tag:theconversation.com,2011:/africa/topics/tanning-1259/articlesTanning – The Conversation2024-02-14T19:22:00Ztag:theconversation.com,2011:article/2231922024-02-14T19:22:00Z2024-02-14T19:22:00ZWhat are ‘collarium’ sunbeds? Here’s why you should stay away<figure><img src="https://images.theconversation.com/files/575176/original/file-20240213-24-k00ogz.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C6000%2C3988&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/beauty-girl-looking-mirror-while-touching-1868918950">Ground Picture/Shutterstock</a></span></figcaption></figure><p>Reports have recently emerged that solariums, or sunbeds – largely banned in Australia because they <a href="https://www.sunsmart.com.au/uv-radiation/solariums-and-tanning">increase the risk</a> of skin cancer – are being <a href="https://www.abc.net.au/news/2024-02-08/health-authorities-investigate-rebranded-collarium-sun-beds/103433306">rebranded</a> as “collarium” sunbeds (“coll” being short for collagen). </p>
<p>Commercial tanning and beauty salons in Queensland, New South Wales and Victoria are marketing collariums, with manufacturers and operators claiming they provide a longer lasting tan and stimulate collagen production, among other purported benefits.</p>
<p>A collarium sunbed emits both UV radiation and a mix of visible wavelength colours to produce a pink or red light. Like an old-school sunbed, the user lies in it for ten to 20 minute sessions to quickly develop a tan. </p>
<p>But as several experts <a href="https://cosmosmagazine.com/health/experts-warn-about-collarium-tanning-beds/">have argued</a>, the providers’ claims about safety and effectiveness don’t stack up.</p>
<h2>Why were sunbeds banned?</h2>
<p>Commercial sunbeds have been <a href="https://www.arpansa.gov.au/understanding-radiation/radiation-sources/more-radiation-sources/solaria">illegal</a> across Australia since 2016 (except for in the Northern Territory) under state-based radiation safety laws. It’s still legal to sell and own a sunbed for private use.</p>
<p>Their dangers were highlighted by <a href="https://www.dailytelegraph.com.au/newslocal/macarthur/melanoma-survivor-jay-allen-welcomes-nsw-government-ban-on-sunbeds/news-story/aa65a9a7072022b7c1c7d07e4bb54ebc">young Australians</a> including <a href="https://www.sunsmart.com.au/about-sunsmart/media-and-communications/media-releases/2017/clare-olivers-legacy-10-years-on.html">Clare Oliver</a> who developed melanoma after using sunbeds. Oliver featured in the <a href="https://www.sunsmart.com.au/about-sunsmart/media-and-communications/sunsmart-campaigns/2000s#clare-oliver">No Tan Is Worth Dying For campaign</a> and died from her melanoma at age 26 in 2007.</p>
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<em>
<strong>
Read more:
<a href="https://theconversation.com/theres-no-such-thing-as-a-safe-tan-heres-whats-happening-underneath-your-summer-glow-109439">There's no such thing as a safe tan. Here's what's happening underneath your summer glow</a>
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</em>
</p>
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<p>Sunbeds lead to tanning by emitting UV radiation – as much as <a href="https://www.sunsmart.com.au/uv-radiation/solariums-and-tanning">six times</a> the amount of UV we’re exposed to from the summer sun. When the skin detects <a href="https://pubmed.ncbi.nlm.nih.gov/23749111/">enough DNA damage</a>, it boosts the production of melanin, the brown pigment that gives you the tanned look, to try to filter some UV out before it hits the DNA. This is only partially successful, providing the equivalent of <a href="https://pubmed.ncbi.nlm.nih.gov/24891049/">two to four SPF</a>.</p>
<p>Essentially, if your body is <a href="https://theconversation.com/theres-no-such-thing-as-a-safe-tan-heres-whats-happening-underneath-your-summer-glow-109439">producing a tan</a>, it has detected a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3709783/">significant amount</a> of DNA damage in your skin.</p>
<p><div data-react-class="TiktokEmbed" data-react-props="{"url":"https://www.tiktok.com/@morgansskinjournal/video/7223660400984837377?_r=1\u0026_t=8jpqp1j1qNu"}"></div></p>
<p>Research shows people who have used sunbeds at least once have a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2993823/">41% increased risk</a> of developing melanoma, while ten or more sunbed sessions led to a 100% increased risk. </p>
<p>In 2008, <a href="https://onlinelibrary.wiley.com/doi/full/10.5694/j.1326-5377.2008.tb02082.x">Australian researchers</a> estimated that each year, sunbeds caused 281 cases of melanoma, 2,572 cases of squamous cell carcinoma (another common type of skin cancer), and $3 million in heath-care costs, mostly to Medicare.</p>
<h2>How are collarium sunbeds supposed to be different?</h2>
<p>Australian sellers of collarium sunbeds imply they are safe, but their machine descriptions note the use of UV radiation, particularly <a href="https://dermnetnz.org/topics/ultraviolet-radiation-and-human-health">UVA</a>.</p>
<p>UVA is one part of the spectrum of <a href="https://www.healthline.com/health/skin/uva-vs-uvb">UV radiation</a>. It penetrates deeper into the skin than UVB. While UVB promotes cancer-causing mutations by discharging energy straight into the DNA strand, UVA sets off damage by creating reactive oxygen species, which are unstable compounds that react easily with many types of cell structures and molecules. These damage cell membranes, protein structures and DNA. </p>
<p>Evidence shows <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2883000/">all types</a> of sunbeds increase the risk of melanoma, including those that use only UVA.</p>
<p>Some manufacturers and clinics suggest the machine’s light spectrum increases UV compatibility, but it’s not clear what this means. Adding red or pink light to the mix won’t negate the harm from the UV. If you’re getting a tan, you have a significant amount of <a href="https://pubmed.ncbi.nlm.nih.gov/23749111/">DNA damage</a>.</p>
<h2>Collagen claims</h2>
<p>One particularly odd claim about collarium sunbeds is that they stimulate collagen.</p>
<p><a href="https://dermnetnz.org/topics/collagen">Collagen</a> is the main supportive tissue in our skin. It provides elasticity and strength, and a youthful appearance. Collagen is constantly synthesised and broken down, and when the balance between production and recycling is lost, the skin loses strength and develops wrinkles. The collagen bundles become thin and fragmented. This is a natural part of ageing, but is accelerated by UV exposure.</p>
<figure class="align-center ">
<img alt="Sun-damaged skin and sun-protected skin from the same person, and the microscopic image of each showing how the collagen bundles have been thinned out in the sun-damaged skin." src="https://images.theconversation.com/files/574816/original/file-20240212-19-v7wlqc.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/574816/original/file-20240212-19-v7wlqc.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=585&fit=crop&dpr=1 600w, https://images.theconversation.com/files/574816/original/file-20240212-19-v7wlqc.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=585&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/574816/original/file-20240212-19-v7wlqc.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=585&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/574816/original/file-20240212-19-v7wlqc.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=735&fit=crop&dpr=1 754w, https://images.theconversation.com/files/574816/original/file-20240212-19-v7wlqc.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=735&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/574816/original/file-20240212-19-v7wlqc.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=735&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Sun-protected skin (top) has thick bands of pink collagen (arrows) in the dermis, as seen on microscopic examination. Chronically sun-damaged skin (bottom) has much thinner collagen bands.</span>
<span class="attribution"><span class="source">Katie Lee/UQ</span></span>
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</figure>
<p>The reactive oxygen species generated by UVA light damage <a href="https://pubmed.ncbi.nlm.nih.gov/24891049/">existing collagen</a> structures and kick off a <a href="https://pubmed.ncbi.nlm.nih.gov/17711532/">molecular chain of events</a> that downgrades collagen-producing enzymes and increases collagen-destroying enzymes. Over time, a build-up of degraded collagen fragments in the skin promotes even more destruction.</p>
<p>While there is growing evidence <a href="https://www.sciencedirect.com/science/article/pii/S0190962224001877?via%3Dihub">red light therapy</a> alone could be useful in wound healing and skin rejuvenation, the UV radiation in collarium sunbeds is likely to undo any benefit from the red light.</p>
<h2>What about phototherapy?</h2>
<p>There are <a href="https://dermnetnz.org/topics/uva1-phototherapy">medical treatments</a> that use controlled UV radiation doses to treat chronic inflammatory skin diseases like <a href="https://dermnetnz.org/topics/puva-photochemotherapy">psoriasis</a>. </p>
<p>The anti-collagen effects of UVA can also be used to treat thickened scars and <a href="https://dermnetnz.org/topics/keloid-and-hypertrophic-scar">keloids</a>. <a href="https://dermnetnz.org/topics/uva1-phototherapy">Side-effects</a> of UV phototherapy include tanning, itchiness, dryness, cold sore virus reactivation and, notably, premature skin ageing.</p>
<p>These treatments use the minimum exposure necessary to treat the condition, and are usually restricted to the affected body part to minimise risks of future cancer. They are administered under medical supervision and are not recommended for people already at high risk of skin cancer, such as people with <a href="https://dermnetnz.org/topics/atypical-melanocytic-naevus">atypical moles</a>.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/thinking-about-trying-collagen-supplements-for-your-skin-a-healthy-diet-is-better-value-for-money-152240">Thinking about trying collagen supplements for your skin? A healthy diet is better value for money</a>
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</p>
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<h2>So what happens now?</h2>
<p>It looks like many collariums are just sunbeds rebranded with red light. Queensland Health is currently <a href="https://www.abc.net.au/news/2024-02-08/health-authorities-investigate-rebranded-collarium-sun-beds/103433306">investigating</a> whether these salons are breaching the state’s <a href="https://www.legislation.qld.gov.au/view/html/inforce/current/sl-2021-0125#sec.67">Radiation Safety Act</a>, and operators could face large fines.</p>
<p>As the <a href="https://www.abc.net.au/listen/programs/adelaide-afternoons/tanning/103401358">2024 Australians of the Year</a> – melanoma treatment pioneers Georgina Long and Richard Scolyer – highlighted in their acceptance speech, “there is nothing healthy about a tan”, and we need to stop glamorising tanning. </p>
<p>However, if you’re desperate for the tanned look, there is a safer and easy way to get one – <a href="https://dermnetnz.org/topics/dihydroxyacetone">out of a bottle</a> or by visiting a salon for a spray tan.</p><img src="https://counter.theconversation.com/content/223192/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Katie Lee receives funding from the National Health and Medical Research Council.</span></em></p><p class="fine-print"><em><span>Anne Cust receives funding from the National Health and Medical Research Council and Medical Research Future Fund. </span></em></p>Collarium sunbeds are promoted as a means to tan quickly, and reduce the effects of aging on the skin. Two experts explain what to make of their claims.Katie Lee, PhD Candidate, Dermatology Research Centre, The University of QueenslandAnne Cust, Professor of Cancer Epidemiology, University of SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2158932023-12-24T20:53:47Z2023-12-24T20:53:47ZA short history of sunscreen, from basting like a chook to preventing skin cancer<p>Australians have used commercial creams, lotions or gels to manage our skin’s sun exposure for nearly a century. </p>
<p>But why we do it, the preparations themselves, and whether they work, has changed over time.</p>
<p>In this short history of sunscreen in Australia, we look at how we’ve slathered, slopped and spritzed our skin for sometimes surprising reasons.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/4-myths-about-sunscreen-and-why-theyre-wrong-125879">4½ myths about sunscreen and why they're wrong</a>
</strong>
</em>
</p>
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<h2>At first, suncreams helped you ‘tan with ease’</h2>
<figure class="align-left zoomable">
<a href="https://images.theconversation.com/files/562563/original/file-20231129-23-98jddw.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Advertisement for Hamilton's Sunburn Vanishing Cream" src="https://images.theconversation.com/files/562563/original/file-20231129-23-98jddw.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/562563/original/file-20231129-23-98jddw.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=1129&fit=crop&dpr=1 600w, https://images.theconversation.com/files/562563/original/file-20231129-23-98jddw.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=1129&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/562563/original/file-20231129-23-98jddw.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=1129&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/562563/original/file-20231129-23-98jddw.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1418&fit=crop&dpr=1 754w, https://images.theconversation.com/files/562563/original/file-20231129-23-98jddw.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1418&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/562563/original/file-20231129-23-98jddw.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1418&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">This early sunscreen claimed you could ‘tan with ease’.</span>
<span class="attribution"><a class="source" href="https://trove.nla.gov.au/newspaper/page/11041390?searchTerm=Hamilton%20sun%20vanishing%20cream">Trove/NLA</a></span>
</figcaption>
</figure>
<p>Sunscreens have been available in Australia since the 30s. Chemist <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10120514/">Milton Blake</a> made one of the first.</p>
<p>He used a kerosene heater to cook batches of “sunburn vanishing cream”, scented with French perfume. </p>
<p>His backyard business became H.A. Milton (Hamilton) Laboratories, which still <a href="https://www.hamiltonsunandskin.com.au/history-of-hamilton">makes sunscreens today</a>. </p>
<p>Hamilton’s first cream <a href="https://trove.nla.gov.au/newspaper/article/128464119?searchTerm=Hamilton%20sun%20vanishing%20cream">claimed</a> you could “
Sunbathe in Comfort and TAN with ease”. According to modern standards, it would have had an SPF (or sun protection factor) of 2.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/explainer-how-does-sunscreen-work-what-is-spf-and-can-i-still-tan-with-it-on-88869">Explainer: how does sunscreen work, what is SPF and can I still tan with it on?</a>
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<h2>The mirage of ‘safe tanning’</h2>
<p>A tan was considered a “<a href="https://trove.nla.gov.au/newspaper/article/21611069?searchTerm=sunburn%20lotion">modern complexion</a>” and for most of the 20th century, you might put something on your skin to help gain one. That’s when “safe tanning” (without burning) was thought possible.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/562843/original/file-20231130-27-l79asi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Coppertone advertisement showing tanned woman in bikini" src="https://images.theconversation.com/files/562843/original/file-20231130-27-l79asi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/562843/original/file-20231130-27-l79asi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=862&fit=crop&dpr=1 600w, https://images.theconversation.com/files/562843/original/file-20231130-27-l79asi.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=862&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/562843/original/file-20231130-27-l79asi.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=862&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/562843/original/file-20231130-27-l79asi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1083&fit=crop&dpr=1 754w, https://images.theconversation.com/files/562843/original/file-20231130-27-l79asi.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1083&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/562843/original/file-20231130-27-l79asi.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1083&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">This 1967 Coppertone advertisement urged you to ‘tan, not burn’.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/91591049@N00/15224409766/in/photolist-pck5By-nY3gWR-86iQ6o">SenseiAlan/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
</figcaption>
</figure>
<p>Sunburn was known to be caused by the <a href="https://www.cancercouncil.com.au/cancer-prevention/sun-protection/understanding-uv-radiation/what-is-uv-radiation/">UVB component</a> of ultraviolet (UV) light. UVA, however, was thought not to be involved in burning; it was just thought to darken the skin pigment melanin. So, medical authorities advised that by using a sunscreen that filtered out UVB, you could “safely tan” without burning.</p>
<p>But that was wrong.</p>
<p>From the 70s, medical research suggested UVA <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/exd.12388">penetrated damagingly deep</a> into the skin, causing ageing effects such as sunspots and wrinkles. And both <a href="https://www.cancercouncil.com.au/cancer-prevention/sun-protection/understanding-uv-radiation/what-is-uv-radiation/">UVA and UVB</a> could cause skin cancer.</p>
<p>Sunscreens from the 80s sought to be “<a href="https://theconversation.com/how-to-pick-the-right-sunscreen-when-youre-blinded-by-choice-125881">broad spectrum</a>” – they filtered both UVB and UVA.</p>
<p>Researchers consequently recommended sunscreens for <a href="https://www.sbs.com.au/language/english/en/article/skin-cancer-in-australia-what-are-the-risks-and-how-to-protect-yourself/sa022ydq1">all skin tones</a>, including for preventing sun damage in people with <a href="https://www.skincancer.org/skin-cancer-information/skin-cancer-skin-of-color/">dark skin</a>.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/sun-damage-and-cancer-how-uv-radiation-affects-our-skin-34538">Sun damage and cancer: how UV radiation affects our skin</a>
</strong>
</em>
</p>
<hr>
<h2>Delaying burning … or encouraging it?</h2>
<p>Up to the 80s, sun preparations ranged from something that claimed to delay burning, to preparations that actively encouraged it to get that desirable tan – think, baby oil or coconut oil. Sun-worshippers even raided the kitchen cabinet, slicking olive oil on their skin.</p>
<p>One manufacturer’s “sun lotion” might effectively filter UVB; another’s merely basted you like a roast chicken.</p>
<p>Since labelling laws before the 80s didn’t require manufacturers to list the ingredients, it was often hard for consumers to tell which was which.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/how-should-i-add-sunscreen-to-my-skincare-routine-now-its-getting-hotter-213453">How should I add sunscreen to my skincare routine now it's getting hotter?</a>
</strong>
</em>
</p>
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<h2>At last, SPF arrives to guide consumers</h2>
<p>In the 70s, two Queensland researchers, Gordon Groves and Don Robertson, developed tests for sunscreens – sometimes experimenting on students or colleagues. They printed their ranking <a href="https://trove.nla.gov.au/newspaper/article/116399802?searchTerm=guide%20to%20sunburn%20protection">in the newspaper</a>, which the public could use to choose a product. </p>
<p>An Australian sunscreen manufacturer then asked the federal health department to regulate the industry. The company wanted standard definitions to market their products, backed up by consistent lab testing methods.</p>
<p><a href="https://store.standards.org.au/product/as-2604-1986">In 1986</a>, after years of consultation with manufacturers, researchers and consumers, Australian Standard AS2604 gave a specified a testing method, based on the Queensland researchers’ work. We also had a way of expressing how well sunscreens worked – the <a href="https://theconversation.com/explainer-how-does-sunscreen-work-what-is-spf-and-can-i-still-tan-with-it-on-88869">sun protection factor or SPF</a>.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/562856/original/file-20231130-17-70ggq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Sunscreen products with various SPF labels" src="https://images.theconversation.com/files/562856/original/file-20231130-17-70ggq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/562856/original/file-20231130-17-70ggq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=257&fit=crop&dpr=1 600w, https://images.theconversation.com/files/562856/original/file-20231130-17-70ggq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=257&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/562856/original/file-20231130-17-70ggq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=257&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/562856/original/file-20231130-17-70ggq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=323&fit=crop&dpr=1 754w, https://images.theconversation.com/files/562856/original/file-20231130-17-70ggq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=323&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/562856/original/file-20231130-17-70ggq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=323&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Consumers could pick their product based on the sun protection factor or SPF.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/set-sunscreen-products-on-turquoise-background-2291735329">Shutterstock</a></span>
</figcaption>
</figure>
<p>This is the ratio of how long it takes a fair-skinned person to burn using the product compared with how long it takes to burn without it. So a cream that protects the skin sufficiently so it takes 40 minutes to burn instead of 20 minutes has an SPF of 2.</p>
<p>Manufacturers liked SPF because businesses that invested in clever chemistry could distinguish themselves in marketing. Consumers liked SPF because it was easy to understand – the higher the number, the better the protection.</p>
<p>Australians, encouraged from 1981 by the <a href="https://www.youtube.com/watch?v=b7nocIenCYg%22">Slip! Slop! Slap!</a> nationwide skin cancer campaign, could now “slop” on a sunscreen knowing the degree of protection it offered.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/how-to-pick-the-right-sunscreen-when-youre-blinded-by-choice-125881">How to pick the right sunscreen when you're blinded by choice</a>
</strong>
</em>
</p>
<hr>
<h2>How about skin cancer?</h2>
<p>It wasn’t until 1999 that research proved that using sunscreen prevents skin cancer. Again, we have Queensland to thank, specifically the residents of Nambour. They took part in a <a href="https://pubmed.ncbi.nlm.nih.gov/10475183/">trial</a> for nearly five years, carried out by a research team led by Adele Green of the Queensland Institute of Medical Research. Using sunscreen daily over that time reduced rates of squamous cell carcinoma (a common form of skin cancer) by about 60%.</p>
<p>Follow-up <a href="https://pubmed.ncbi.nlm.nih.gov/21135266/">studies</a> in 2011 and 2013 showed regular sunscreen use almost halved the rate of melanoma and <a href="https://pubmed.ncbi.nlm.nih.gov/23732711/">slowed skin ageing</a>. But there was no impact on rates of <a href="https://www.cancer.org.au/cancer-information/types-of-cancer/non-melanoma-skin-cancer">basal cell carcinoma</a>, another common skin cancer. </p>
<p>By then, researchers had shown sunscreen stopped sunburn, and stopping sunburn would prevent at least some types of skin cancer.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1729258841827635600"}"></div></p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/theres-a-serious-ethical-problem-with-some-sunscreen-testing-methods-and-youre-probably-not-aware-of-it-195359">There's a serious ethical problem with some sunscreen testing methods – and you're probably not aware of it</a>
</strong>
</em>
</p>
<hr>
<h2>What’s in sunscreen today?</h2>
<p>An effective sunscreen uses one or more active ingredients in a cream, lotion or gel. The <a href="https://theconversation.com/explainer-how-does-sunscreen-work-what-is-spf-and-can-i-still-tan-with-it-on-88869">active ingredient</a> either works:</p>
<ul>
<li><p>“chemically” by absorbing UV and converting it to heat. Examples include PABA (para-aminobenzoic acid) and benzyl salicylate, or</p></li>
<li><p>“physically” by blocking the UV, such as zinc oxide or titanium dioxide. </p></li>
</ul>
<p>Physical blockers at first had limited cosmetic appeal because they were opaque pastes. (Think cricketers with zinc smeared on their noses.) </p>
<p>With microfine particle technology from the 90s, sunscreen manufacturers could then use a combination of chemical absorbers and physical blockers to achieve high degrees of sun protection in a cosmetically acceptable formulation.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/research-check-should-we-be-worried-that-the-chemicals-from-sunscreen-can-get-into-our-blood-116738">Research Check: should we be worried that the chemicals from sunscreen can get into our blood?</a>
</strong>
</em>
</p>
<hr>
<h2>Where now?</h2>
<p>Australians have embraced sunscreen, but they still don’t apply enough <a href="https://www.cancervic.org.au/get-support/stories/australians-dont-apply-enough-sunscreen.html">or</a> reapply often enough.</p>
<p>Although some people are concerned sunscreen will block the skin’s ability to <a href="https://theconversation.com/should-i-be-getting-my-vitamin-d-levels-checked-211268">make vitamin D</a> this is unlikely. That’s because even SPF50 sunscreen doesn’t filter out all UVB.</p>
<p>There’s also concern about the active ingredients in sunscreen <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9652235/">getting into the environment</a> and whether their <a href="https://www.fda.gov/drugs/news-events-human-drugs/spotlight-cder-science-new-fda-study-shines-light-sunscreen-absorption">absorption by our bodies</a> is a problem.</p>
<p>Sunscreens have evolved from something that at best offered mild protection to effective, easy-to-use products that stave off the harmful effects of UV. They’ve evolved from something only people with fair skin used to a product for anyone.</p>
<p>Remember, slopping on sunscreen is just one part of sun protection. Don’t forget to also slip (protective clothing), slap (hat), seek (shade) and slide (sunglasses).</p><img src="https://counter.theconversation.com/content/215893/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Laura Dawes does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Early products focused on tanning. Others roasted you like a chicken. Which of these claims can you remember?Laura Dawes, Research Fellow in Medico-Legal History, Australian National UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2164922023-12-18T04:45:54Z2023-12-18T04:45:54ZWhat sunscreen is best? A dermatologist offers advice on protecting your skin<p><em>Sunburn is a sign that skin has experienced significant levels of damage. Ultraviolet light can change a person’s <a href="https://www.news-medical.net/life-sciences/The-Mechanism-of-DNA-Damage-by-UV-Radiation.aspx#:%7E:text=UVB%20light%20interferes%20directly%20">DNA structure</a>, which can lead to <a href="https://www.skincancer.org/risk-factors/sunburn/#:%7E:text=Even%20one%20blistering%20sunburn%20in,there%20is%20no%20obvious%20burn.">cancer</a>. At the same time, choosing from the multitude of modern sunscreens can be overwhelming. Health & Medicine editor Nadine Dreyer asked dermatologist Bianca Tod what to look for in sun protection.</em></p>
<h2>What are the dangers of too much exposure to the sun, especially in Africa?</h2>
<p>People living in Africa are exposed to high levels of <a href="https://link.springer.com/article/10.1039/c5pp00419e">solar radiation</a>. The continent includes a wide range of latitudes, as well as the Equator. </p>
<p>Even the most northerly and southerly points of Africa experience significant levels of solar radiation. Altitude, weather patterns and other phenomena influence the intensity of this radiation. </p>
<p>People’s lifestyles also determine the level of solar radiation that they are exposed to. Do they work or socialise outside? How much does their traditional dress cover them up? </p>
<p>The sun has many <a href="https://www.medicalnewstoday.com/articles/benefits-of-sunlight#:%7E:text=Sunlight%20is%20essential%20for%20human,and%20promoting%20good%20mental%20health.">beneficial</a> effects, for example improving mood and contributing to vitamin D levels, but it is easy to overdose! </p>
<p>The immediate dangers include sunburn, dehydration, heat stroke and even changes to the immune system. Some of the <a href="https://www.phrp.com.au/issues/march-2022-volume-32-issue-1/review-of-sun-exposure-guidance-documents/">long-term effects</a> are eye damage such as cataracts, visible ageing and skin cancer. </p>
<h2>Are people with dark skin at risk?</h2>
<p>Melanin, which is the main skin pigment, offers protection to living tissues. The more concentrated the melanin, the darker the skin colour. </p>
<p>So, someone with a <a href="https://link.springer.com/article/10.1007/s40257-021-00670-z">darker skin</a> has a greater degree of inherent protection against some of the negative consequences of sun exposure, compared to someone with light skin colour. This protection is not absolute and varies with the skin colour. </p>
<p>There are many types of skin cancer, but sun-related skin cancers occur far more commonly in people with light skin colours, especially people with blue eyes, and red or blonde hair. </p>
<p>But that doesn’t mean they don’t occur in people with darker skin colours, and we certainly see them in people with light brown skin. We occasionally see skin cancer in people with very dark skin. To what extent sun exposure drives these cancers is still not clear. This is an area where we need more research. </p>
<p>People with dark skin are more likely than people with fair skin to develop vitamin D deficiency if they have low levels of sun exposure. Lack of vitamin D has many <a href="https://www.msdmanuals.com/home/disorders-of-nutrition/vitamins/vitamin-d-deficiency">side-effects</a>. It can lead to fatigue, bone pain and muscle cramps as well as mood changes, such as depression.</p>
<p>People with dark skin colours are also more prone than people with light skin to develop uneven or blotchy pigmentation after sun exposure. </p>
<p>Eye damage from the sun occurs in people with all <a href="https://www.aarp.org/health/conditions-treatments/info-2022/eye-color-and-medical-conditions.html">eye colours</a>. </p>
<h2>What should we be looking for when choosing sunscreen?</h2>
<p>Choosing from the multitude of modern sunscreens can be overwhelming, even for a dermatologist. </p>
<p>There are a couple of basic principles that can guide us though. </p>
<p>There are many different types of rays present in sunlight. We are still learning about all the parts of the <a href="https://geoengineering.global/solar-radiation-management/">solar spectrum</a> that have important effects on our skin. </p>
<p>The rays that are most damaging to our skin are called ultraviolet rays.
There are both UVB and UVA rays.</p>
<p>Most <a href="https://dermnetnz.org/topics/ultraviolet-radiation-and-human-health">UVB</a> from the sun doesn’t reach us. It penetrates our skin relatively superficially. But nevertheless it can cause sunburn and some types of skin cancer. </p>
<p>Sun protection factor (SPF) is a measure of UVB protection. Sunscreen should have an SPF of at least 30, but preferably 50. This is because very few of us actually apply as much sunscreen as the manufacturer uses to test the product, so we actually get a lower SPF out of our product.</p>
<p>Around <a href="https://www.skincancer.org/risk-factors/uv-radiation/">95%</a> of the ultraviolet radiation we experience is UVA. It penetrates the skin more deeply than UVB. It plays a role in tanning, sunburn, ageing and skin cancer. </p>
<p>This is where things get very confusing. There is some variation in how manufacturers report UVA protection. You might see PA+ (protection grade of UVA), a star-rating or UV protection factor (UPF). Most sunscreens simply indicate that it is present, or say “broad-spectrum”. </p>
<p>Finding a sunscreen with particularly high levels of UVA coverage is probably only beneficial to people with darker skin colours who are worried about the evenness of their complexion, and people already struggling with uneven pigmentation. </p>
<p>This is because this portion of the light spectrum drives the development of uneven pigmentation. Look for brands that state that their sunscreen is “anti-dark spot”, if this is a concern to you.</p>
<p>Visible light, especially <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/jocd.15576">blue light</a>, and <a href="https://onlinelibrary.wiley.com/doi/10.1111/phpp.12899">infrared radiation</a> protection, are now included in some sunscreens. Both types can damage the eyes. Visible light in particular plays an important role in uneven pigmentation. </p>
<p>It’s important to apply sunscreen <a href="https://www.aad.org/public/everyday-care/sun-protection/shade-clothing-sunscreen/how-to-apply-sunscreen">correctly</a> and to remember that <a href="https://www.aad.org/public/everyday-care/sun-protection/shade-clothing-sunscreen/practice-safe-sun">protection</a> is more than just sunscreen. </p>
<h2>How much damage does sunburn do? What can we do to prevent this?</h2>
<p>Sunburn is to be avoided at all costs. It’s a sign your skin has been damaged.</p>
<p>If you look at sunburned skin under a microscope you’ll see <a href="https://dermnetnz.org/topics/sunburn">swelling, dead skin cells, dilated blood vessels and changes in immune cells</a> that fight harmful substances and germs that enter the body. </p>
<p>Ultraviolet light can actually change the structure of your DNA, which can lead to a <a href="https://link.springer.com/article/10.1007/s42764-020-00009-8">mutation</a> in a specific gene that either promotes cancer or one that fails to suppress cancer. </p>
<p>Luckily, our bodies have a number of safety mechanisms to prevent this, but the more we strain this system, the greater our chance of developing a skin cancer. Melanoma, in particular, can be deadly if it is picked up only when it’s advanced. </p>
<p>Once you have a sunburn, there’s not a lot that you can do besides relieving the symptoms with rest, anti-inflammatories, moisturisers and oral hydration. </p>
<p>With all these dangers it’s really important to avoid sunburns, especially in children. They have many decades ahead for mutations to accumulate, and childhood sunburns are a risk factor for developing melanoma later in life. </p>
<p>Early sun protection is like saving for your retirement.</p><img src="https://counter.theconversation.com/content/216492/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Bianca Tod does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Sunburn can cause cancer, heat stroke and changes to the immune system. Choosing the right sun protection, even for darker skin, is more complicated than it looks.Bianca Tod, Dermatologist and senior lecturer, Stellenbosch UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2142702023-09-27T05:00:44Z2023-09-27T05:00:44ZIs TikTok right – will eating three carrots a day really give me a natural tan?<figure><img src="https://images.theconversation.com/files/550462/original/file-20230926-27-87gql8.jpg?ixlib=rb-1.1.0&rect=367%2C22%2C2851%2C2132&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/young-woman-knife-chopping-raw-carrot-2323628919">Shutterstock</a></span></figcaption></figure><p>A beauty trend gaining popularity on TikTok, dubbed the “<a href="https://www.tiktok.com/@isabelle.lux/video/7255811427246558507?lang=en">carrot tan</a>”, claims eating three carrots a day will give you a natural tan. </p>
<p><iframe id="tc-infographic-929" class="tc-infographic" height="400px" src="https://cdn.theconversation.com/infographics/929/42552deab2963e0b80627704784d1a4b63fd0302/site/index.html" width="100%" style="border: none" frameborder="0"></iframe></p>
<p>But can this really give you a natural glow? And is it healthy?</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/explainer-why-are-carrots-orange-20646">Explainer: why are carrots orange?</a>
</strong>
</em>
</p>
<hr>
<h2>Why would carrots affect your skin tone?</h2>
<p><a href="https://www.ncbi.nlm.nih.gov/books/NBK225469/">Carotenoids</a> are natural pigments that give red, orange and yellow colours to fruits and vegetables. Think of them as nature’s paint. </p>
<p>There are many carotenoids including lutein, lycopene, alpha-carotene and beta-carotene. Beta-carotene is the carotenoid responsible for a carrot’s vibrant orange colour. </p>
<p>Once a beta-carotene containing food is digested, special cells in the gut break it into two molecules of retinol (also known as vitamin A). This vitamin A is then used in various critical bodily functions such as vision, reproduction, immunity and growth. </p>
<p>The body controls the conversion of beta-carotene into vitamin A based on what it needs. So, when the body has enough vitamin A, it slows down or stops converting beta-carotene into vitamin A. </p>
<p>Any extra beta-carotene is then either stored in the liver and fat tissue, excreted through poo, or removed via sweat glands in the outer layer of the skin. This is when the orange skin “tan” can happen. In medicine, this is called <a href="https://onlinelibrary.wiley.com/doi/full/10.1046/j.1365-4362.2003.01657.x#:%7E:text=Carotenoderma%20is%20a%20phenomenon%20characterized,finding%2C%20but%20a%20harmless%20condition.">carotenoderma</a>. </p>
<p>Carotenoderma gives your skin a yellow/orange pigment that is not the same colour you’d turn from a sun tan. It is <a href="https://dermnetnz.org/topics/carotenoderma">concentrated</a> in the palms of the hands, the soles of the feet and smile lines near the nose.</p>
<figure class="align-center ">
<img alt="Carrots" src="https://images.theconversation.com/files/550463/original/file-20230926-27-jzcbex.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/550463/original/file-20230926-27-jzcbex.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/550463/original/file-20230926-27-jzcbex.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/550463/original/file-20230926-27-jzcbex.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/550463/original/file-20230926-27-jzcbex.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/550463/original/file-20230926-27-jzcbex.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/550463/original/file-20230926-27-jzcbex.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Eating lots of carrots can give your skin an orange tone.</span>
<span class="attribution"><a class="source" href="https://www.ncbi.nlm.nih.gov/books/NBK225469/">Shutterstock</a></span>
</figcaption>
</figure>
<p>Carrots are not the only food that contains beta-carotene. Dark-green leafy vegetables, some (not all) other yellow- and orange-coloured vegetables and fruits also contain high amounts. Beta-carotene is also found in parsley, basil, chives, chilli powder, sun-dried tomatoes and some dietary supplements. </p>
<h2>How many carrots are we talking?</h2>
<p>A few days of high carrot intake will unlikely result in a change in skin colour.</p>
<p>No high quality trials have been conducted to test the relationship between number of carrots eaten per day and skin colour changes or other outcomes. However, there is evidence that carotenoderma appears when blood levels get higher than <a href="https://www.ncbi.nlm.nih.gov/books/NBK534878/">250-500 µg/dL</a>.</p>
<p>One published <a href="https://onlinelibrary.wiley.com/doi/10.1002/eat.22015">case report</a> (where researchers talk about one patient’s case) found eating around 3 kilograms of carrots per week (about seven large carrots a day) induced skin colour changes. </p>
<p>Other experts suggest you would need to eat <a href="https://health.clevelandclinic.org/can-eating-too-many-carrots-turn-your-skin-orange/#:%7E:text=%E2%80%9CYou%20would%20need%20to%20be,weeks%20you%20could%20develop%20it.%E2%80%9D">at least ten carrots per day</a>, for at least a few weeks, for colour changes to occur. Most people would find this carrot intake challenging.</p>
<p>The amount of carrots needed to change skin colour will also <a href="https://www.sciencedirect.com/science/article/pii/S0002916523030289#:%7E:text=The%20absorption%20of%20%CE%B2%2Dcarotene,28%3A1%2C%20by%20weight.">depend on</a> the variety of carrot, its size and ripeness, the way the carrot is prepared (raw or cooked) and whether or not the carrot is eaten with a source of fat. A person’s weight and gastrointestinal health will also impact the amount of beta-carotene absorbed. </p>
<h2>Is it dangerous to eat too much beta-carotene?</h2>
<p>Vitamin A comes in two main forms, preformed vitamin A and provitamin A. </p>
<p>Preformed vitamin A is the active form of vitamin A found in animal-based foods including liver, fish liver oil, egg yolks and dairy products. When you eat these foods the preformed vitamin A is already ready to be used by the body. </p>
<p>Provitamin A compounds (including beta-carotene) are the precursors to vitamin A. Provitamin A compounds need to be converted into active vitamin A once inside the body. </p>
<p>Preformed vitamin A can be toxic if consumed in <a href="https://www.eatforhealth.gov.au/nutrient-reference-values/nutrients/vitamin-a">large amounts</a>.
However, provitamin A compounds <a href="https://www.ncbi.nlm.nih.gov/books/NBK225469/">don’t cause vitamin A toxicity</a> in humans because the body tightly regulates the conversion of provitamin A compounds to vitamin A. For this reason, there are <a href="https://www.eatforhealth.gov.au/nutrient-reference-values/nutrients/vitamin-a">no recommended</a> limits on how much beta-carotene a person can safely consume each day.</p>
<p>There is, however, <a href="https://jamanetwork.com/journals/jama/fullarticle/2793446">some</a> <a href="https://www.nejm.org/doi/full/10.1056/NEJM199404143301501">evidence</a> that taking high-dose beta-carotene supplements (20 mg per day or more) increases lung cancer risk in people who smoke cigarettes or used to smoke. This <a href="https://www.tandfonline.com/doi/full/10.1080/01635580903285155">may be due to</a> changes to chemical signalling pathways. </p>
<p>The Cancer Council therefore <a href="https://www.cancercouncil.com.au/cancer-prevention/diet-exercise/nutrition-and-diet/vitamin-supplements-and-cancer/">recommends</a> avoiding high doses of beta-carotene supplements (more than 20 mg per day), especially if you smoke. This <a href="https://wiki.cancer.org.au/policy/Position_statement_-_Beta-carotene_and_cancer_risk">does not</a> relate to wholefoods though, so people who smoke should still consume fruits and vegetables that have beta-carotene.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/carrots-and-pumpkin-might-reduce-your-risk-of-cancer-but-beware-taking-them-in-pill-form-75537">Carrots and pumpkin might reduce your risk of cancer, but beware taking them in pill form</a>
</strong>
</em>
</p>
<hr>
<h2>Why you should aim for a variety of vegetables</h2>
<p>You can still use food to look great without focusing on eating carrots. Incorporating various colourful vegetables, particularly those high in carotenoids, into your diet may <a href="https://www.mdpi.com/2072-6643/7/7/5251">promote</a> a natural radiance and a gentle enhancement in <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0032988">skin tone</a>. </p>
<p>Rather than processed foods, a high variety of fresh vegetables provide various nutrients, and some may have what others lack. So it’s important to have a balanced diet that doesn’t depend on a single type of vegetable. </p>
<p>No matter how many carrots you eat in a day, it’s important to <a href="https://www.sciencedirect.com/science/article/pii/S0002916523030265?via%3Dihub">protect</a> your skin with sunscreen when going outside.</p><img src="https://counter.theconversation.com/content/214270/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Lauren Ball works for The University of Queensland and receives funding from the National Health and Medical Research Council, Queensland Health, Mater Misericordia and the Royal Australian College of General Practitioners. She is a Director of Dietitians Australia, a Director of the Darling Downs and West Moreton Primary Health Network and an Associate Member of the Australian Academy of Health and Medical Sciences.</span></em></p><p class="fine-print"><em><span>Emily Burch works for Southern Cross University.</span></em></p>Can this really give you a natural glow? And is it healthy?Lauren Ball, Professor of Community Health and Wellbeing, The University of QueenslandEmily Burch, Dietitian, Researcher & Lecturer, Southern Cross UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1323752020-03-05T14:20:42Z2020-03-05T14:20:42ZThere’s a complex history of skin lighteners in Africa and beyond<figure><img src="https://images.theconversation.com/files/317538/original/file-20200227-24680-l3fa2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Detail of book cover</span> <span class="attribution"><span class="source">Wits University Press</span></span></figcaption></figure><p>Somali-American activists recently scored a victory against Amazon and against <a href="https://www.theguardian.com/commentisfree/2019/oct/09/colourism-is-finally-being-taken-seriously-thanks-to-celebrities-like-lupita-nyongo">colourism</a>, which is prejudice based on preference for people with lighter skin tones. Members of the non-profit <a href="http://thebeautywell.org/">The Beautywell Project</a> teamed up with the <a href="https://www.sierraclub.org/">Sierra Club</a> to convince the online retail giant to stop selling skin lightening products that contain <a href="https://www.thoughtco.com/mercury-element-facts-608433">mercury</a>.</p>
<p>After more than a year of protests, this coalition of antiracist, health, and environmental activists <a href="https://www.mprnews.org/story/2019/11/22/amazon-pulls-skinlightening-creams-from-site-after-demands-from-minnesota-activists">persuaded Amazon</a> to remove some 15 products containing <a href="https://www.zeromercury.org/">toxic levels of mercury</a>. This puts a small but noteworthy dent in the global trade in skin lighteners, estimated to reach US$31.2 billion by 2024.</p>
<figure class="align-left ">
<img alt="" src="https://images.theconversation.com/files/318031/original/file-20200302-18283-k3bdh0.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/318031/original/file-20200302-18283-k3bdh0.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=1067&fit=crop&dpr=1 600w, https://images.theconversation.com/files/318031/original/file-20200302-18283-k3bdh0.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=1067&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/318031/original/file-20200302-18283-k3bdh0.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=1067&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/318031/original/file-20200302-18283-k3bdh0.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1340&fit=crop&dpr=1 754w, https://images.theconversation.com/files/318031/original/file-20200302-18283-k3bdh0.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1340&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/318031/original/file-20200302-18283-k3bdh0.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1340&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Amira Adawe, an activist with The Beautywell Project pickets outside Amazon.</span>
<span class="attribution"><span class="source">Amira Adawe</span></span>
</figcaption>
</figure>
<p>What are the roots of this sizeable trade? And how might its most toxic elements be curtailed?</p>
<p>The online sale of skin lighteners is relatively new, but the in-person traffic is very old. My new <a href="https://www.dukeupress.edu/beneath-the-surface">book</a> explores this layered history from the vantage point of South Africa.</p>
<p>As in other parts of the world colonised by European powers, the politics of skin colour in South Africa have been importantly shaped by the <a href="https://www.sahistory.org.za/article/history-apartheid-south-africa">history</a> of white supremacy and institutions of racial slavery, colonialism, and segregation. My book examines that history.</p>
<p>Yet, racism alone cannot explain skin lightening practices. My book also attends to intersecting dynamics of class and gender, changing beauty ideals and the expansion of consumer capitalism.</p>
<h2>A deep history of skin whitening and lightening</h2>
<p>For centuries and even millennia, elites used paints and powders to create smoother, paler appearances, unblemished by illness and the sun’s darkening and roughening effects.</p>
<p>Cosmetic users in ancient Mesopotamia, Egypt, Greece, and Rome created dramatic appearances by pairing skin whiteners containing lead or chalk with black eye makeup and red lip colourants. In China and Japan too, elite women and some men used white lead preparations and rice powder to achieve complexions resembling white jade or fresh lychee.</p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/318048/original/file-20200302-18308-t3ibht.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/318048/original/file-20200302-18308-t3ibht.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=1079&fit=crop&dpr=1 600w, https://images.theconversation.com/files/318048/original/file-20200302-18308-t3ibht.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=1079&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/318048/original/file-20200302-18308-t3ibht.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=1079&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/318048/original/file-20200302-18308-t3ibht.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1356&fit=crop&dpr=1 754w, https://images.theconversation.com/files/318048/original/file-20200302-18308-t3ibht.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1356&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/318048/original/file-20200302-18308-t3ibht.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1356&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">In this 1623 portrait by Anthony van Dyck, Elena Grimaldi’s regal whiteness is underscored by a dark-toned servant.</span>
<span class="attribution"><span class="source">Wikimedia Commons</span></span>
</figcaption>
</figure>
<p>Skin lighteners generate a less painted look than skin whiteners by removing rather than concealing blemished or melanin-rich skin. <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/melanin">Melanin</a> is the biochemical compound that makes skin colourful.</p>
<p>Active ingredients in skin lighteners have ranged from acidic compounds like lemon juice and milk to harsher chemicals like sulfur, arsenic, and mercury. In parts of precolonial Southern Africa, some people used mineral and botanical preparations to brighten – rather than whiten or lighten – their skin and hair.</p>
<p>During the era of the <a href="http://www.unesco.org/new/en/social-and-human-sciences/themes/slave-route/transatlantic-slave-trade/">trans-Atlantic slave trade</a>, skin colour and associated physical difference were used to distinguish enslaved people from free, and to justify the former’s oppression. Colonisers cast melanin-rich hues as the embodiment of ugliness and inferiority. Within this racist political order, some sought to whiten and lighten their complexions.</p>
<p>By the twentieth century, mass-produced skin lightening creams ranked among the world’s most popular cosmetics. Consumers included white, black, and brown women.</p>
<figure class="align-left ">
<img alt="" src="https://images.theconversation.com/files/317436/original/file-20200226-24690-8e4tu1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/317436/original/file-20200226-24690-8e4tu1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=756&fit=crop&dpr=1 600w, https://images.theconversation.com/files/317436/original/file-20200226-24690-8e4tu1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=756&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/317436/original/file-20200226-24690-8e4tu1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=756&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/317436/original/file-20200226-24690-8e4tu1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=950&fit=crop&dpr=1 754w, https://images.theconversation.com/files/317436/original/file-20200226-24690-8e4tu1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=950&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/317436/original/file-20200226-24690-8e4tu1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=950&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">This ad appeared in an issue of the Central and East African edition of Drum magazine.</span>
<span class="attribution"><span class="source">Duke University Press</span></span>
</figcaption>
</figure>
<p>In the 1920s and 1930s, many white consumers swapped skin lighteners for tanning lotions as time spent sunbathing and playing outdoors became a sign of a healthy and leisured lifestyle. <a href="https://www.theguardian.com/commentisfree/2012/feb/19/history-of-tanning">Seasonal tanning</a> embodied new forms of white privilege.</p>
<p>Skin lighteners became primarily associated with people of colour. For black and brown consumers, living in places like the United States and South Africa where racism and colourism have flourished, even slight differences in skin colour could carry political and social consequences.</p>
<h2>The mercury effect</h2>
<p>Skin lighteners can be physically harmful. Mercury, one of their most common active ingredients, lightens skin in two ways. It inhibits the formation of melanin by rendering the enzyme <a href="https://www.ncbi.nlm.nih.gov/pubmed/8496620">tyrosinase</a> inactive; and it exfoliates the tanned, outer layers of the skin through the production of <a href="https://pubchem.ncbi.nlm.nih.gov/compound/Hydrochloric-acid">hydrochloric acid</a>.</p>
<p>By the early twentieth century, pharmaceutical and medical textbooks recommended mercury – usually in the form of ammoniated mercury – for treating skin infections and dark spots while often warning of its harmful effects. Cosmetic manufacturers marketed creams containing ammoniated mercury as “freckle removers” or “skin bleaches”.</p>
<p>When the US Congress passed the <a href="https://www.fda.gov/about-fda/histories-product-regulation/1938-food-drug-and-cosmetic-act">Food, Drug and Cosmetics Act in 1938</a>, such creams were among the first to be regulated.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/317446/original/file-20200226-24659-1ii165p.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/317446/original/file-20200226-24659-1ii165p.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=479&fit=crop&dpr=1 600w, https://images.theconversation.com/files/317446/original/file-20200226-24659-1ii165p.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=479&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/317446/original/file-20200226-24659-1ii165p.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=479&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/317446/original/file-20200226-24659-1ii165p.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=602&fit=crop&dpr=1 754w, https://images.theconversation.com/files/317446/original/file-20200226-24659-1ii165p.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=602&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/317446/original/file-20200226-24659-1ii165p.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=602&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Part of Twins’s success lay in their recruitment of hawkers to sell their products in townships. Bona, May 1959.</span>
<span class="attribution"><span class="source">Duke University Press</span></span>
</figcaption>
</figure>
<p>After World War II, the negative environmental and health impact of mercury became more apparent. The devastating case of <a href="https://www.sciencedaily.com/releases/2020/02/200213135755.htm">mercury poisoning</a> caused by industrial wastewater in Minamata, Japan, prompted the Food and Drug Administration to take a closer look at mercury’s toxicity, including in cosmetics. Here was a visceral instance of what environmentalist <a href="https://www.rachelcarson.org/">Rachel Carson</a> meant about small, domestic choices making the world uninhabitable.</p>
<p>In 1973, the administration banned all but trace amounts of mercury from cosmetics. Other countries followed suit. South Africa banned mercurial cosmetics in 1975, the European Economic Union in 1976, and Nigeria in 1982. The trade in skin lighteners, nonetheless, continued as other active ingredients – most notably <a href="https://www.rxlist.com/consumer_hydroquinone_melquin_3/drugs-condition.htm">hydroquinone</a> – replaced ammoniated mercury.</p>
<h2>Meanwhile in South Africa</h2>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/317447/original/file-20200226-24664-1uevavc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/317447/original/file-20200226-24664-1uevavc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=767&fit=crop&dpr=1 600w, https://images.theconversation.com/files/317447/original/file-20200226-24664-1uevavc.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=767&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/317447/original/file-20200226-24664-1uevavc.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=767&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/317447/original/file-20200226-24664-1uevavc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=964&fit=crop&dpr=1 754w, https://images.theconversation.com/files/317447/original/file-20200226-24664-1uevavc.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=964&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/317447/original/file-20200226-24664-1uevavc.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=964&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">A full-color.
In the early 1960s, colour photography and printing saw skin lightener ads feature a range of light brown and reddish skintones. Drum, September 1961.</span>
<span class="attribution"><span class="source">Duke University Press</span></span>
</figcaption>
</figure>
<p>In apartheid South Africa, the trade was especially robust. Skin lighteners ranked among the most commonly used personal products in black urban households. During the 1980s, activists inspired by <a href="https://www.sahistory.org.za/article/defining-black-consciousness">Black Consciousness</a> and the sentiment “<a href="https://www.theguardian.com/artanddesign/2019/mar/26/kwame-brathwaite-photographer-black-is-beautiful">Black is Beautiful</a>” teamed up with concerned medical professionals to make opposition to skin lighteners part of the <a href="https://www.aluka.org/struggles/collection/AAM">anti-apartheid movement</a>.</p>
<p>In the early 1990s, activists convinced the government <a href="https://theconversation.com/why-its-time-all-african-countries-took-a-stand-on-skin-lightening-creams-49780">to ban</a> all cosmetic skin lighteners containing known depigmenting agents – and to prohibit cosmetic advertisements from making any claims to “bleach”, “lighten” or “whiten” skin. This prohibition was the first of its kind and the regulations immediately shuttered the in-country manufacture of skin lighteners.</p>
<p>South Africa’s regulations testify to the broader antiracist political movement from which they emerged. Thirty years on, however, South Africa again possesses a <a href="https://www.lawforall.co.za/2019/10/skin-lightening-south-africa-law/">robust</a> – if now illicit – trade in skin lighteners. An especially disturbing element is the resurgence of mercurial products.</p>
<figure class="align-left ">
<img alt="" src="https://images.theconversation.com/files/317449/original/file-20200226-24664-9ddcjv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/317449/original/file-20200226-24664-9ddcjv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=905&fit=crop&dpr=1 600w, https://images.theconversation.com/files/317449/original/file-20200226-24664-9ddcjv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=905&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/317449/original/file-20200226-24664-9ddcjv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=905&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/317449/original/file-20200226-24664-9ddcjv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1137&fit=crop&dpr=1 754w, https://images.theconversation.com/files/317449/original/file-20200226-24664-9ddcjv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1137&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/317449/original/file-20200226-24664-9ddcjv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1137&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption"></span>
<span class="attribution"><span class="source">Wits University Press</span></span>
</figcaption>
</figure>
<p>South African researchers have found that over 40% of skin lighteners sold in <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/j.1365-4632.2012.05566.x">Durban</a> and <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/ced.12720">Cape Town</a> contain mercury.</p>
<p>The activists’ recent victory against Amazon suggests one way forward. They took out a full-page ad in a local newspaper denouncing Amazon’s sale of mercurial skin lighteners as “dangerous, racist, and illegal.” A petition with 23,000 signatures was hand-delivered to the company’s Minnesota office.</p>
<p>By combining antiracist, health, and environmentalist arguments, activists held one of the world’s most powerful companies accountable. They also brought the toxic presence of mercurial skin lighteners to public awareness and made them more difficult to purchase.</p>
<p><em>Lynn M. Thomas’s latest book Beneath the Surface: A Transnational History of Skin Lighteners is available from <a href="https://witspress.co.za/catalogue/beneath-the-surface/">Wits University Press</a> and from <a href="https://www.dukeupress.edu/beneath-the-surface">Duke University Press</a>.</em></p><img src="https://counter.theconversation.com/content/132375/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Lynn M. Thomas does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The long history of racist beauty standards alone cannot explain the ongoing global use of harmful skin lighteners.Lynn M. Thomas, History Professor, University of WashingtonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1094392019-01-10T18:24:49Z2019-01-10T18:24:49ZThere’s no such thing as a safe tan. Here’s what’s happening underneath your summer glow<figure><img src="https://images.theconversation.com/files/253167/original/file-20190110-32130-1iudwn8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">You might prefer the way you look with a tan (most Aussies do), but you won't when your skin is prematurely aged. </span> <span class="attribution"><span class="source">from www.shutterstock.com</span></span></figcaption></figure><p>There’s a lot to be said for sunshine – both <a href="https://wiki.cancer.org.au/policy/Position_statement_-_Risks_and_benefits_of_sun_exposure">good and bad</a>. It’s our main source of vitamin D, which is essential for bone and muscle health. Populations with higher levels of sun exposure also have better blood pressure and mood levels, and fewer autoimmune diseases such as multiple sclerosis. </p>
<p>On the other hand, excess UV exposure is estimated to contribute to <a href="https://www.cancer.org.au/about-cancer/types-of-cancer/skin-cancer.html">95% of melanomas</a> and 99% of non-melanoma skin cancers. These skin cancers account for a whopping <a href="https://www.cancer.org.au/about-cancer/types-of-cancer/skin-cancer.html">80% of all new cancers</a> each year in Australia. </p>
<p>Like any medicine, <a href="https://theconversation.com/columns/ian-musgrave-1808">the dose counts</a>. And in Australia, particularly in the summer, our dose of UV is so high that even short incidental exposures – like while you hang out the washing or walk from your carpark into the shops – adds up to huge lifetime doses.</p>
<p>Fortunately, when it comes to tanning, the advice is clear: don’t. A UV dose that’s <a href="https://www.ncbi.nlm.nih.gov/pubmed/23749111">high enough to induce a tan</a> is already much higher than the dose needed for vitamin D production. A <a href="https://www.ncbi.nlm.nih.gov/pubmed/22634425">four-year-long study</a> of 1,113 people in Nambour, Queensland, found no difference in vitamin D levels between sunscreen users and sunscreen avoiders. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/mondays-medical-myth-were-not-getting-enough-sun-10205">Monday's medical myth: we’re not getting enough sun</a>
</strong>
</em>
</p>
<hr>
<h2>What’s happening in the skin when I get a tan?</h2>
<p>A tan forms when ultraviolet (UV) rays from the sun discharge too much energy into our skin, causing damage to membranes, proteins, and most importantly, DNA. The excess energy of UVB rays (part of the UV ray that penetrates the upper layers of our skin) prevents the DNA from copying correctly when the cells multiply which can cause mutations.</p>
<p>UVA rays which penetrate deeper into the skin can trigger a reactive and harmful process (known as oxidative free radical damage) which can damage not just DNA but also many of the skin’s structural components. It’s been estimated a single day’s sun exposure can cause <a href="https://www.ncbi.nlm.nih.gov/pubmed/23749111">up to a million DNA defects</a> in each skin cell. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/253157/original/file-20190110-32142-3dgzzc.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/253157/original/file-20190110-32142-3dgzzc.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=462&fit=crop&dpr=1 600w, https://images.theconversation.com/files/253157/original/file-20190110-32142-3dgzzc.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=462&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/253157/original/file-20190110-32142-3dgzzc.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=462&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/253157/original/file-20190110-32142-3dgzzc.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=581&fit=crop&dpr=1 754w, https://images.theconversation.com/files/253157/original/file-20190110-32142-3dgzzc.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=581&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/253157/original/file-20190110-32142-3dgzzc.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=581&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Excess energy from UVB rays causes DNA bases to link up incorrectly, making it difficult to copy accurately and leading to mutations that can cause cancer.</span>
<span class="attribution"><span class="source">NASA/David Herring</span></span>
</figcaption>
</figure>
<p>Once their DNA repair mechanisms detect large amounts of damage, skin cells signal pigment-producing cells (melanocytes) to start producing extra melanin, the pigment that gives our skin, hair and eyes their colour. </p>
<p>The extra melanin is parcelled up and transported into other skin cells to settle over and protect the part of the cell containing the DNA. This filters some UV rays and gives tanned skin its brown colour. But this tan doesn’t provide much help – it’s only as protective as <a href="https://www.ncbi.nlm.nih.gov/pubmed/24891049">SPF 2 sunscreen</a>.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/explainer-what-happens-to-your-skin-when-you-get-sunburnt-53865">Explainer: what happens to your skin when you get sunburnt?</a>
</strong>
</em>
</p>
<hr>
<h2>Wrinkles, blotches and broken capillaries</h2>
<p><a href="https://www.cancer.org.au/about-cancer/types-of-cancer/skin-cancer.html">Two in three Australians</a> will develop a skin cancer in their lifetime, mostly thanks to the DNA damage caused by UVB rays. But premature ageing is a less well-known effect of too much sun exposure.</p>
<p>UVA rays penetrate deep into the dermis, the lower layer of the skin, and generate reactive oxygen that damages the skin’s structures. Over time this causes <a href="https://www.dermnetnz.org/topics/solar-elastosis">solar elastosis</a>, where irregularly thickened clumps of elastic fibres form, then degrade into disorganised, tangled structures.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/253153/original/file-20190110-32139-1vt2olq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/253153/original/file-20190110-32139-1vt2olq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=398&fit=crop&dpr=1 600w, https://images.theconversation.com/files/253153/original/file-20190110-32139-1vt2olq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=398&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/253153/original/file-20190110-32139-1vt2olq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=398&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/253153/original/file-20190110-32139-1vt2olq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/253153/original/file-20190110-32139-1vt2olq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/253153/original/file-20190110-32139-1vt2olq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">This 70-year-old has deep wrinkling and skin darkening caused by long-term sun exposure on her neck and part of her chest exposed by her shirt, while the rest of her skin has stayed relatively clear and unwrinkled.</span>
<span class="attribution"><span class="source">Author provided</span></span>
</figcaption>
</figure>
<p>Eventually this can take the form of roughening or leathery appearance, deep wrinkling, dark blotches and star-shaped white patches, and an overall yellowish tone. Prematurely-aged skin is often more easily-bruised or has broken capillaries. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/253162/original/file-20190110-32139-xfwi6c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/253162/original/file-20190110-32139-xfwi6c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=225&fit=crop&dpr=1 600w, https://images.theconversation.com/files/253162/original/file-20190110-32139-xfwi6c.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=225&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/253162/original/file-20190110-32139-xfwi6c.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=225&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/253162/original/file-20190110-32139-xfwi6c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=283&fit=crop&dpr=1 754w, https://images.theconversation.com/files/253162/original/file-20190110-32139-xfwi6c.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=283&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/253162/original/file-20190110-32139-xfwi6c.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=283&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Dark blotches and white scar-like patches are common signs of ageing caused by too much sun.</span>
<span class="attribution"><span class="source">DermNetNZ.org</span></span>
</figcaption>
</figure>
<h2>But I like the way a tan looks. What now?</h2>
<p>It’s well known that a tanned look seems healthy and attractive to many Australians. Recent research shows Australians who feel <a href="https://onlinelibrary.wiley.com/doi/10.1111/ajd.12974">particularly self-conscious</a> about their body are more likely to intentionally tan to increase their sense of attractiveness. </p>
<p>Fortunately, there’s a safe way to indulge in the aesthetics of golden-brown skin: any tan that comes out of a bottle with the active ingredient <a href="https://www.dermnetnz.org/topics/dihydroxyacetone">dihydroxyacetone</a>. This is a colourless sugar molecule that turns brown when it reacts with amino acids in the skin. It’s safe to use because it doesn’t penetrate deeper than the very top layer of skin, where the cells are already dead. </p>
<p>Don’t be tempted by solariums and sunbeds, because they emit <a href="http://www.sunsmart.com.au/uv-sun-protection/solariums">up to six times as much UV</a> as the midday summer sun. Commercial solariums are illegal in Australia for this reason, but there are still privately-owned sunbeds in use. Avoid them at all costs. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/how-do-the-chemicals-in-sunscreen-protect-our-skin-from-damage-74355">How do the chemicals in sunscreen protect our skin from damage?</a>
</strong>
</em>
</p>
<hr>
<h2>So how do I stay sun safe without living in a cave?</h2>
<p>There are two parts to sunsafe behaviour in Australia that lets you get the health benefits of sunshine and prevents you from being one of the <a href="https://www.cancer.org.au/news/media-releases/new-research-shows-almost-2.4-million-aussie-adults-sunburnt-on-summer-weekends.html">2.4 million Aussies</a> getting sunburnt each weekend.</p>
<p>First, you should wear 30+ SPF sunscreen every day when the UV index in your area is three or higher. By putting it on everywhere that isn’t covered by that day’s outfit, you protect yourself from the damage accumulated by short exposures, day in and day out, in Australia’s intense UV environment. </p>
<p>You should make sunscreen part of your morning routine, like brushing your teeth. Use the Cancer Council’s free <a href="https://www.cancer.org.au/preventing-cancer/sun-protection/uv-alert/sunsmart-app.html">Sun Smart app</a> or check your local weather report to find out the UV index where you are today. </p>
<p>During the cooler months in southern parts of Australia, when the UV index is often below three, it’s good to spend some time on most days, in the middle of the day, with skin exposed to the sun to <a href="https://wiki.cancer.org.au/policy/Position_statement_-_Risks_and_benefits_of_sun_exposure">maintain healthy vitamin D levels</a>. </p>
<p>So, a lunchtime stroll with your sleeves rolled up is a good idea in July in Hobart, where the UV index only gets up to one. In Brisbane at the same time, with an average July UV index of four, you don’t need to take special steps to get enough vitamin D.</p>
<p>Second, if you’re <a href="http://www.assc.org.au/eventssunscreen-summit-19-20-march-2018/">planning to be outside for a prolonged time</a>, you should follow the Slip Slop Slap Seek Slide advice. Slip on a long-sleeved shirt, slop on sunscreen, slap on a hat, seek shade and slide on some sunglasses. Reapply your sunscreen every two hours, and be sure to use plenty: you want about a teaspoon each for your back, chest, head/neck, and each arm and leg.</p><img src="https://counter.theconversation.com/content/109439/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>H. Peter Soyer is a consultant for Canfield Scientific Inc, MoleMap NZ Limited, e-derm consult GmbH, and First Derm, and is a shareholder in MoleMap NZ and e-derm GmbH. He receives funding from the National Health and Medical Research Council. </span></em></p><p class="fine-print"><em><span>Katie Lee does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>You need far less sun than you think you do.H. Peter Soyer, Professor of Dermatology, The University of QueenslandKatie Lee, Research assistant, The University of QueenslandLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1002822018-08-01T09:29:27Z2018-08-01T09:29:27ZDonald Trump’s orange face may be funny, but this tanning historian says it masks something deeper<figure><img src="https://images.theconversation.com/files/230016/original/file-20180731-136652-1tufvln.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/london-uk-13th-july-2018-editorial-1137310259?src=9glTfIIjouvBaTyswKQESg-1-15">John Gomez / Shutterstock.com</a></span></figcaption></figure><p>Angry Creamsicle, Comrade Cheetolino, Mango Mussolini, Agent Orange – these are just a few of the nicknames that Donald Trump has picked up along his presidential road. Trump may ethnically identify as “white”, but his skin is categorically and scathingly portrayed <a href="https://medium.com/@allanishac/50-nicknames-for-donald-trump-you-wont-be-hearing-on-fox-news-7b7a5ca1b1b1">as orange</a>.</p>
<p>When Trump was elected in 2016, succeeding former president Barack Obama, I remember references such as “<a href="https://www.usnews.com/news/articles/2016-01-14/why-is-donald-trump-orange">orange is the new black</a>”. At once an allusion to the popular Netflix series and a bold comment on race, colour here functions as an important form of satire. And this satiric use of colour has persisted throughout Trump’s presidency. His recent UK visit witnessed the orange <a href="https://theconversation.com/trump-baby-balloon-why-humour-is-such-a-powerful-form-of-protest-99724">baby balloon</a> and orange-faced protesters continuing this in full force.</p>
<p>My specialism is the <a href="http://www.oapen.org/search?identifier=633234;keyword=soaking%20up%20the%20rays">history of tanning</a>, so I find this particular form of humour fascinating. It’s striking that Trump’s skin tone, above all else, has prompted such a level of derision. </p>
<h2>Fake it to make it</h2>
<p>Orange is a colour with such comedic value because it is impossible, disingenuous: it is a mark of artifice. Tanning enthusiasts speak of achieving a healthy “glow”, looking “bronzed”, and one’s (implicitly and necessarily once white) skin “browning” in the sun. “Fake bake” would seem, and is marketed as, the safer alternative to true exposure to the sun’s UV rays, which we know can cause cancer. </p>
<p>But the problem is it remains just that: fake. The colouring is a dye, sitting on the skin’s upper surface layer, not a natural alteration of pigment embedded deeper within the cells. Unlike red lipstick, violet hair dye, or blue eye shadow – which are also clearly “unnatural” aesthetic additions and colour modifications to the human face – the orange fake tan (or serious overuse of bronzer) is widely viewed as unacceptable within popular culture. The natural progression of skin “<a href="https://en.wikipedia.org/wiki/Fitzpatrick_scale">phototypes</a>” does not include orange as a colour “<a href="http://char.txa.cornell.edu/language/element/color/color.htm">value</a>” on this light-dark spectrum.</p>
<p>Less a subtle browning than a fluorescent face plant, we find the colour funny because it’s an all-too-obvious applied coating that fails to convince anyone of <a href="http://www.dailymail.co.uk/femail/article-3474768/The-WORST-fake-tan-fails-time-revealed-avoid-them.html">natural pigmentation</a>. Orange is not bronze, not brown, not black (and never will be). It is laughable, therefore, because it is a mark of failure, an act of mimicry gone wrong. Put simply, orange isn’t “of value” to us because it isn’t a “value” as a skin colour at all.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/230019/original/file-20180731-136673-v8g21v.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/230019/original/file-20180731-136673-v8g21v.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=449&fit=crop&dpr=1 600w, https://images.theconversation.com/files/230019/original/file-20180731-136673-v8g21v.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=449&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/230019/original/file-20180731-136673-v8g21v.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=449&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/230019/original/file-20180731-136673-v8g21v.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=565&fit=crop&dpr=1 754w, https://images.theconversation.com/files/230019/original/file-20180731-136673-v8g21v.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=565&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/230019/original/file-20180731-136673-v8g21v.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=565&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Agent Orange.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/grant-park-chicagojanuary-20-2018-womens-1007833165?src=0o21NbjoU5NsSKycZJ6drA-3-67">Antwon McMullen / Shutterstock.com</a></span>
</figcaption>
</figure>
<p>And let us remember why it exists in the first place. It is a normalised belief in white Western culture that dark skin is to be envied, that altering (however temporarily) one’s original colour by darkening it several shades down the colour line will make it look more beautiful, healthier, sexier, younger. This is the case for both women, especially young white women in the US and UK, as well as men, not least male bodybuilders. </p>
<p>It’s not surprising, then, that Trump believes altering his <a href="https://www.buzzfeed.com/jenlewis/this-is-what-donald-trump-would-look-like-without-his-fake-t?bftw&utm_term=.ys2dkq5xo#.bb69jqb1O">natural skin colour</a> will improve his appearance and, hence, sense of self. The belief in a “healthy tan” has existed since the early 20th century, and continues to drive tourism just as it drives the tanning bed and fake tan industries. </p>
<h2>Getting below the surface</h2>
<p>I’d argue that there is something very serious about Trump’s orange face – something serious about the superficial. Scottish artist and writer <a href="http://www.davidbatchelor.co.uk/books/chromophobia/">David Batchelor</a> argues that colour has been feared and marginalised as trivial, as artifice, as “other”, throughout the history of Western civilisation. He terms this “chromophobia”, describing the prejudice against colour as operating two ways: </p>
<blockquote>
<p>In the first, colour is made out to be the property of some ‘foreign’ body - usually the feminine, the oriental, the primitive, the infantile, the vulgar, the queer or the pathological. In the second, colour is relegated to the realm of the superficial, the supplementary, the inessential or the cosmetic. In one, colour is regarded as alien and therefore dangerous; in the other, it is perceived merely as a secondary quality of experience, and thus unworthy of serious consideration. Colour is dangerous, or it is trivial, or it is both. </p>
</blockquote>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/230018/original/file-20180731-136655-1cq6f1b.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/230018/original/file-20180731-136655-1cq6f1b.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/230018/original/file-20180731-136655-1cq6f1b.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/230018/original/file-20180731-136655-1cq6f1b.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/230018/original/file-20180731-136655-1cq6f1b.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/230018/original/file-20180731-136655-1cq6f1b.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/230018/original/file-20180731-136655-1cq6f1b.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Fake tan, fake news.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/cheetos-face-trump-fake-you-tan-1005829585?src=h29Evh0vwiVyD8s7VB9Xxg-1-4">Manutsawee Buapet / Shutterstock.com</a></span>
</figcaption>
</figure>
<p>Like his combover (his thinning hair suggesting lost youth and virility) or his sourpuss pouts (lost composure under intense media scrutiny), Trump’s orange skin is a target of ridicule – of a man obsessed with vanity yet marked by signs of failed masculinity. And yet there is danger here, too, for they are implicitly signs of weak and worrisome leadership, of a man out of control of his appearance and perhaps, by extension to his opponents, his country.</p>
<p>The reference to Trump as “<a href="https://en.wikipedia.org/wiki/Agent_Orange">Agent Orange</a>” is particularly relevant. Used by the US military in the Vietnam War to destroy foliage, this chemical also contained the carcinogen, TCDD, which <a href="https://en.wikipedia.org/wiki/File:Agent-Orange-dioxin-skin-damage-Vietnam.jpg">seriously harmed</a> many local inhabitants and their future unborn children. For artists like Busta Rhymes, <a href="https://www.telegraph.co.uk/music/news/busta-rhymes-calls-president-agent-orange-donald-trump-grammys/">Trump is envisioned</a> as a dangerous weapon or force of destruction that threatens global peace.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"830988507833212928"}"></div></p>
<p>Above all, there is a crucial irony that the orange-saturated skin that has become so characteristic of Trump’s image is totally at odds with the overt xenophobia and racism that saturate his words and actions. Yet here, too, are historical parallels: Hitler equally praised the “bronzed”, sculpted bodies of the ancients and encouraged his soldiers to tan and exercise in the open air while simultaneously spouting of the purity of the Aryan race.</p>
<p>I am not arguing that Trump is a modern-day Hitler (even if <a href="https://theconversation.com/trump-hitler-comparisons-too-easy-and-ignore-the-murderous-history-92394">others have</a>). What I am arguing is that orange is a colour not of comedy but of contention, even <a href="https://theconversation.com/humitas-a-new-word-for-when-humour-and-seriousness-combine-82556">provocation</a>. <a href="http://www.abc.net.au/news/2017-02-21/thousands-of-demonstrators-across-us-say-not-my-president/8289346">Protesters</a> wear orange paint like a war mask, mocking Trump’s unstable character and confused “values”. His odd, even toxic, colouring may seem trivial, but its meaning is more than skin deep.</p><img src="https://counter.theconversation.com/content/100282/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Tania Woloshyn has received funding from the Wellcome Trust, through a Research Fellowship and a People Award (2012-2016). Previously (2004-2008; 2010-2012) she received funding from the Social Sciences and Humanities Research Council of Canada (SSHRC).</span></em></p>Comrade Cheetolino, Mango Mussolini, Agent Orange … just a few of Trump’s fake tan induced nicknames.Tania Woloshyn, Associate Fellow in History, University of WarwickLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/989992018-07-18T15:12:01Z2018-07-18T15:12:01ZHealth clubs using tanning beds to attract members despite cancer risks, new study shows<figure><img src="https://images.theconversation.com/files/224982/original/file-20180626-112598-pyftsg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Individuals using indoor tanning are exposed to two types of UV rays -- UVA and UVB -- that damage skin and DNA and can lead to cancer, including the deadliest one: melanoma. Young users are most at risk.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/young-beautiful-latin-lady-lying-on-88135858?src=BpuO-_EIkjDyv8-TxSQmZA-1-12">By Rido/shutterstock.com</a></span></figcaption></figure><p>I drove past Planet Fitness on the way to my 10-year-old’s gymnastics class and had to chuckle at their sign advertising free pizza as part of a new member promotion. I decided to use this as a teaching moment, explaining to my daughter why we should avoid using junk food as a reward for exercise. This is one of many lectures she has heard from her mom, a cancer prevention scientist. </p>
<p>When I decided to look a little deeper into what gyms are offering to entice people to sign up, pizza turned out to be the least of my concerns. Many gyms offer access to tanning beds, a <a href="https://doi.org/10.1002/ijc.22453">known carcinogen</a>, to their patrons. We would be astounded if gyms provided tobacco to patrons, so we must pose serious questions to gyms who provide ultraviolet radiation.</p>
<p>The comparison of tobacco and tanning beds might seem like hyperbole, but it is not. They are both rated <a href="https://doi.org/10.1002/ijc.22453">group 1 carcinogens</a> and <a href="http://doi.org/10.1001/jamadermatol.2013.6896">research</a> shows that we now have more cancers related to tanning beds than cancers related to tobacco.</p>
<h2>Gyms are supporting the tanning industry</h2>
<p>To explore how pervasive these gym-tanning salons were, I asked my research assistant to call every Planet Fitness, Anytime Fitness and Gold’s Gym in Massachusetts and Connecticut to find out just how many had tanning beds. Of the 167 gyms we found on Google, 66 percent offer patrons tanning beds, with Planet Fitness the biggest offender where a whopping 100 percent of their franchises have tanning beds. In total, these gyms have 408 tanning beds. <a href="https://jamanetwork.com/journals/jamadermatology/fullarticle/2687548">Extrapolating this to all 50 states</a> would mean that these three gym chains alone house over 10,000 tanning beds nationwide. That’s an equivalent capacity to 1,600 tanning salons. The tanning industry must be thrilled.</p>
<p>Making the presence of tanning beds in gyms even more shocking is a recent <a href="https://doi.org/10.1001/jamainternmed.2016.1548">study</a> showing that people who are physically active are at increased risk for melanoma, the deadly form of skin cancer. <a href="https://doi.org/10.1093/jnci/dju112">Tanning bed use</a> is a major risk factor for melanoma, which is now the <a href="https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2018/cancer-facts-and-figures-2018.pdf">third most prevalent cancer</a> in women under 49 years old, a popular gym demographic. Why would we put a carcinogen in the facility frequented by people who are at increased risk for the very cancer it causes? </p>
<p><a href="https://jamanetwork.com/journals/jamadermatology/fullarticle/2687548">I decided to conduct a study</a> to learn more about people who use those gym tanning beds. We surveyed 636 people who have ever used a tanning bed in their life and found that about a quarter of them had tanned in gyms. When I compared the group who had tanned in a gym to the group who had not, I was surprised to find that the gym tanner is a much harder core tanner. They hit the tanning bed 67 percent more often than other salon tanners and were far more likely to report tanning addiction. Gyms seem to be a great place for tanners to get their fix.</p>
<p>We also found in our sample of tanners that more tanning was associated with more exercise. Now we may be onto why gyms provide tanning beds – people who tan a lot love to workout. </p>
<h2>Undermining public health messaging</h2>
<p>We do not know why tanning and exercise is linked so I can only speculate. Both activities are driven by a desire to look and feel better. Regardless, gyms that provide tanning beds reinforce the idea that tanning is part of a beauty regimen, and perhaps even worse, that tanning is part of a healthy lifestyle. Tanning is part of neither. It will destroy your skin and has the potential to completely destroy your health. For decades <a href="https://www.cdc.gov/cancer/skin/burningtruth/base_tan_not_safe_tan.htm">public health campaigns</a> have attempted to dismantle the popular misconception that tanned skin is a sign of good health. </p>
<p>Tanning is a sign the body is receiving too much cancer-causing ultraviolet radiation. It is a warning sign.</p>
<p>Gyms should not provide tanning beds to patrons. Removing tanning beds from gyms surely won’t stop everybody from tanning, but that is certainly no argument for making them convenient for people at higher than average risk of melanoma. By pairing exercise with tanning beds, gyms undermine public health messaging and contribute to the cancer risk of their patrons. If you are
joining a gym to get healthy, my advice is: pick one that has your back.</p><img src="https://counter.theconversation.com/content/98999/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Sherry Pagoto receives funding from the National Institutes of Health.</span></em></p>Many gyms use free tanning beds to lure in new members who are eager to look and feel their best. But this, argues Sherry Pagoto, runs against the health lifestyle premise these gyms are advocating.Sherry Pagoto, Professor of Allied Health Sciences, University of ConnecticutLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/888692018-01-07T19:09:59Z2018-01-07T19:09:59ZExplainer: how does sunscreen work, what is SPF and can I still tan with it on?<figure><img src="https://images.theconversation.com/files/199186/original/file-20171214-27562-jt433n.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Sunscreen protects from skin cancer, burning and from the sun's ageing effects.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/thenickster/14368926652/in/photolist-nTJvhG-fpA68L-98dQzd-riRP91-snfAhe-4XHaqt-523knG-4aGwii-6RWoNM-9uXwko-8mBLqB-dUhHiP-9y1To8-51Y6Qe-e9KsRV-7ywGz1-9y4RKd-sVeqzj-b2TKxn-6TMieA-ac96Po-9WX1Gz-9y1TFp-F9M8w-bqfzVF-5cpJwZ-sVkZNF-eRPTDz-9XhCSX-ZPSFw8-sfYThZ-nZKFus-a5ExNL-9Ts6Kr-5bLjth-6ZQscZ-sVd7tj-hSD3Wz-Cqa5t-5q9c24-6q7nCD-cchSyy-7re8qy-2XD2jU-a5ZE3k-5A6DbJ-FSXmKV-6S9ZTw-5Rzq8d-y6XrR2">PRONicki Dugan Pogue/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span></figcaption></figure><p>Sunscreen use not only <a href="https://www.ncbi.nlm.nih.gov/pubmed/10475183">reduces the risk</a> of <a href="https://www.ncbi.nlm.nih.gov/pubmed/21135266">skin cancer</a> and sunburn, it also <a href="http://annals.org/aim/article-abstract/1691733/sunscreen-prevention-skin-aging-randomized-trial">reduces the ageing effect</a> of the sun.</p>
<p>But whenever summer rolls around, it’s easy to forget the basics – like, how should I apply sunscreen? How long should I wait after applying it to go in the sun, and how long can I stay in the sun with it on? And how does it work anyway?</p>
<h2>How does sunscreen work ?</h2>
<p>There are two main parts to all sunscreens. The active ingredient and the emulsion.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/199538/original/file-20171217-17854-4k3d6x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/199538/original/file-20171217-17854-4k3d6x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/199538/original/file-20171217-17854-4k3d6x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/199538/original/file-20171217-17854-4k3d6x.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/199538/original/file-20171217-17854-4k3d6x.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/199538/original/file-20171217-17854-4k3d6x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/199538/original/file-20171217-17854-4k3d6x.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/199538/original/file-20171217-17854-4k3d6x.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Sunscreens either absorb UV radiation or reflect it.</span>
<span class="attribution"><span class="source">from shuttersrock.com</span></span>
</figcaption>
</figure>
<p>The active ingredient does the sun protection work. These come in two categories: UV absorbers and UV reflectors.</p>
<p>UV absorbers are chemicals that absorb UV radiation and convert it to a very low level of heat. So low most don’t notice it, but a small proportion of people do report sunscreens make them feel uncomfortably warm.</p>
<p>UV absorber chemicals are also called “organic”, because they contain carbon atoms, a basis for all organic matter. </p>
<p>Some absorb the UVB part of the spectrum, which is known to cause sunburn and contribute to skin cancer risk. Others absorb the UVA part of the spectrum. Recent research suggests the longer UVA wavelengths not only penetrate to deeper layers of the skin but <a href="https://www.ncbi.nlm.nih.gov/pubmed/21192263">contribute to skin cancer</a> through compromising immune response to DNA damage. </p>
<p>For that reason, sunscreen labelled “broad spectrum” is recommended as it offers the best protection.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/199537/original/file-20171217-17842-1nu28a7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/199537/original/file-20171217-17842-1nu28a7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/199537/original/file-20171217-17842-1nu28a7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=233&fit=crop&dpr=1 600w, https://images.theconversation.com/files/199537/original/file-20171217-17842-1nu28a7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=233&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/199537/original/file-20171217-17842-1nu28a7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=233&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/199537/original/file-20171217-17842-1nu28a7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=293&fit=crop&dpr=1 754w, https://images.theconversation.com/files/199537/original/file-20171217-17842-1nu28a7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=293&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/199537/original/file-20171217-17842-1nu28a7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=293&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Broad action sunscreen is recommended.</span>
<span class="attribution"><span class="source">from shutterstock.com</span></span>
</figcaption>
</figure>
<p>UV “reflectors” are mostly made up of oxides, like zinc oxide and titanium dioxide, that absorb and scatter UV radiation.</p>
<p>There is normally more than one and often up to six or more active ingredients in most sunscreens.</p>
<p>The emulsion – the lotion, milk, cream, oil, foam or gel – is what carries the active ingredient. It is usually made up of some combination of oil and water, plus other goodies. These are important as they preserve the product so it lasts on the shelf or in your cupboard. They also help with water resistance, influence how the sunscreen feels and smells, and how well it binds to the skin. </p>
<h2>What does SPF mean and how is it measured?</h2>
<p>Sunscreen provides a <em>screen</em>, not a <em>block</em>. Think of a fly-screen door: air gets though but flies don’t. In the same way, the sun lotion or potion of your choice allows some small amount of UV radiation onto your skin.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/199539/original/file-20171217-17845-cclwbq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/199539/original/file-20171217-17845-cclwbq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/199539/original/file-20171217-17845-cclwbq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=823&fit=crop&dpr=1 600w, https://images.theconversation.com/files/199539/original/file-20171217-17845-cclwbq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=823&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/199539/original/file-20171217-17845-cclwbq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=823&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/199539/original/file-20171217-17845-cclwbq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1034&fit=crop&dpr=1 754w, https://images.theconversation.com/files/199539/original/file-20171217-17845-cclwbq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1034&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/199539/original/file-20171217-17845-cclwbq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1034&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A sunscreen with SPF 30 isn’t much lower in protection than SPF 50.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/jeepersmedia/17855705411/in/photolist-tcRa8R-9kKWpL-6dXBqN-8TRiSp-5CHmuS-g3ZVFe-3QpNR-qpT9wg-aN6iE4-aN6iVB-cCmuPJ-sfYSRP-tatAWL-tcxKcQ-tcR94M-9TssdX-5ASZLL-FcMoR-UBeywg-BeYxS-3ePfsz-9XveSu-5gsrSr-6aeQL6-tatFdm-5dUxds-aijESW-9dv4iy-69RaLZ-8tjcm-7P58Gv-7U28y3-iiAcC-e7kULf-59CnVh-3e3mz-nVDFC7-LqfSm-Pp294-fDzbrd-8uao9D-6zCwUa-jk7Vw-i7oaU-cyWnfy-4TkmU6-5iAymk-43h1b-6ngGtx-eeWN4t/">Mike Mozart/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>SPF stands for sun protection factor. It’s the measure of how much UV gets through the screen. The higher the number, the less UV passes through.</p>
<p>An SPF of 30 allows one-thirtieth or 3.3% of UV to reach your skin. This means it filters 96.7% of UV. With an SPF of 50, 98% is filtered and one-fiftieth or 2% gets through. </p>
<p>So while the difference between SPF 30 and SPF 50 sounds like a lot – it is a <a href="https://theconversation.com/mondays-medical-myth-spf50-sunscreen-almost-doubles-the-protection-of-spf30-3949">pretty modest</a> (1.3%) - difference in protection.</p>
<p>Put another way, if your unprotected skin would take ten minutes to show signs of burning, then <em>properly</em> applying SPF 30 sunscreen would slow the rate of burning to the point where it would take 30 times longer, or 300 minutes in total. SPF 15 would take 150 minutes, while SPF 50, 500 minutes. </p>
<p>But this is perfect world stuff. If you extend your stay in the sun for 500 minutes (over eight hours!) only relying on sunscreen, you will very likely still burn!</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/explainer-what-happens-to-your-skin-when-you-get-sunburnt-53865">Explainer: what happens to your skin when you get sunburnt?</a>
</strong>
</em>
</p>
<hr>
<h2>When and how do I put it on?</h2>
<p>At a microscopic level, the skin is a series of peaks and troughs. Layering on sunscreen around 20 minutes before going into the sun allows the product to flow into the troughs and bind properly to the skin. </p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/199540/original/file-20171217-17860-dsx3hp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/199540/original/file-20171217-17860-dsx3hp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/199540/original/file-20171217-17860-dsx3hp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=353&fit=crop&dpr=1 600w, https://images.theconversation.com/files/199540/original/file-20171217-17860-dsx3hp.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=353&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/199540/original/file-20171217-17860-dsx3hp.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=353&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/199540/original/file-20171217-17860-dsx3hp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=444&fit=crop&dpr=1 754w, https://images.theconversation.com/files/199540/original/file-20171217-17860-dsx3hp.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=444&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/199540/original/file-20171217-17860-dsx3hp.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=444&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The skin is a series of peaks and troughs.</span>
<span class="attribution"><span class="source">from shutterstock.com</span></span>
</figcaption>
</figure>
<p>Many sunscreens recommend reapplying every two hours. But another way to look at it is like painting a wall of your house. The first coat gets a reasonable coverage, but a reapplication 20-30 minutes after being in the sun – after the first coat has “dried” – gets you much more reliable coverage. And this will cover the bits you may have missed, or covered too thinly, on first pass.</p>
<p>Also, use it generously. Most people <a href="http://www.bmj.com/content/313/7062/942.1">use too little</a> (between a quarter and three-quarters) of the amount of sunscreen necessary to achieve the sun protection claimed on the label. A teaspoon per limb is a good rule of thumb. Add another teaspoon for your face, front and back. This comes to <a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Schneider+J+sunscreen+2002">seven teaspoons</a> (35ml) in all if you are at the beach in board shorts or a bikini.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/199541/original/file-20171217-17863-xjgjtl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/199541/original/file-20171217-17863-xjgjtl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/199541/original/file-20171217-17863-xjgjtl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=856&fit=crop&dpr=1 600w, https://images.theconversation.com/files/199541/original/file-20171217-17863-xjgjtl.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=856&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/199541/original/file-20171217-17863-xjgjtl.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=856&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/199541/original/file-20171217-17863-xjgjtl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1075&fit=crop&dpr=1 754w, https://images.theconversation.com/files/199541/original/file-20171217-17863-xjgjtl.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1075&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/199541/original/file-20171217-17863-xjgjtl.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1075&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">You need to apply around seven teaspoons of sunscreen in all if you’re at the beach in a bikini.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/W3nPLWO1ePU">Photo by rawpixel.com on Unsplash</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>Layer it on and spread it around. Reapply every two hours or more often if you are active (sweating, towelling off, skin making physical contact with anything that might rub it off), even if the bottle claims four-hour water resistance. And a good idea is to check if the lotion hasn’t passed its use-by date. </p>
<p>Use other things to protect your skin too. Hats, shade, clothing and even staying indoors at the highest UV periods. The closer to solar noon, usually between midday and 12.30pm, the higher the UV. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-will-i-damage-my-eyes-if-i-dont-wear-sunglasses-68582">Health Check: will I damage my eyes if I don't wear sunglasses?</a>
</strong>
</em>
</p>
<hr>
<p>The World Health Organisation recommends protecting skin from the sun when the <a href="http://www.who.int/uv/publications/globalindex/en/">UV Index is 3</a> or above. The Bureau of Meteorology reports on the <a href="http://www.bom.gov.au/uv/">UV Index around Australia</a> and the <a href="http://www.sunsmart.com.au/tools/interactive-tools/free-sunsmart-app">SunSmart App</a> allows you to get live readings on your smartphone. </p>
<h2>How long can I stay in the sun with sunscreen on?</h2>
<p>It’s wise to stay in the sun no longer than is necessary to do your planned activity. Staying out longer just because you have the sunscreen “suit of armour” (which it is not) is a bad idea. </p>
<p>Even following all the best advice, the normal daily activity – wiping water from your eyes, scratching an itch, cuddling the kids, brushing against a tree or your best buddy – will remove sunscreen and diminish its performance. And remember it is screening, not blocking the sun.</p>
<p>And will you still get a tan if you put on sunscreen properly? Well, no. If sunscreen is properly applied to do its job of reducing UV radiation exposure, it prevents the biological process of tanning.</p>
<hr>
<p><em>Update: this article originally stated metallic particles reflect UV but in fact UV is scattered by oxides.</em></p><img src="https://counter.theconversation.com/content/88869/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Terry Slevin works for Cancer Council Western Australia (CCWA), and works with Cancer Council Australia (CCA). Cancer Councils sell sunscreen. Less than 5% of Cancer Council income is derived from sunscreen sales. CCWA received government grants to run the SunSmart program in Western Australia. He is editor of Sun Skin and Health (2014 CSIRO publishing). Proceeds of both sunscreen sales and the book go to cancer research, education and support for people with cancer.</span></em></p>Whenever summer rolls around, it’s easy to forget the basics of sunscreen. How long should I wait after applying it to go in the sun, and how long can I stay in the sun with it on?Terry Slevin, Adjunct Professor, School of Psychology, Curtin University; Education and Research Director, Cancer Council WA; Chair, Occupational and Environmental Cancer Committee, Cancer Council AustraliaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/794142017-06-20T01:38:37Z2017-06-20T01:38:37ZResearch Check: can a new drug really protect redheads from cancer?<figure><img src="https://images.theconversation.com/files/174375/original/file-20170619-5835-1qbgf3s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The study looked at helping redheads to tan and protect them from the sun. But the redheads were mice, not humans.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/458007013?src=HZaHC68vwVOiFSEJmcHgnA-1-31&size=medium_jpg">from www.shutterstock.com</a></span></figcaption></figure><p>A recently published US <a href="http://www.sciencedirect.com/science/article/pii/S2211124717306848">study</a> on an experimental drug that leads to tanning without sun exposure has generated a host of headlines around the world.</p>
<p>Some went with <a href="http://www.dailymail.co.uk/sciencetech/article-4596644/Tan-treatment-bypasses-need-harmful-sun-beds.html#ixzz4kQ0PMzd9">what the drug means for redheads</a>, with the headline:</p>
<blockquote>
<p>Good news for redheads: Cream can give even the lightest skin a tan WITHOUT exposure to harmful UV radiation</p>
</blockquote>
<p>Others went for the drug’s apparent protection against <a href="https://www.theguardian.com/society/2017/jun/13/scientists-create-fake-tan-which-could-protect-against-skin-cancer">skin cancer</a>:</p>
<blockquote>
<p>Suntans for all: chemical causes any skin to tan – and protects against cancer</p>
</blockquote>
<p>Some coverage was more <a href="http://www.news.com.au/lifestyle/beauty/face-body/scientists-create-chemical-that-changes-skin-colour-without-tanning/news-story/832e1c86060b8a0416c10d9f687ba06c">measured</a>:</p>
<blockquote>
<p>Scientists create chemical that changes skin colour without tanning</p>
</blockquote>
<p>You can read more examples <a href="https://news.google.com/news/story?ncl=dtXq6PxnGa3p9eMBaCVU1nBoHhpyM&q=drug+skin+tanning&lr=English&hl=en&sa=X&ved=0ahUKEwjb1-qI-8jUAhUKS7wKHX4EC-cQqgIILTAA">here</a>.</p>
<p>So, does the media’s reporting of the study, published in the journal Cell Reports, reflect the actual research?</p>
<p>The study’s senior author <a href="http://www.dfhcc.harvard.edu/insider/member-detail/member/david-e-fisher-md-phd/">David Fisher</a>, professor of dermatology at Harvard Medical School, said, of the reports he had read, the coverage was generally accurate and balanced:</p>
<blockquote>
<p>I have not seen any problems (yet) … No particular gaps either.</p>
</blockquote>
<p>However, we found the fact the drug wasn’t tested on live humans, but in mice, was generally buried in media reports. And most coverage failed to mention the research’s real potential, in treating other conditions.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/174604/original/file-20170619-770-fzrub4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/174604/original/file-20170619-770-fzrub4.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=778&fit=crop&dpr=1 600w, https://images.theconversation.com/files/174604/original/file-20170619-770-fzrub4.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=778&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/174604/original/file-20170619-770-fzrub4.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=778&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/174604/original/file-20170619-770-fzrub4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=978&fit=crop&dpr=1 754w, https://images.theconversation.com/files/174604/original/file-20170619-770-fzrub4.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=978&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/174604/original/file-20170619-770-fzrub4.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=978&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption"></span>
<span class="attribution"><span class="source">The Conversation</span>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
</figcaption>
</figure>
<p>Skin cancers account for <a href="http://www.cancer.org.au/about-cancer/types-of-cancer/skin-cancer.html">around 80% of all new cancers in Australia</a>, with most caused by overexposure to the sun. </p>
<p>Skin cancers are more common in people with pale skin. And with more than two million Australians getting <a href="http://www.cancer.org.au/news/media-releases/new-research-shows-almost-2.4-million-aussie-adults-sunburnt-on-summer-weekends.html">sunburnt every summer weekend</a>, it’s no wonder interest in damage-free, UV-protective tanning is high.</p>
<h2>How was the study conducted and what did it find?</h2>
<p>The researchers wanted to manipulate the pathway that leads to pigment (melanin) production to see if this could induce tanning. In particular, they hoped to activate the MITF gene, the master-regulator of skin pigment production.</p>
<p>They built on their <a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=forskolin+AND+pigmentation+AND+2006%5BYear%5D">earlier work</a> identifying a group of molecules known as salt-inducible kinase inhibitors (or SIKi for short) that could do this.</p>
<p>First, the researchers grew pigment-producing cells (melanocytes) in a flask in a laboratory and treated them with the SIKi drug or a control substance. They then checked what happened to the MITF gene.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/174366/original/file-20170619-5778-1cjy7a2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/174366/original/file-20170619-5778-1cjy7a2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/174366/original/file-20170619-5778-1cjy7a2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=505&fit=crop&dpr=1 600w, https://images.theconversation.com/files/174366/original/file-20170619-5778-1cjy7a2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=505&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/174366/original/file-20170619-5778-1cjy7a2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=505&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/174366/original/file-20170619-5778-1cjy7a2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=634&fit=crop&dpr=1 754w, https://images.theconversation.com/files/174366/original/file-20170619-5778-1cjy7a2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=634&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/174366/original/file-20170619-5778-1cjy7a2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=634&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The researchers looked at melanin-producing cells (melanocytes) cultured in a flask rather than the melanocytes in someone’s skin (pictured here).</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/177142175?src=dEjd9diNoHTuR2-V4XfuUA-1-39&size=medium_jpg">from www.shutterstock.com</a></span>
</figcaption>
</figure>
<p>The SIKi prompted a 400% increase in gene activity plus pigment production (basically, like tanned cells in a flask). So, the researchers moved on to experiments in mice. </p>
<p>They chose yellow-haired mice, which were specially bred to have defects in the same gene causing red hair and easily-burned skin in humans. In effect, they were “redhead” mice.</p>
<p>The researchers waxed the mice to make a patch of bare skin they treated either with a lotion containing SIKi or plain lotion, applied daily. They also measured skin colour daily. The researchers also took samples of skin and looked at them under the microscope.</p>
<p>There was very noticeable darkening (pigmentation) in the mice treated with the SIKi but not with the control lotion. The darkening gradually increased over the six days of treatment and then gradually faded over two weeks, much like a natural suntan. The mice appeared to have no obvious ill effects.</p>
<p>Microscopic examination of the darkened skin showed the melanin had settled in caps over the nucleus of the cells, just as melanin produced after sun exposure would. So, theoretically it should protect the cell’s DNA in much the same way as naturally produced melanin would.</p>
<p>Then, the researchers used a <a href="http://www.nature.com/nature/journal/v481/n7382/box/481455a_BX1.html">modified form</a> of the SIKi that would be more easily absorbed to see its effects on healthy human skin. Rather than applying it directly to someone’s arm or leg, the researchers used leftover breast skin from reconstructive surgery and cultured it in petri dishes to keep it alive. The darkening also increased gradually.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/174365/original/file-20170619-5774-tytzg0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/174365/original/file-20170619-5774-tytzg0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=147&fit=crop&dpr=1 600w, https://images.theconversation.com/files/174365/original/file-20170619-5774-tytzg0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=147&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/174365/original/file-20170619-5774-tytzg0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=147&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/174365/original/file-20170619-5774-tytzg0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=185&fit=crop&dpr=1 754w, https://images.theconversation.com/files/174365/original/file-20170619-5774-tytzg0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=185&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/174365/original/file-20170619-5774-tytzg0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=185&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Human skin was treated with a control substance (left), a SIKi that couldn’t penetrate the skin (centre) and the new-version SIKi (right).</span>
<span class="attribution"><span class="source">Cell Reports/Nisma Mujahud and David Fisher</span></span>
</figcaption>
</figure>
<h2>How should we interpret the findings?</h2>
<p>While other drugs like Melanotan-II <a href="https://theconversation.com/is-this-injectable-tanning-drug-safe-to-use-60628?sr=1">promote tanning</a>, they are usually delivered by injection. So, finding a way to skip both the UV and a needle makes the SIKi research very biologically interesting. But in terms of medical use, these results are very early in the testing process. </p>
<p>The SIKis have yet to be tested on whole humans (not just loose patches of skin) to check for the effects of the drug leaking into the rest of the body, or discomfort from the drug’s action on the skin.</p>
<p>News outlets followed the research team’s lead in speculating a topical SIKi could help protect against skin cancer. However, these claims may be over-egged, as a tan is only as protective as <a href="https://www.ncbi.nlm.nih.gov/pubmed/24891049">SPF 2-4 sunscreen</a>.</p>
<p>Using a SIKi cream might help reduce a person’s cancer risk if it steers them away from risky behaviour like sunbathing or using solariums, but case reports suggest people might assume they can have more UV exposure once they are tanned, with <a href="http://onlinelibrary.wiley.com/doi/10.1111/jdv.13310/full">cancerous results</a>. </p>
<p>However, Fisher’s idea of including a SIKi in a traditional sunscreen might help combat this.</p>
<h2>What about those headlines?</h2>
<p>Headlines like “Suntans for all” and “Risk-free tanning” are jumping ahead of the research. But fortunately most articles note the “human” research has so far only been done in a petri dish.</p>
<p>The emphasis on tanning for redheads is also overdone in <a href="http://www.sciencealert.com/scientists-have-discovered-a-chemical-that-causes-any-skin-type-to-tan">some</a> <a href="http://www.dailymail.co.uk/sciencetech/article-4596644/Tan-treatment-bypasses-need-harmful-sun-beds.html#ixzz4k7x7HX95">articles</a>. But most mention deeper in the article the redheads were really mice.</p>
<p>Most articles also note Fisher envisions SIKi being used with normal sun-protection measures like sunscreen, rather than instead of them, and safety still needs to be assessed. </p>
<p><a href="https://www.theguardian.com/society/2017/jun/13/scientists-create-fake-tan-which-could-protect-against-skin-cancer">The Guardian</a> quoted Fisher saying:</p>
<blockquote>
<p>It’s obviously critical that safety and toxicity studies need to be done … This is not a toy, it’s not a cosmetic.</p>
</blockquote>
<h2>Could these drugs have other uses?</h2>
<p>One little-reported aspect is SIKis also have potential as a treatment for diseases causing severe sun-sensitivity, like <a href="http://www.dermnetnz.org/topics/erythropoietic-protoporphyria">erythropoietic protoporphyria</a>, or anomalies in skin pigmentation, like <a href="http://www.dermnetnz.org/topics/vitiligo">vitiligo</a>. People with these under-researched conditions might be the real winners from a UV-free tanning cream.</p>
<p>In the meantime, the advice remains to <a href="http://www.cancer.org.au/preventing-cancer/sun-protection/preventing-skin-cancer/">slip, slop, slap, seek and slide</a> whenever the UV index reaches <a href="http://www.cancer.org.au/preventing-cancer/sun-protection/uv-alert/">three or higher</a> – daily from September to April in Australia’s southern states and all year round further north. You can also use the <a href="http://www.cancer.org.au/preventing-cancer/sun-protection/uv-alert/sunsmart-app.html">SunSmart app</a> to find out today’s UV index and sun protection times in your area. – <strong>Katie Lee and Richard Sturm</strong></p>
<hr>
<h2>Peer review</h2>
<p>As this Research Check clarifies, the study into activating a gene to increase skin pigmentation was performed in mice and isolated human skin. This analysis also echoes the researchers’ comment that the drug has never been tested in humans and “would require careful considerations of safety”.</p>
<p>Such considerations might include whether activating the gene could trigger cancer, as the researchers suggest could occur in certain circumstances. </p>
<p>If safe, as the Research Check says, it would be more convenient to be apply a drug to the skin rather than injecting it. And although more pigmented skin reduces the risk of skin cancer with sun exposure, the protection is only the equivalent of SPF 2-4 sunscreen. So I agree with Fisher that, if safe, the drug could only be used in addition to other skin protection measures.</p>
<p>The real issue is all this talk of risk and benefit is simply in pursuit of a fashion, said to have been started by fashion designer <a href="http://www.skincancer.org/prevention/tanning/tale-of-tanning">Coco Chanel</a>. It is not a universal fashion as in South East Asia pale skin <a href="https://theconversation.com/tall-pale-and-handsome-why-more-asian-men-are-using-skin-whitening-products-67580?sr=1">is more highly sought</a>. </p>
<p>Perhaps the more effective protection against cancer is to change Western fashion and promote the message that pale skin and red hair is beautiful too. – <strong>Ian Olver</strong></p><img src="https://counter.theconversation.com/content/79414/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Katie Lee is supported by funding from NHMRC, Epiderm Foundation, Queensland Genomic Health Alliance and the Queensland Cancer Council. </span></em></p><p class="fine-print"><em><span>Richard Sturm currently receives funding from the Australian NHMRC, Queensland Cancer Council, Queensland Genomic Health Alliance and the Epiderm Foundation. In the past he has been the recipient of ARC Discovery grant funding. </span></em></p><p class="fine-print"><em><span>Ian Olver sits on the NHMRC Council.</span></em></p>A US study into whether a new drug can give us a tan without going into the sun generated headlines around the world. Here’s what the study really says.Katie Lee, Study coordinator and research assistant, The University of QueenslandRichard Sturm, Principal Research Fellow, Dermatology Research Centre, The University of QueenslandLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/743552017-05-26T01:32:59Z2017-05-26T01:32:59ZHow do the chemicals in sunscreen protect our skin from damage?<figure><img src="https://images.theconversation.com/files/171062/original/file-20170525-23230-m46xg5.jpg?ixlib=rb-1.1.0&rect=0%2C98%2C2000%2C1419&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Don't skimp on the SPF.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/toned-photo-kid-beach-smooth-skin-381581356">Sabphoto via Shutterstock.com</a></span></figcaption></figure><p>Not so long ago, people like my Aunt Muriel thought of sunburn as a necessary evil on the way to a “good base tan.” She used to slather on the baby oil while using a large reflector to bake away. Aunt Muriel’s mantra when the inevitable burn and peel appeared: Beauty has its price.</p>
<p>Was she ever right about that price – but it was a lot higher than any of us at the time recognized. What sun addicts didn’t know then was that we were setting our skin up for damage to its structural proteins and DNA. Hello, wrinkles, liver spots and cancers. No matter <a href="https://doi.org/10.1001/archderm.1988.01670060015008">where your complexion falls</a> on the <a href="http://www.skincancer.org/prevention/are-you-at-risk/fitzpatrick-skin-quiz">Fitzpatrick Skin Type</a> scale, ultraviolet radiation (UV) from the sun or tanning beds will damage your skin.</p>
<p>Today, recognition of the risks posed by UV rays has motivated scientists, myself included, to study what’s going on in our cells when they’re in the sun – and devise modern ways to ward off that damage.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/170967/original/file-20170525-23279-110s6q8.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/170967/original/file-20170525-23279-110s6q8.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/170967/original/file-20170525-23279-110s6q8.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=236&fit=crop&dpr=1 600w, https://images.theconversation.com/files/170967/original/file-20170525-23279-110s6q8.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=236&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/170967/original/file-20170525-23279-110s6q8.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=236&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/170967/original/file-20170525-23279-110s6q8.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=297&fit=crop&dpr=1 754w, https://images.theconversation.com/files/170967/original/file-20170525-23279-110s6q8.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=297&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/170967/original/file-20170525-23279-110s6q8.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=297&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">UV light that affects our skin has a shorter wavelength than the parts of the electromagnetic spectrum we can see.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:EM_Spectrum_Properties_edit.svg">Inductiveload, NASA</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
</figcaption>
</figure>
<h2>What happens when sun hits skin</h2>
<p>Sunlight is composed of packets of energy called photons. The visible colors we can see by eye are relatively harmless to our skin; it’s the sun’s ultraviolet (UV) light photons that can cause skin damage. UV light can be broken down into two categories: UVA (in the wavelength range 320-400 nanometers) and UVB (in the wavelength range 280–320 nm). </p>
<p><iframe id="Niww2" class="tc-infographic-datawrapper" src="https://datawrapper.dwcdn.net/Niww2/8/" height="400px" width="100%" style="border: none" frameborder="0"></iframe></p>
<p>Our skin contains molecules that are perfectly structured to absorb the energy of UVA and UVB photons. This puts the molecule into an energetically excited state. And as the saying goes, what goes up must come down. In order to release their acquired energy, these molecules undergo chemical reactions – and in the skin that means there are biological consequences.</p>
<p>Interestingly, some of these effects used to be considered helpful adaptations – though we now recognize them as forms of damage. Tanning is due to the production of <a href="https://www.derm101.com/inflammatory/embryologic-histologic-and-anatomic-aspects/melanocytes/">extra melanin pigment induced by UVA rays</a>. Exposure to the sun also turns on the skin’s natural antioxidant network, which <a href="http://www.nature.com/nchembio/journal/v10/n7/pdf/nchembio.1548.pdf">deactivates highly destructive reactive oxygen species (ROS) and free radicals</a>; if left unchecked, these can cause cellular damage and oxidative stress within the skin.</p>
<p>We also know that UVA light penetrates deeper into the skin than UVB, destroying a structural protein called collagen. As collagen degrades, our skin loses its elasticity and smoothness, leading to wrinkles. UVA is responsible for many of the visible signs of aging, while UVB light is considered the primary source of sunburn. Think “A” for aging and “B” for burning.</p>
<p>DNA itself can absorb both <a href="http://www.pnas.org/content/103/37/13765.short">UVA and UVB rays, causing mutations</a> which, if unrepaired, can lead to non-melanoma (basal cell carcinoma, squamous cell carcinoma) or <a href="https://doi.org/10.1126/science.1253735">melanoma skin cancers</a>. Other skin molecules pass absorbed UV energy on to those highly reactive ROS and free radicals. The resulting oxidative stress can overload the skin’s built-in antioxidant network and cause cellular damage. ROS can react with DNA, forming mutations, and with collagen, leading to wrinkles. They can also interrupt cell signaling pathways and gene expression.</p>
<p>The end result of all of these photoreactions is photodamage that accumulates over the course of a lifetime from repeated exposure. And – this cannot be emphasized enough — this applies to all skin types, from Type I (like Nicole Kidman) to Type VI (like Jennifer Hudson). <a href="http://www.skincancer.org/skin-cancer-information/skin-cancer-facts">Regardless of how much melanin we have in our skin</a>, we can develop UV-induced skin cancers and we will all eventually see the signs of photo-induced aging in the mirror.</p>
<h2>Filtering photons before the damage is done</h2>
<p>The good news, of course, is that the risk of skin cancer and the visible signs of aging can be minimized by preventing overexposure to UV radiation. When you can’t avoid the sun altogether, today’s sunscreens have got your back (and all the rest of your skin too).</p>
<p>Sunscreens employ UV filters: molecules specifically designed to help reduce the amount of UV rays that reach through the skin surface. A film of these molecules forms a protective barrier either absorbing (chemical filters) or reflecting (physical blockers) UV photons before they can be absorbed by our DNA and other reactive molecules deeper in the skin. </p>
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<p>In the United States, the Food and Drug Administration regulates sunscreens as drugs. Because we were historically most concerned with protecting against sunburn, <a href="http://dx.doi.org/10.1016/j.jaad.2010.01.005">14 molecules that block sunburn-inducing UVB rays</a> are approved for use. That we have just two UVA-blocking molecules available in the United States – avobenzone, a chemical filter; and zinc oxide, a physical blocker – is a testament to our more recent understanding that UVA causes trouble, not just tans.</p>
<p>The FDA also has enacted <a href="https://www.federalregister.gov/documents/2011/06/17/2011-14766/labeling-and-effectiveness-testing-sunscreen-drug-products-for-over-the-counter-human-use">strict labeling requirements</a> – most obviously about SPF (sun protection factor). On labels since 1971, SPF represents the relative time it takes for an individual to get sunburned by UVB radiation. For example, if it takes 10 minutes typically to burn, then, if used correctly, an SPF 30 sunscreen should provide 30 times that – 300 minutes of protection before sunburn. </p>
<p>“Used correctly” is the key phrase. Research shows that it takes about one ounce, or basically a <a href="https://www.aad.org/media/stats/prevention-and-care/sunscreen-faqs">shot glass-sized amount of sunscreen</a>, to cover the exposed areas of the average adult body, and a nickel-sized amount for the face and neck (more or less, depending on your body size). The majority of people apply between a <a href="https://www.ncbi.nlm.nih.gov/pubmed/12374537">quarter to a half of the recommended amounts</a>, placing their skin at risk for sunburn and photodamage.</p>
<p>In addition, sunscreen efficacy decreases in the water or with sweating. To help consumers, FDA now requires sunscreens labeled <a href="https://www.federalregister.gov/documents/2011/06/17/2011-14766/labeling-and-effectiveness-testing-sunscreen-drug-products-for-over-the-counter-human-use">“water-resistant” or “very water-resistant”</a> to last up to 40 minutes or 80 minutes, respectively, in the water, and the <a href="https://www.aad.org/media/stats/prevention-and-care/sunscreen-faqs">American Academy of Dermatology</a> and other medical professional groups <a href="https://www.cancer.org/cancer/skin-cancer/prevention-and-early-detection/uv-protection.html">recommend reapplication immediately after any water sports</a>. The general <a href="https://www.aad.org/media/stats/prevention-and-care/sunscreen-faqs">rule of thumb</a> is to reapply about every two hours and certainly after water sports or sweating.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/171063/original/file-20170525-23234-v4lxdi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/171063/original/file-20170525-23234-v4lxdi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/171063/original/file-20170525-23234-v4lxdi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/171063/original/file-20170525-23234-v4lxdi.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/171063/original/file-20170525-23234-v4lxdi.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/171063/original/file-20170525-23234-v4lxdi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=565&fit=crop&dpr=1 754w, https://images.theconversation.com/files/171063/original/file-20170525-23234-v4lxdi.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=565&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/171063/original/file-20170525-23234-v4lxdi.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=565&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">In the U.S., the FDA regulates sunscreens available to consumers.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/alameda-ca-june-05-2016-store-433399849">Sheila Fitzgerald via Shutterstock.com</a></span>
</figcaption>
</figure>
<p>To get high SPF values, multiple UVB UV filters are combined into a formulation based upon <a href="https://www.federalregister.gov/documents/2011/06/17/2011-14766/labeling-and-effectiveness-testing-sunscreen-drug-products-for-over-the-counter-human-use">safety standards set by the FDA</a>. However, the SPF doesn’t account for UVA protection. For a sunscreen to make a claim as having UVA and UVB protection and be labeled “Broad Spectrum,” it must pass <a href="https://www.fda.gov/drugs/guidancecomplianceregulatoryinformation/guidances/ucm330694.htm">FDA’s Broad Spectrum Test</a>, where the sunscreen is hit with a large dose of UVB and UVA light before its effectiveness is tested. </p>
<p>This pre-irradiation step was established in <a href="https://www.fda.gov/drugs/guidancecomplianceregulatoryinformation/guidances/ucm330694.htm">FDA’s 2012 sunscreen labeling rules</a> and acknowledges something significant about UV-filters: some can be photolabile, meaning they can degrade under UV irradiation. The most famous example may be <a href="http://onlinelibrary.wiley.com/doi/10.1046/j.1440-0960.1999.00319.x/full">PABA</a>. This UVB-absorbing molecule is rarely used in sunscreens today because it forms photoproducts that elicit an allergic reaction in some people.</p>
<p>But the Broad Spectrum Test really came into effect only once the UVA-absorbing molecule avobenzone came onto the market. Avobenzone can interact with octinoxate, a strong and widely used UVB absorber, in a way that makes avobenzone less effective against UVA photons. The UVB filter octocrylene, on the other hand, helps stabilize avobenzone so it lasts longer in its UVA-absorbing form. Additionally, you may notice on some sunscreen labels the molecule ethylhexyl methoxycrylene. It helps stabilize avobenzone even in the presence of octinoxate, and provides us with longer-lasting protection against UVA rays.</p>
<p>Next up in sunscreen innovation is the broadening of their mission. Because even the highest SPF sunscreens don’t block 100 percent of UV rays, the addition of antioxidants can supply a second line of protection when the skin’s natural antioxidant defenses are overloaded. Some antioxidant ingredients my colleagues and I have worked with include <a href="http://www.springer.com/us/book/9783319293813">tocopheral acetate (Vitamin E), sodium ascorbyl phosophate (Vitamin C), and DESM</a>. And sunscreen researchers are beginning to investigate if the <a href="http://www.springer.com/us/book/9783319293813">absorption of other colors of light</a>, like infrared, by skin molecules has a role to play in photodamage.</p>
<p>As research continues, one thing we know for certain is that protecting our DNA from UV damage, for people of every color, is synonymous with preventing skin cancers. The Skin Cancer Foundation, American Cancer Society and the American Academy of Dermatology all stress that research shows regular use of an SPF 15 or higher sunscreen prevents sunburn and reduces the risk of <a href="http://dx.doi.org/10.1016/S0140-6736(98)12168-2">non-melanoma cancers by 40 percent</a> and <a href="https://doi.org//10.1200/jco.2010.28.7078">melanoma by 50 percent</a>.</p>
<p>We can still enjoy being in the sun. Unlike my Aunt Muriel and us kids in the 1980s, we just need to use the resources available to us, from long sleeves to shade to sunscreens, in order to protect the molecules in our skin, especially our DNA, from UV damage.</p><img src="https://counter.theconversation.com/content/74355/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Kerry Hanson has consulted for Bayer, J&J/Neutrogena, and P&G. Her academic work has been funded by Hallstar and through a joint University of California Discovery Grant with Merck. She is a member of the American Chemical Society. </span></em></p>Energy from the sun’s rays can cause skin damage and cancers. Sunscreens can absorb or reflect the dangerous UV light. Here’s how it works.Kerry Hanson, Research Chemist, University of California, RiversideLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/606282016-06-16T05:14:10Z2016-06-16T05:14:10ZIs this injectable tanning drug safe to use?<figure><img src="https://images.theconversation.com/files/125494/original/image-20160607-31942-18v9jwr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A 'melanotanner' monitors progress in selfie photos. But what effect might this fad have on years of anti-tan messages?</span> <span class="attribution"><span class="source">Forthcoming research by S. Raymond</span>, <span class="license">Author provided</span></span></figcaption></figure><p>Most Australians are familiar with the Cancer Council’s slogans reminding us to <a href="http://www.cancer.org.au/preventing-cancer/sun-protection/campaigns-and-events/slip-slop-slap-seek-slide.html">“slip, slop, slap”</a>, and that “<a href="http://www.darksideoftanning.com.au/">there’s nothing healthy about a tan</a>”.</p>
<p>Now a controversial injectable tanning agent Melanotan is growing in popularity. But how safe is it, and can it protect us from the sun’s damage?</p>
<h2>What is Melanotan?</h2>
<p>Known as “Mel”, “MT” or “the Barbie drug”, Melanotan is a synthetic melanocortin, which is a hormone derived from the pituitary gland at the base of the brain that regulates growth and development. </p>
<p>It helps to accelerate the production of melanin, the pigment that absorbs ultraviolet radiation and gives skin its colour. When delivered by injection over the course of as little as a week, Melanotan has the effect of (semi-permanently) darkening the skin, as though tanned by the sun.</p>
<p>First developed in the 1980s by researchers at the <a href="http://uacc.arizona.edu/news/ua-discovered-drug-for-skin-disease-approved-for-patients-in-europe">University of Arizona</a>, Melanotan is principally used for the treatment of skin disorders including <a href="http://www.clinuvel.com/en/skin-science/skin-conditions">vitiligo and erythropoietic protoporphyria</a> that affect skin appearance and sensitivity (especially to sunlight). By promoting melanin in the skin, Melanotan can help ease the symptoms of these conditions and enable those diagnosed to live a more normal life.</p>
<p>However, Melanotan’s tanning capability and potential use as a “natural” photoprotectant (that helps to prevent damage caused by sunlight) has also received much public interest, and led to its appropriation as a lifestyle drug. </p>
<p>The logic behind this trend is that creating tanned skin (by increasing melanin) with minimal to no sun exposure could protect individuals from skin damage, and even potentially lower melanoma risk. More melanin means more protection from UV radiation, and therefore a healthier (and conveniently, deeper) complexion. In this sense, there is perhaps a kernel of truth to the idea of the “healthy glow”.</p>
<h2>Is it safe to use?</h2>
<p>Clinical trials of the safety and effectiveness of Melanotan are ongoing, but in 2008 the <a href="http://www.ema.europa.eu/ema/index.jsp?curl=pages/medicines/human/orphans/2009/11/human_orphan_000398.jsp&mid=WC0b01ac058001d12b">European Medicines Agency</a> approved a blend of the peptide called <a href="http://www.clinuvel.com/en/scenesse/scenesse-afamelanotide">Scenesse</a> to be marketed for limited prescription-only use by those with specific skin conditions throughout the European Union. </p>
<p>However, there are no published clinical trials of the drug among people without these disorders. This means its long-term efficacy and safety for use in the general population is unknown.</p>
<p>In Australia, Melanotan use is unregulated. Although the drug is currently captured in Schedule 4 (prescription only medications) of the <a href="http://www.tga.gov.au/scheduling-decision-final/reasons-scheduling-delegates-final-decisions-december-2010">Therapeutic Goods Administration’s Poisons Standard</a>, no products containing Melanotan are registered for use in Australia.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/126849/original/image-20160616-19925-1d7vh50.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/126849/original/image-20160616-19925-1d7vh50.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/126849/original/image-20160616-19925-1d7vh50.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/126849/original/image-20160616-19925-1d7vh50.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/126849/original/image-20160616-19925-1d7vh50.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/126849/original/image-20160616-19925-1d7vh50.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/126849/original/image-20160616-19925-1d7vh50.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/126849/original/image-20160616-19925-1d7vh50.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A sun tan does offer some protection from UV rays.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/tzofia/125755302/">Brittney Bush Bollay/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>This means while there are rumours of some practitioners prescribing the drug, <a href="http://www.tga.gov.au/sites/default/files/scheduling-decisions-1012-final-a.pdf">most practitioners warn against</a> – and will not prescribe – Melanotan for aesthetic or lifestyle purposes.</p>
<p>There are currently no population-based studies on Melanotan to indicate the extent of its use, however, there are <a href="http://www.bmj.com/content/338/bmj.b566">reports of its increased off-label use</a> in the UK.</p>
<p>The majority of users source the drug via “underground” online vendors at costs ranging from A$30-50 for a one-month supply, and self-administer the injections at home. Users report a range of short-lived side effects including facial flushing, nausea, temporary freckling and darkening of moles, and in some males, spontaneous erections.</p>
<p>Considering Australia’s reputation for more skin cancers than <a href="https://www.cancerwa.asn.au/prevention/sunsmart/">almost anywhere in the world</a>, the ways in which Australians respond to “melanotanning” will be intriguing.</p>
<p>There is a possibility Melanotan may some day present a viable solution to achieving a “healthy tan” in line with current western beauty ideals. But it also creates new forms of risk concerning needle safety, unsettling patient-practitioner relationships via unregulated use, and the subversion of public health messages that groups such as Cancer Council Australia have worked for decades to promote.</p><img src="https://counter.theconversation.com/content/60628/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>This article is authored by a PhD Candidate and her supervisory team at University of Queensland, and reflects the interests of the student’s doctoral project in undertaking the nation’s first qualitative study into experiences of Melanotan use among the general population. Dubbed ‘Project Melanotan’, the investigation aims to directly engage with ‘melanotanners’ in a non-judgemental environment, in an effort to both critically evaluate as well as understand lived experiences of melanotaning as they relate to conceptually relevant notions of risk, technology and the body.</span></em></p><p class="fine-print"><em><span>Rebecca Olson has received funding in the past from Cancer Australia and Cancer Council ACT, for research into the experiences of carers of cancer patients. </span></em></p>Melanotan helps to accelerate the production of melanin, the pigment that absorbs ultraviolet radiation and gives skin its colour.Stephanie Raymond, Sociology PhD Candidate, The University of QueenslandRebecca E. Olson, Senior Lecturer School of Social Science, The University of QueenslandLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/536042016-02-11T05:53:57Z2016-02-11T05:53:57ZUV radiation: the risks and benefits of a healthy glow<p>Eighty years ago, when sun exposure was first associated with skin cancer, <a href="http://dx.doi.org/10.1067/mjd.2002.127254">popular culture was exalting tanning</a> by emphasizing that a “fine brown color suggests health and good times, and is a pleasant thing to see.”</p>
<p>We know that sun exposure can be deadly, and today’s public awareness campaigns strongly focus on <a href="http://www.cdc.gov/cancer/skin/chooseyourcover/">sun avoidance</a> to prevent skin cancer. But we also know that sunlight is important to our health and plays a role in many biological processes in our bodies.</p>
<p>In fact, some physicians and scientists are taking a closer look at sunlight to expose the lesser known benefits of ultraviolet (UV) light. </p>
<h2>What is UV light?</h2>
<p>When we are talking about the dangerous component of sunlight, we are really talking UV light. UV light is ionizing radiation, meaning that it frees electrons from atoms or molecules, causing chemical reactions. UV light is divided into three categories listed in order of increasing energy: UVA, UVB, UVC. </p>
<p>UVC is the most harmful, but the ozone layer and other components of the atmosphere filter all of it out before it reaches us. That’s also the case for a large percentage of UVB light. But nearly all UVA light reaches the Earth’s surface.</p>
<p>Both latitude and season play large factors in our individual exposure to UV radiation. Countries farthest from the equator during winter months receive the least amount of UV radiation, while equatorial countries receive the most. </p>
<h2>UV light causes chemical reactions in the body</h2>
<p>Unlike visible light, the energy from UV radiation can be absorbed by molecules in our body, causing chemical reactions. When the energy from UV radiation is absorbed by DNA, it can cause reactions that lead to genetic mutations. Some of these mutations can lead to the development of skin cancer, which is the <a href="http://www.cdc.gov/cancer/skin/statistics/">most common cancer</a> in the U.S. Basal cell carcinoma, squamous cell carcinoma and malignant melanoma (one of the deadliest cancers) are all associated with UV light exposure.</p>
<figure class="align-left ">
<img alt="" src="https://images.theconversation.com/files/110368/original/image-20160204-2998-1ygxu9g.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/110368/original/image-20160204-2998-1ygxu9g.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/110368/original/image-20160204-2998-1ygxu9g.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/110368/original/image-20160204-2998-1ygxu9g.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/110368/original/image-20160204-2998-1ygxu9g.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/110368/original/image-20160204-2998-1ygxu9g.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/110368/original/image-20160204-2998-1ygxu9g.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Making some vitamin D.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/ethermoon/4132039512/in/photolist-7i8Moy-rm1cmh-du2ufd-aSwJKT-ibETe7-bkaJbN-rUiRBC-dneNRZ-pCUs8B-4jkndR-7JHqFx-2kw1iG-9mqoEM-f7J66c-9ZBMjY-6rUF1e-7ScsWZ-7Hor9X-a3EnKp-8dMoSt-8i9sNS-as6MSr-dZAsVR-bmebkv-ecQShd-pGR3qs-psjUQg-p6rKgc-qwaVpz-fwsHEL-5Mocdw-bC4Bsz-rGkHYt-p82M2P-bqPnYe-nXETw3-odHoZh-aiMffw-gCd1Xs-5U7i1F-q9ANm2-4APbGP-qhQucB-bUFhAM-qKhaMc-7j8tzA-ewNTw-abW3Lf-hHaHv7-aukjJa">ethermoon/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
</figcaption>
</figure>
<p>However, not all chemical reactions that UV light induces are harmful. In fact, some of them are beneficial. For instance, we can get vitamin D from eating certain plants and animals, but a main source of vitamin D comes from exposure to UV radiation. </p>
<p>Vitamin D is critical to maintaining bone density by increasing calcium absorption in the gut. Chronically low levels of vitamin D can lead to osteoporosis. Apart from its effects on bone, vitamin D has also been shown to <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1532-5415.2011.03733.x/full">improve balance and muscle strength in the elderly</a>, which decreases the number of falls leading to fracture.</p>
<p>UV light induces the body to synthesize other molecules as well, including <a href="http://dx.doi.org/10.1016/j.cell.2014.04.032">opioid-like molecules</a> thought to cause a tanning “high.”</p>
<h2>UV decreases cancer mortality</h2>
<p>Research suggests that the risk of developing lung, prostate, breast, colorectal and pancreatic cancer may be decreased by sun exposure. This protective effect against cancer is most pronounced in <a href="http://www.sciencedirect.com/science/article/pii/S0959804907003243">sunny countries</a>. While smaller studies of <a href="http://link.springer.com/article/10.1023/A:1018450531136">colorectal</a> and <a href="http://link.springer.com/article/10.1007/BF00051795">prostate</a> cancer have conflicted with this finding, many studies support a beneficial relationship between sun exposure and <a href="http://oem.bmj.com/content/59/4/257.short">internal cancers</a>, and it has been suggested that the risks associated with sun exposure may be outweighed by its ability to prevent <a href="http://www.pnas.org/content/105/2/668.short">certain types of internal cancers</a>. </p>
<p>Sunlight may also improve cancer outcomes. The prognosis for patients diagnosed in summer and fall is better than those <a href="http://link.springer.com/article/10.1023/B:CACO.0000019494.34403.09">diagnosed in winter</a>, and total sun exposure prior to diagnosis is a <a href="http://onlinelibrary.wiley.com/doi/10.1002/ijc.22052/abstract">predictor of survival</a>.</p>
<p>Given the relationship between sun exposure and vitamin D production, it was initially thought that vitamin D was the underlying cause for improved cancer outcomes. Unfortunately, data to support this are still lacking. Initial trials of <a href="http://www.nejm.org/doi/full/10.1056/NEJMoa055222">vitamin D supplementation</a> have failed to demonstrate a benefit on cancer prevention, which has led researchers to believe that this benefit is from the effects of UV radiation. </p>
<h2>UV light decreases blood pressure and inflammation</h2>
<p>UV exposure positively affects blood pressure as well. People living in countries in higher latitudes with less UV exposure have higher blood pressures at baseline than <a href="http://dx.doi.org/10.1161/01.HYP.30.2.150">countries receiving more sunlight</a>. This effect is also seasonal, as more UV exposure in summer results in lower blood pressure. </p>
<p>And clinical trials have proven UVB radiation <a href="http://dx.doi.org/10.1016/S0140-6736(05)60827-6">effectively treats patients with mild hypertension</a>. It was thought that vitamin D was the cause for decreased blood pressure, but follow-up trials proved this effect was due to UVB exposure alone. </p>
<p>Some chemical reactions caused by UV light are known to have anti-inflammatory effects in the skin. Immune cells living in the skin can stop functioning, migrate out of the skin or undergo cell death <a href="http://www.sciencedirect.com/science/article/pii/S0896841109001516">following exposure to UV radiation</a>. Due to its anti-inflammatory effects, UV light can be used to effectively treat inflammatory skin conditions like psoriasis and eczema.</p>
<h2>Protection against autoimmune conditions</h2>
<p>On a larger scale, certain autoimmune conditions are more common in countries with less UV exposure. For instance, there is a higher prevalence of multiple sclerosis (MS) <a href="http://www.mdpi.com/1422-0067/13/9/11718/htm">in Scandinavian countries</a>. </p>
<p>In MS, immune cells attack the insulation around nerve cells in the brain, ultimately leading to nerve damage. While lack of vitamin D is a leading hypothesis for how MS develops, studies have also shown that lack of sun exposure may be an independent <a href="http://www.neurology.org/content/76/6/540.short">risk factor for nerve damage</a>.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/110370/original/image-20160204-11389-9mn266.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/110370/original/image-20160204-11389-9mn266.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/110370/original/image-20160204-11389-9mn266.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/110370/original/image-20160204-11389-9mn266.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/110370/original/image-20160204-11389-9mn266.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/110370/original/image-20160204-11389-9mn266.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/110370/original/image-20160204-11389-9mn266.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Be careful out there.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/alexmartin81/7755295064/in/photolist-cPiV2S-2uMWP-6WFEBx-d9SS2s-5GpLLF-rUix4-33Hx4J-523MXZ-4JgYDx-6Kq83L-uBPtwS-dwJW34-yiwHit-5cpJwZ-4aGwii-4XHaqt-9UHz4k-gtjLDq-9uXwko-a51SM8-e9KsRV-51Y6Qe-5kMNiu-9y4RKd-7qNTG2-nTJvhG-6u5RYo-8p19KJ-nZKFus-7JXLQw-8i5tut-sduZY9-b2TKxn-9y1TFp-8USaWF-8mBLqB-bqfzVF-qpTa9i-9XhCSX-58kJyj-eEv2A2-hiG9kF-9Ts6Kr-a9c1jA-c6ryyj-56UPna-oiDDj3-6q7nCD-7ywGz1-Cqa5t">Alex Liivet/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<h2>Of course, sunlight has a dark side</h2>
<p>In addition to skin cancer, UV radiation also causes photoaging. UVA radiation penetrates deep into the skin, destroying collagen, which leads to wrinkles and skin thinning. Also, some autoimmune diseases, such as lupus, flare in response to UV radiation. UV radiation can also affect the eye, causing cataracts. </p>
<p>So, how can you maximize the benefits of sun exposure while minimizing your risk of skin cancer and aging? The key is to practice safe sun habits, which means using sunscreen and avoiding sunburns. This will decrease photoaging, and more importantly, your risk of skin cancer. Also, vitamin D is most effectively synthesized at UV radiation doses below those causing sunburn.</p>
<p>Several factors, including your skin type, latitude, longitude and weather, play into your overall UV exposure. This means different amounts of time in the sun for different people. People living in California may need only brief sun exposure on a cloudless day for adequate vitamin D production. This differs for places like Boston, where there aren’t adequate amounts of UV radiation from November to February. Skin type becomes important because melanin, which gives skin its pigment, effectively blocks UV radiation. This means darker-skinned people need more UV exposure for adequate vitamin D production than lighter-skinned people.</p>
<p>There are online tools that let you <a href="http://zardoz.nilu.no/%7Eolaeng/fastrt/VitD_quartMEDandMED_v2.html">calculate</a> how much time you should spend in the sun to achieve adequate levels of vitamin D without causing sunburn. If you think you aren’t getting enough sun exposure, or you live somewhere with long winters, check with your doctor to see if you are vitamin D deficient.</p><img src="https://counter.theconversation.com/content/53604/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Emanual Maverakis receives funding from the NIH. </span></em></p><p class="fine-print"><em><span>Andrea Sukhov does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The risks of UV radiation exposure are well-known, but some scientists are exploring lesser-known benefits of UV light.Emanual Maverakis, Associate Professor- Departments of Medical Microbiology & Immunology and Dermatology | Member- Foods For Health Institute | Member- Comprehensive Cancer Center | Director- Autoimmunity | Director- Immune Monitoring Core, University of California, DavisAndrea Sukhov, Medical student, University of California, DavisLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/426752015-06-10T10:17:33Z2015-06-10T10:17:33ZThink indoor tanning is a safer alternative to sitting in the sun? Think again<figure><img src="https://images.theconversation.com/files/84237/original/image-20150608-8697-1m0f3g2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">International Agency for Research on Cancer has classified UV-emitting tanning devices as a Group I carcinogen -- the most dangerous cancer-causing substances. </span> <span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-55286200/stock-photo-solarium-machine-in-spa-salon.html?src=eu2xLFDQk4rmrd32YsbwIw-1-8">Tanning bed via www.shutterstock.com.</a></span></figcaption></figure><p>June 21 marks the official start of summer, signaling months of long days spent in the sun, vacations to warm and tropical locations, and, of course, suntans. </p>
<p>In a quest for a perfect tan, many people – especially young white women between age 18 and 25 – may head to a tanning salon, using tanning booths, sunbeds and sunlamps to kick-start their tan. Others (including people who are more prone to burn instead of tan) may head to the salon to slowly develop a “base tan,” with the <a href="http://www.mayoclinic.org/diseases-conditions/sunburn/expert-answers/tanning/faq-20057866">mistaken</a> belief that it will prevent a sunburn. For many consumers of indoor tanning salons, this approach offers what they believe to be a safer alternative to outdoor tanning. But here’s the thing: indoor tanning is just as damaging to your health as lying out in the real sun.</p>
<h2>Indoor tanning isn’t risk-free</h2>
<p>In the US, approximately five million individuals are diagnosed and treated for skin cancer each year, making it the most common type of cancer in the country, so common that most of us know at least one person who has been diagnosed with skin cancer. Of these, <a href="http://www.mayoclinic.org/diseases-conditions/melanoma/basics/definition/con-20026009">melanoma</a> is the deadliest form of skin cancer (relative to others like <a href="http://www.cancer.org/cancer/skincancer-basalandsquamouscell/detailedguide/skin-cancer-basal-and-squamous-cell-what-is-basal-and-squamous-cell">basal and squamous cell carcinomas</a>), accounting for approximately <a href="http://www.surgeongeneral.gov/library/calls/prevent-skin-cancer/exec-summary.html">9,000 deaths each year</a> in the US.</p>
<p>Skin cancer is associated with ultra violet (UV) radiation exposure from both the sun, and artificial sources such as UV-emitting tanning devices found in indoor tanning salons. These devices emit UVA rays, UVB rays, or a combination of both. Exposure to UV radiation has well-documented <a href="http://www.ncbi.nlm.nih.gov/pubmed/2748244">adverse health effects</a>. It is a known human carcinogen, so exposure to UV radiation may cause cancer. To your skin, there isn’t a difference between UV radiation from the sun and UV radiation from a tanning device.</p>
<p>In 2009 the International Agency for Research on Cancer (IRAC), part of the World Health Organization (WHO), classified UV-emitting tanning devices as a <a href="http://monographs.iarc.fr/ENG/Classification/index.php">Group I carcinogen</a> – the classification for the most dangerous cancer-causing substances. That means tanning booths and beds, sunlamps and other artificial tanning devices are in same category as tobacco smoke. That’s right, the world’s leading authority on cancer research considers indoor tanning devices to be as dangerous as <a href="http://www.ncbi.nlm.nih.gov/pubmed/12738186">tobacco smoke</a> from cigarettes.</p>
<p>That’s a strong statement to make, but it is backed up by a robust and growing body of evidence linking UV tanning devices to health problems. The use of UV tanning devices has been linked to <a href="http://www.ncbi.nlm.nih.gov/pubmed/17131335">skin</a> and <a href="http://www.ncbi.nlm.nih.gov/pubmed/2400347">eye melanomas</a>. Of the five million cases of skin cancer diagnosed each year in the US, researchers have estimated that 8% (or 400,000) of these cases can be attributed to indoor tanning.</p>
<p>About <a href="https://www.aad.org/media-resources/stats-and-facts/prevention-and-care/dangers-of-indoor-tanning">30 million people tan indoors</a> in the US every year, and about 2.3 million of them are teens. And research indicates, for example, that the lifetime risk of skin melanoma <a href="http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm186687.htm">increases by 75%</a> among people who began using UV tanning devices before age of 35 (called young exposure). Yes – 75%. That figure alone should be enough to make some of us rethink the importance of that tan. </p>
<p>And if the increased risk of skin cancer isn’t enough, what about the increased risk of eye damage, wrinkles and other forms of premature aging of the skin? It begs the question – is that tan really worth it?</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/84239/original/image-20150608-8732-19ztwgd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/84239/original/image-20150608-8732-19ztwgd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/84239/original/image-20150608-8732-19ztwgd.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/84239/original/image-20150608-8732-19ztwgd.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/84239/original/image-20150608-8732-19ztwgd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=504&fit=crop&dpr=1 754w, https://images.theconversation.com/files/84239/original/image-20150608-8732-19ztwgd.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=504&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/84239/original/image-20150608-8732-19ztwgd.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=504&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">8% of skin cancer cases diagnosed in US annually can be attributed to indoor tanning.</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-7010602/stock-photo-illuminated-green-and-blue-tanning-neon-sign-on-black.html?src=TkjqbD6SYxlzhum3lArXqw-2-72">Tanning sign via www.shutterstock.com.</a></span>
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</figure>
<h2>Limited regulatory oversight for indoor tanning</h2>
<p>Indoor tanning might be unhealthy, but its popularity, especially among young people, hasn’t dampened. Researchers in Texas found that apartment buildings near some college campuses offer free indoor tanning <a href="http://www.npr.org/sections/health-shots/2015/06/04/411739662/apartments-lure-students-with-free-access-to-tanning-beds">to lure students</a>. And a study of 125 college and university campuses in the US found <a href="http://archderm.jamanetwork.com/article.aspx?articleid=1919438">that almost half</a> had indoor tanning facilities on campus or in off-campus housing. </p>
<p>Why haven’t governments taken a more aggressive role in regulating the industry, including implementing partial or complete bans for cosmetic tanning? This seems a pretty obvious question, given the flurry of legislative and regulatory action that we have witnessed over the last decade or two in relation to the tobacco industry. Today, smoking cigarettes is more and more expensive (due to ever-increasing taxes), highly regulated, and, in many regions, socially unacceptable. </p>
<p>Several countries have taken steps to <a href="http://archderm.jamanetwork.com/article.aspx?articleid=1216974">regulate indoor tanning</a>. In 2011, Brazil became the first country in the world to ban the use of commercial indoor tanning for nontherapeutic purposes for all age groups (the country had already banned tanning for minors in 2002). Australia quickly followed. As of today, all but one Australian state prohibit individuals from operating a commercial tanning business. There are significant financial penalties for breaking the law. It is anticipated that the ban will help to reduce the incidence of skin cancer in the Australian public over time. </p>
<p>A number of other countries – including France, Italy and the United Kingdom – prohibit people under 18 from indoor cosmetic tanning. </p>
<p>But regulations in the US aren’t nearly as strict. Commercial indoor tanning operations <a href="http://www.ncsl.org/research/health/indoor-tanning-restrictions.aspx">are regulated</a> through a patchwork of state registration, licensing and/or inspection requirements. The nature of the regulations varies greatly and so too does the strength of enforcement. </p>
<p>The majority of states regulate the use of tanning devices by minors in some way. Seventeen states <a href="http://www.ncsl.org/research/health/indoor-tanning-restrictions.aspx">require</a> parental accompaniment, or parental consent, for the use of a tanning bed by minors. Maximum exposure times and the provision of eye protection to the minor are also common in these states. <a href="http://www.nature.com/nature/journal/v515/n7527_supp/box/515S114a_BX1.html">Eleven states</a> – including <a href="http://well.blogs.nytimes.com/2011/10/10/california-bans-indoor-tanning-for-minors/">California</a> and <a href="http://www.texastribune.org/2013/08/30/minors-no-longer-allowed-use-tanning-salons/">Texas</a> – have gone further and created legislation that prohibits indoor tanning by minors. But eight states still have no such protections. In these states, despite the overwhelming epidemiological evidence, minors may engage in unhealthy tanning practices without any checks and balances to help minimize the risks. </p>
<p>On the federal side, the Food and Drug Administration (FDA) <a href="http://www.surgeongeneral.gov/library/calls/prevent-skin-cancer/exec-summary.html">reclassified</a> indoor tanning devices as <a href="https://www.federalregister.gov/articles/2014/06/02/2014-12546/general-and-plastic-surgery-devices-reclassification-of-ultraviolet-lamps-for-tanning-henceforth-to#h-7">Class II medical devices</a> in 2014. That means manufacturers will need to include a warning that people under 18 shouldn’t use these devices and need to meet other regulatory requirements. And as of 2010 there is a <a href="http://money.cnn.com/2012/06/28/pf/taxes/tanning-tax/">10% federal excise tax</a> on tanning services. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/84241/original/image-20150608-8677-6awxbp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/84241/original/image-20150608-8677-6awxbp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/84241/original/image-20150608-8677-6awxbp.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/84241/original/image-20150608-8677-6awxbp.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/84241/original/image-20150608-8677-6awxbp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/84241/original/image-20150608-8677-6awxbp.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/84241/original/image-20150608-8677-6awxbp.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Lifetime risk of skin melanoma increases by 75% among people who began using UV tanning devices before 35.</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-189514670/stock-photo-sunbathing-on-tanning-bed-beautiful-young-woman-lying-on-tanning-bed-and-keeping-eyes-closed.html?src=eu2xLFDQk4rmrd32YsbwIw-1-45">Woman in tanning bed via www.shutterstock.com.</a></span>
</figcaption>
</figure>
<h2>What can be done to protect minors?</h2>
<p>The demand for that bronzed look remains high (the indoor tanning industry is valued at US$2.6 billion) and this is unlikely to change any time soon given the aesthetic appeal. And while a call for an outright ban may make sense from a public health perspective, such a call would be highly unpalatable to consumers, business operators and the states, which benefit from the economic activity. </p>
<p>But more should and can be done to protect young tanners. A first step would be for all states to follow the lead set by, for example, California, and enact legislation that prohibits minors from using indoor tanning facilities. Across all states, maximum exposure times and requirements for the provision of eye protection for all clients, regardless of age, should be introduced and strictly enforced. Greater education around the risks of exposure, but especially young exposure, is also needed.</p><img src="https://counter.theconversation.com/content/42675/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Diana Bowman does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Researchers have estimated that 8% of the five million cases of skin cancer diagnosed each year in the US can be attributed to indoor tanning.Diana Bowman, Associate Professor of Health Management Policy, University of MichiganLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/304942014-08-19T05:17:38Z2014-08-19T05:17:38ZA third of sunscreens could have overestimated SPF protection – it’s a scandal<figure><img src="https://images.theconversation.com/files/56534/original/jt6ypfhv-1408024304.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Throwing in the towel. </span> <span class="attribution"><a class="source" href="http://commons.wikimedia.org/wiki/File:Sunbathing_couple.jpg">Mark Probst</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span></figcaption></figure><p>Despite the many awareness-raising campaigns on the harmful effects of ultraviolet (UV) radiation, a walk along any tourist beach will tell you just how many sun worshippers continue to soak up the sun excessively. And despite our use of all kinds of sunscreens, the statistics show a constant increase in the number of skin cancer cases. Why?</p>
<p>Things that protect us against harmful rays from the sun include clothing such as hats and longer sleeves and sunglasses. But topical sun protection from sunscreens is ideal as it allows us to be more free. </p>
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<p>These products only appeared on the market in the 1930s and were promoted as tanning aids. The formulation of sunscreen products is complex and the first ones were especially flawed – because the UV-filters were used at low concentrations and their effectiveness was limited in UVB light range. Since then, the history of topical sun protection has been marked by milestones, or scandals as we could call them. Let’s not forget the Bergasol affair in the 1980s. Products were formulated with bergapten, a photo-sensitising molecule that is found in bergamot essential oil and other oils, but which had no place whatsoever in this type of product because mixed with light it can cause skin irritation.</p>
<p>Today we have the Sun Protection Factor (SPF) to guide us. SPF is a universal indicator that testifies to the effectiveness of a product against UV (which includes UVA and UVB wavelengths), which <a href="http://www.nhs.uk/Livewell/skin/Pages/Sunsafe.aspx">can penetrate and damage</a> the skin and cells. SPF is worked out by putting on a thick layer of a suncream on in the lab and working out the difference it makes based on a multiplier – so if unprotected skin took 15 minutes to burn, a sunscreen with an SPF of 10 would take 150 minutes, and SPF30 would take 450 minutes.</p>
<p>This method of calculating protection is voted for overwhelmingly by manufacturers. Apart from the clear ethical shortcomings of this method (it does, after all involve irradiating volunteers for not insignificant periods or doses), we’ve discovered and revealed a certain number of potential biases. We’ve tested many products each year since 2000 and would say that about a third have much less protection than their SPF would suggest. </p>
<p>Concerns <a href="http://www.medwirenews.com/66/88067/Dermatology/Sunscreen_labels_may_overestimate_SPF_at_temperate_latitudes.html">have previously been raised</a> about SPF performance out in the real world and <a href="http://press.which.co.uk/wp-content/uploads/2014/05/suncream_R2f.pdf">a recent investigation by Which?</a> consumer magazine found three suncreams – Piz Buin, Malibu and Hawaiian Tropic – had lower protection than the SPF30 on the bottle.</p>
<h2>Anti-inflammatories</h2>
<p><a href="http://www.ncbi.nlm.nih.gov/pubmed/22707250">We’ve highlighted</a> that a certain number of ingredients found in suncreams including allantoin (a molecule found in <em>Symphytum officinale</em>, a plant more commonly known as comfrey but which is now mostly synthetic), bisabolol (found in chamomile, also now mostly synthetic), and liquorice extracts, are likely to inhibit the appearance of redness due to their anti-inflammatory properties. As redness is a clinical sign that is used to determine SPF under current procedures, it can result in an overestimation of the SPF of products that contain these molecules. Using products high in anti-inflammatories can give a false sense of security – your DNA is still being damaged, you just don’t see or feel it happening. </p>
<p>We <a href="http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0046187">have also demonstrated</a> that the majority of filters approved in sunscreen products, including salicylates, benzophenones, PABA by-products, cinnamates and octocrylene, are highly anti-inflammatory. The problem is that despite this UV-filters are an essential ingredient for sunscreens to work.</p>
<p>Our current work has been looking at how long these anti-inflammatory effects last and we’ve found that this can be several hours. It’s worth bearing in mind that any molecule that is likely to inhibit the development of the redness, regardless of what other action it has, will plays a part in overestimating SPF using current measures.</p>
<p>Another major problem with topical sun protection comes from mineral products – titanium dioxide and/or zinc oxide – whether or not they are organic. Despite some claims, high SPF factors in sunscreens (50, 50+) <a href="http://www.ncbi.nlm.nih.gov/pubmed/18271305">can’t be obtained</a> with this type of sunscreen. Again the difference is due to an anti-flammatory effect and people who use these type of products for high SPF won’t be well protected.</p>
<h2>A better way to test?</h2>
<p>Instead, we think there should be a new standardised system of testing products based on chemical testing in the lab that only considers the optical properties of filters. This is the only way of quantifying the real effectiveness of sunscreen products.</p>
<p>Sunscreen products are different from all others; they can actively protect against skin cancers. And crucially, we have trust in them so happily stay out in the sun longer, thinking they’re working as well as they claim. It would therefore be appropriate that they return to being classed as a medication, as they are in the US. The marketing of ineffective sunscreen products today will have to take a share of the responsibility in skin cancers – we can’t leave this heavy responsibility to the cosmetics industry.</p><img src="https://counter.theconversation.com/content/30494/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Despite the many awareness-raising campaigns on the harmful effects of ultraviolet (UV) radiation, a walk along any tourist beach will tell you just how many sun worshippers continue to soak up the sun…Laurence Coiffard, Lecturer of Industrial Pharmacy and Cosmetology, Université de NantesCéline Couteau, Lecturer of Industrial Pharmacy and Cosmetology, Université de NantesLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/282832014-06-20T11:41:46Z2014-06-20T11:41:46ZSunshine addiction is a hot topic – but does ‘tanorexia’ really exist?<figure><img src="https://images.theconversation.com/files/51771/original/qkrnctpb-1403261598.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Half-baked.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/hjl/14062720616/sizes/l/in/photolist-nqF7Uh-Hy1SJ-51BMvz-NKvQZ-9UVhtC-6ASz29-43wtzb-cw8d9L-8gqAPx-bKCp5M-2Nj2f-2wUCf-c1Lo17-coZFh-3giweQ-2yewT-8jnAcB-K3D6K-4dVEu7-6yJLTe-hKDtE-4CeQi-9xckjW-ckeV81-ckeTMo-ckeRZW-ckeVjN-ckeSoW-ckePHA-4JK6qM-bbw6fP-9zcCEu-eoiwct-YLVH-FaWtB-b3s5xM-coZAC-coZDD-wAWfR-4LC7oF-ddE5RA-coZCp-coZA9-64MiU7-9AAMiZ-fxBSs-3D6WK-6owBmg-5N2FfT-6WtoYX-2LbZza/">Hjl</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc/4.0/">CC BY-NC</a></span></figcaption></figure><p>If the many <a href="http://www.telegraph.co.uk/health/healthnews/10912105/Sunshine-can-be-addictive-like-heroin.html">media reports</a> are to be believed: “Sunshine can be addictive like heroin.” The claim comes via a <a href="http://bit.ly/1iLJpal">study published in Cell</a> based on an experiment carried out on mice at Harvard Medical School. Researchers found that ultraviolet light exposure leads to elevated endorphin levels – the body’s own “feel good” internal morphine – that mice experience withdrawal effects after exposure, and that chronic ultraviolet light exposure causes dependency and “addiction-like” behaviour.</p>
<p>Although the study was carried out on animals, the authors speculated that their findings may help to explain why we love lying in the sun and that in addition to topping up our tans, sunbathing may be the most natural way to satisfy our cravings for a “sunshine fix” in the same way that drug addicts yearn for their drug of choice.</p>
<h2>Summer of ‘98</h2>
<p>Reading the findings of this new study took me back to 1998 when I appeared as a “behavioural addiction expert” on a daytime BBC television alongside people who claimed they were addicted to tanning (dubbed by the researchers on the programme as “tanorexia”). I have to admit that none of the case studies on the show appeared to be addicted to tanning – at least based on my own six behavioural addiction criteria: salience (being the most important and preoccupying activity in the person’s life), mood modifying, tolerance, withdrawal, conflict, and relapse. But it did at least alert me to the fact that some people thought sunbathing and tanning was addictive.</p>
<p>On the show, people likened their excessive tanning to nicotine addiction and there certainly appeared to be some similarities between the people interviewed and nicotine addiction, in the sense that the “tanorexics” knew they were significantly increasing their chances of getting skin cancer as a direct result of their risky behaviour but felt they were unable to stop doing it, which you could argue is very similar to smoking despite knowing the health warnings.</p>
<p>Since then, tanorexia has become a topic for scientific investigation. A <a href="http://archderm.jamanetwork.com/article.aspx?articleid=398011">2005 study published</a> in the Archives of Dermatology claimed that a quarter of the sample of 145 “sun worshippers” would qualify as having a substance-related disorder if ultraviolet light was classed as the substance they craved. The paper also reported that frequent tanners experienced a “loss of control” over their tanning schedule and displayed a pattern of addiction similar to smokers and alcoholics.</p>
<p><a href="http://bit.ly/1yrJb29">A 2006 study</a>, published in the Journal of the American Academy of Dermatology, reported that frequent tanners (those who tanned eight to 15 times a month) that took naltrexone, an endorphin blocker normally used to treat drug addictions, significantly reduced the amount of time spent tanning compared to a control group of light tanners.</p>
<p>Two years later, <a href="http://www.ingentaconnect.com/content/png/ajhb/2008/00000032/00000005/art00001">another study</a> published in the American Journal of Health Behavior reported that 27% of 400 surveyed students were classified as “tanning dependent”. The authors claimed that those classed as being tanning dependent had a number of similarities to substance use, including a higher prevalence among youth; an initial perception that the behaviour was image enhancing; high health risks and disregard for warnings about those risks; and the activity being mood enhancing.</p>
<p>Another <a href="http://ajhpcontents.org/doi/abs/10.4278/ajhp.120912-QUAN-442">just published study</a> in the American Journal of Health Promotion surveyed 306 female students, and classed 25% of the respondents as “tanning dependent” based upon a self-devised tanning dependence questionnaire. </p>
<p>But the problem with this and most of the psychological research on tanorexia to date is that almost all of the research is carried out on relatively small convenience samples using self-reporting and non-psychometrically validated “tanning addiction” measurement scales.</p>
<p>Although some studies suggest that some of my addiction criteria appear to have been met, I have yet to be convinced that any of the published studies to date show all of them. In short, empirical research evidence demonstrating a genuine addiction to tanning that encompasses all the known and expected physical and psychological consequences of addiction has yet to be proven.</p><img src="https://counter.theconversation.com/content/28283/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Dr. Mark Griffiths has received research funding from a wide range of organizations including the Economic and Social Research Council, the British Academy and the Responsibility in Gambling Trust. He has also carried out consultancy for numerous gaming companies in the area of social responsibility and responsible gaming.</span></em></p>If the many media reports are to be believed: “Sunshine can be addictive like heroin.” The claim comes via a study published in Cell based on an experiment carried out on mice at Harvard Medical School…Mark Griffiths, Director of the International Gaming Research Unit and Professor of Gambling Studies, Nottingham Trent UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/21792011-08-23T04:15:56Z2011-08-23T04:15:56ZNot a sunny outlook: tighter sunbed regulation is long overdue<figure><img src="https://images.theconversation.com/files/3087/original/Cadillac_Solarium.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Sunbeds session pose a significant risk of developing melanomas that is completely avoidable.</span> <span class="attribution"><span class="source">Froztbyte/Wikimedia Commons</span></span></figcaption></figure><p>Before she died in September 2007 of melanoma attributed to solarium tanning sessions, 26-year-old Clare Oliver waged a public campaign from her hospital bed to raise awareness of the risks of using sunbeds. </p>
<p>Oliver called for a ban on solaria and expressed frustration that governments had failed to effectively regulate the industry despite knowing of associated risks.</p>
<p>Her efforts attracted significant media and public attention to scientific evidence about the dangers of sunbed sessions. </p>
<p>Politicians at state and federal levels were forced to address seeming official reluctance to regulate an industry that operated under a <a href="http://www.mja.com.au/public/issues/189_07_061008/mac10610_fm.html">voluntary code of conduct despite constituting a significant and wholly avoidable risk</a> for melanoma. </p>
<p>The significance of official reluctance to ban the industry has been magnified by <a href="http://onlinelibrary.wiley.com/doi/10.1002/ijc.25576/abstract">findings of a recent Australian study</a> on the links between sunbed use and early onset malignant melanoma.</p>
<p>Analysis on 604 diagnoses of melanoma in people aged 18 to 39 years in Sydney, Melbourne and Brisbane found the risk of early onset melanoma was 41% greater among sunbed users.</p>
<p>And the risk was roughly double for those who had undergone more than ten sessions in their lifetime.</p>
<p>Sunbed use is also estimated to be responsible for three-quarters of melanomas occurring among 18- to 29-year-olds who have ever used one, accounting for 16% of all melanomas diagnosed in this age group. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/3089/original/Tanning_bed_in_use__282_29.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/3089/original/Tanning_bed_in_use__282_29.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/3089/original/Tanning_bed_in_use__282_29.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/3089/original/Tanning_bed_in_use__282_29.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/3089/original/Tanning_bed_in_use__282_29.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/3089/original/Tanning_bed_in_use__282_29.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/3089/original/Tanning_bed_in_use__282_29.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Sunbeds may be responsible for three-quarters of all melanomas in people aged 18 to 29. Alexis O’Toole.</span>
</figcaption>
</figure>
<h2>Failure of self-regulation</h2>
<p>At the time of Clare Oliver’s campaign, the solarium industry was expanding rapidly due largely to misguided perceptions about the cosmetic benefits of tanned skin.</p>
<p>The number of outlets in Melbourne, for instance, grew by more than five times between 1996 and 2006. </p>
<p>The industry’s voluntary code of practice included guidelines on UV radiation, session length, and hygiene. </p>
<p>Potential users with Type 1 skin, defined by the World Health Organization (WHO) as <a href="http://www.who.int/uv/publications/en/sunbeds.pdf">skin that cannot tan and is most susceptible to sunburn</a>, and those under 15 were prohibited.</p>
<p>Fifteen to 18-year-olds required written parental permission and all clients were to be informed of associated cancer risks. </p>
<p>But the code allowed for UV radiation levels five times higher than levels possible from sun exposure. </p>
<p>And assessments of solaria operations at the time <a href="http://www.mja.com.au/public/issues/189_07_061008/gor10291_fm.html">found lax compliance with guidelines</a> on users with Type 1 skin, age limits, informed consent, and posting of warning notices. </p>
<p>A <a href="http://tiny.cc/v6ku7">survey in Melbourne</a>, for instance, found:</p>
<ul>
<li><p>over half the operations observed allowed teenagers access without parental permission; </p></li>
<li><p>90% allowed access to customers with type I skin and; </p></li>
<li><p>staff at three-quarters of solaria contravened the code by reassuring clients about the safety of sunbed tanning.</p></li>
</ul>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/3083/original/Clare_Oliver_AAP.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/3083/original/Clare_Oliver_AAP.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=484&fit=crop&dpr=1 600w, https://images.theconversation.com/files/3083/original/Clare_Oliver_AAP.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=484&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/3083/original/Clare_Oliver_AAP.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=484&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/3083/original/Clare_Oliver_AAP.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=608&fit=crop&dpr=1 754w, https://images.theconversation.com/files/3083/original/Clare_Oliver_AAP.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=608&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/3083/original/Clare_Oliver_AAP.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=608&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The solarium industry was found to have made false and misleading claims in the aftermath of Clare Oliver’s death. AAP.</span>
</figcaption>
</figure>
<h2>Steps in the right direction?</h2>
<p>Since Clare Oliver’s campaign, the Federal Court has ruled that the solarium industry made false and misleading claims on Internet sites about the safety of indoor tanning days after her death.</p>
<p>The Court required outlets to post signs informing customers of the risks associated with their facilities. And state governments enacted regulations, primarily around skin type and age. </p>
<p>Typically heralded as tough by policymakers, these <a href="http://www.mja.com.au/public/issues/189_07_061008/mac10610_fm.html">regulations wouldn’t have impeded Clare Oliver using solaria</a>, as she was not fair-skinned and was 19 years old at the time of her sessions.</p>
<p>Worryingly, these regulations could also unintentionally reassure the public about sunbed use and potentially protect the industry from legal action. </p>
<p>Solarium numbers have dropped in the wake of unfavourable media attention and regulation, possibly by as much as one-third. But <a href="http://www.environment.nsw.gov.au/resources/radiation/09814solicarus.pdf">recent reports</a> by the NSW Depart of Environment, Climate Change & Water pointing to <a href="http://www.environment.nsw.gov.au/resources/radiation/10310solaurora.pdf">poor compliance</a> with new state regulations suggest key problems with the industry have not been adequately resolved. </p>
<p><a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1753-6405.2009.00436.x/full">Estimates</a> of 281 new melanoma diagnoses and 43 related deaths in Australia annually due to solarium visits, raise the question of why governments fail to ban the industry outright. </p>
<p>Sunbed sessions offer no positive consequences while posing significant and wholly avoidable risks for melanoma. </p>
<p>Campaigns to convince people to reduce exposure to the sun have achieved mixed results but the solarium industry represents an easily managed risk factor if governments act decisively. </p>
<p>The demise of the industry would be mourned by few.</p><img src="https://counter.theconversation.com/content/2179/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Ross MacKenzie has previously worked for Cancer Council NSW, which has called for stricter regulation of the solarium industry. </span></em></p>Before she died in September 2007 of melanoma attributed to solarium tanning sessions, 26-year-old Clare Oliver waged a public campaign from her hospital bed to raise awareness of the risks of using sunbeds…Ross MacKenzie, Lecturer in Health Studies, Macquarie UniversityLicensed as Creative Commons – attribution, no derivatives.