Skin Typing Your Clients

Skin Typing Your Clients
Determining Their Exposure Times

by Judie Gaillard

In order to maintain a successful business, it is essential to stay current about the latest facts and figures surrounding the indoor tanning industry. One way to accomplish this is to make sure your staff is knowledgeable about skin typing and photosensitivity. Not only will this help your salon gain a reputation as a valuable source of information, but it also will ensure that your clients are comfortable in your salon and with your advice.

Remind your employees to stress the importance of skin typing to each and every customer who walks through your door. As a responsible salon owner, you must keep a list of photosensitizing agents and drugs posted for all to see; however, you also must be able to accurately explain the effects of photosensitivity to gain customers' confidence.

Being able to quickly and accurately identify the various skin types is essential for any tanning salon employee. Prior to getting in a tanning bed or booth, every tanner should be skin typed and recorded, either in a computer file or card file for easy reference. The tanner also should be asked about any medications he or she may be taking and directed to the list of photosensitizing agents posted in the salon.

Skin typing will help tanners know how many sessions it will take to establish a base tan and how long they can be in the tanning unit without experiencing an uncomfortable and unnecessary sunburn.

Remember, skin type determines the amount of natural protection a person has against ultraviolet light. Because of the variety among people with different genetic backgrounds, dermatologists categorize humans into six different skin types, starting from lightest and working up to darkest. Fair skin burns easily and produces little tan because it has little natural protection. Dark skin tans more easily and burns less because it has more natural protection. Therefore, lighter shades should tan for relatively short time periods, while darker shades may tan for more extended periods of time.

For liability reasons, however, no one should be allowed to exceed the maximum exposure time posted on the unit, no matter how dark his or her skin tone.

Recently (December, 1999), an article by Patricia E. Reykdal in LOOKING FIT magazine introduced a new phototyping/subtyping system that was developed specifically for the indoor tanning industry. This article will compare the old system (Fitzpatrick-Pathak) with the new (Reykdal-Smith).

The most obvious difference is that the new Reykdal-Smith system has incorporated three subtypes (2A, 2B and 2C) of phototype 2 and two subtypes (3A and 3B) of phototype 3. The subtypes were added in order to more accurately identify those individuals who are most sensitive to UVR. Tanning salon owners know how important it is to handle UVR sensitive individuals very carefully, especially in their initial tanning sessions.

LOOKING FIT offers the following chart as a comparison of the Fitzpatrick skin typing system and the Reykdal-Smith phototyping/subtyping system.

Photosensitization

Photosensitivity is a physical reaction that occurs in varying degrees to a certain portion of the population. It occurs when different drugs or medical conditions react with ultraviolet light to cause the body to become more sensitive regarding the skin's acceptance of ultraviolet light.

The chemical may enter the skin several ways: orally, topically or parenterally (not through the digestive tract), but must be present when the skin is exposed. Compounds that cause photosensitivity are usually cosmetic or therapeutic in nature. Sometimes the chemical changes that occur reduce the skin's ability to defend or heal itself. Some medications are specifically designed to enhance the immune system or reduce the immune response. There also are medical conditions that cause a similar response.

Hopefully, the client will be aware of the medical condition and has been told by his or her physician to be careful of sun exposure. However, it is the salon owner's responsibility to inform the client that ultraviolet light is the same whether it is emitted from the sun or from a tanning bed or booth.

There are a number of reactions that can occur from mixing certain medications with ultraviolet light. The reaction is almost the opposite of putting sunscreen lotion on the skin. For example, an SPF 8 lotion is formulated to allow a person to remain in the sun for eight times as long without burning. In the case of a photosensitizing agent, the individual may only be able to be out in the sun for one-fourth of the time they normally can before getting erythema or sunburn.

It also is important to note that certain drugs are more photosensitive than others. For example, Tetracycline, Thiazide and anti-cancer drugs, such as Interferon, top the list as most probable to cause a severe reaction.

As responsible salon owners, we must be aware of the fact that each individual is different and there are varying portions of the population that will react to any given medication or product.

Additional points to consider are formulation, metabolism, elimination factors and photochemical reactivity, as well as the method of administration. Factors associated with radiation include the special irradiance of the ultraviolet source, dose and rate of delivery, number and frequency of exposure and the timing of the radiation relative to the presence of the chemical in the body. Please refer to the complete list of photosensitizing drugs and agents beginning on page 86 of this issue.

The clinical features of photosensitization reactions vary with the chemical and the individual. Skin eruptions tend to occur in areas of greatest exposure. In the event of an injury developing from overexposure to ultraviolet light in a tanning facility, medical advice or attention should be sought immediately. Tanning facilities that are regulated by state law are required to submit a written report of the incident within five working days of the incident.

Exposure to ultraviolet radiation should be stopped at once. For mild sunburn, cool compresses should be kept on the affected area until the pain subsides. Soaking with Aveeno Oilated oatmeal, cold cream and other bland medications are fine for mild burns. Do not use any anesthetic ointment with the word "caine" in it, as this could cause a severe allergic reaction. If an eye injury is incurred, immediately refer your client to either an emergency room or an ophthalmologist (not an optometrist or optician).

The following pages provide you with a detailed list of photosensitizing medications and products. Please post them in your salon and refer to them often.