. Put on a wide-brimmed hat to protect your face and resist the urge to expose too much skin. Yes, the bikini beckons and hemlines hike up when the temperature rises, but you'll be thankful years from now when people mistake you and your smooth skin for someone much younger. Buy sunglasses that offer both UVA and UVB protection. Ocular melanoma, or cancer of the eye, is diagnosed in about 2,500 Americans every year.

Seek some shade. Avoid the outdoors between 10 a.m. and 2 p.m. if possible, as UVA and UVB rays are most intense with the midday sun.

Go bronze from a bottle. "Bronzers are temporary self-tanning products containing pigments or dyes that provide instant color. They can be easily removed with soap and water," says Ron Robinson, a cosmetic chemist and research executive who has developed products for companies like Clinique, Avon, and Revlon. "The main ingredient in self-tanners is dihydroxyacetone, a sugar molecule that reacts with the proteins in the skin to give the skin a tanned color that develops in a few hours." And while "bronzers and self-action tanners are safe and effective," says Tina Alster, a clinical professor of dermatology at Georgetown University Medical Center, it should be noted that they do not provide any sun protection and sunscreen is advised.

Be like Bugs Bunny. Studies show that you can get that golden glow from the food you eat. "Beta carotene is a form of vitamin A that has a yellow or orange pigment and is found in certain fruits and vegetables like carrots, winter squash, and cantaloupe," says Bailey. Eating a diet rich in beta carotene imparts a golden hue to the skin. "It's entirely non-toxic and looks good."

Some doctors say a little exposure to the sun is essential when it comes to vitamin D, also known as the "sunshine vitamin." Research has shown that a deficiency in vitamin D may increase the risk of some cancers, heart disease, multiple sclerosis, osteoporosis, tuberculosis, and the flu. The body produces vitamin D from cholesterol through a process activated by sunlight on the skin. Although this is the most efficient way to produce the vitamin, many dermatologists would rather you eat foods rich in vitamin D -- such as fatty fish like tuna and salmon and fortified foods like dairy products and breakfast cereals -- or take supplements instead of basking in the sun. The Institute of Medicine recommends a daily dose of 600 IU for most people under 70. "The amount of sun needed for adequate amounts of vitamin D causes suntans and sunburns," says Lawrence Samuels, chief of dermatology at St. Luke's Hospital in Chesterfield, Mo. "People die from melanoma and metastatic skin cancer. No one dies from vitamin D supplements."

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