Facultative Pigmentation

For the past three decades, members of the dermatology community have perpetuated the lie that facultative pigmentation, better known by the public as a tan, provides only limited protection against skin damage regardless of the fact that they know, or reasonably should know, that the statement is not—and never has been—true.

This article contains the facts about the role that our normal and natural constitutive pigmentation (i.e., genetically-determined skin color) and facultative pigmentation (i.e., acquired/adaptive level of tan) plays in increasing our tolerance to ultraviolet radiation (TUVR) and decreasing our sensitivity to ultraviolet radiation (SUVR).

Salons need to do their part to educate and inform the American public and media about the incontrovertible benefits of maintaining a year-round tan because we must reclaim our birthright, i.e., that facultative pigmentation (a tan) provides significant protection against UVR-induced damage to the skin. Getting this important story out to the public should be our first priority as an industry.

The following are important terms that must be defined in order to understand this topic’s importance.

1. Overexposure to ultraviolet radiation (OUVR) means the client has been exposed to a dose/exposure time of UVR more than they can tolerate without damaging their skin.

2. Underexposure to ultraviolet radiation (UUVR) means the client has been exposed to a dose/exposure time less than what is required to stimulate vitamin D and maintain the desired tan.

3. Exposure to ultraviolet radiation (EUVR) means the individual has been exposed to an optimal dose of UVR.

4. Tolerance to ultraviolet radiation (TUVR) is the terminology used to explain the fact that an individual with darker natural skin color and/or a darker level of tan can tolerate a larger UVR dose (or a longer exposure time) without damaging their skin. A higher TUVR level means there is a lower probability of skin damage, and a lower TUVR level means there is a higher probability of skin damage.

Note: Skin type 1 individuals cannot develop facultative pigmentation and always will have a TUVR value of 1.0. A skin subtype 2A with no tan has the same TUVR value as a skin type 1, science & technology but the difference is that the skin subtype 2A can develop a tan and increase TUVR.

5. Sensitivity to ultraviolet radiation (SUVR) is the terminology used to define the probability of suffering UVR-induced skin damage. A larger SUVR percentage means there is a higher probability of skin damage; a smaller SUVR percentage means the individual has a lower probability of damaging their skin when overexposed to UVR.

Note: A skin type 1 individual cannot develop facultative pigmentation and always will have a SUVR value of 100 percent. A skin subtype 2A with no tan has the same SUVR value as does a skin type 1, but the difference is that the skin subtype 2A can develop a tan and thereby reduce their SUVR.

There is a reciprocal relationship between TUVR and SUVR, which means they should be considered as being two sides of the same coin. When an individual’s TUVR increases, their SUVR decreases; when their SUVR increases, their TUVR decreases.

6. Biological equivalent. An increase in TUVR resulting in a decrease in SUVR is the biological equivalent of reducing the cumulative annual UVR dose by the same percentage as the SUVR is reduced. This means that an increase in TUVR resulting in a 50-percent decrease in SUVR has the same ability to reduce skin damage as if the cumulative annual UVR dose was cut in half.

7. Factors affecting TUVR/SUVR:

A.Constitutive pigmentation. This form of “normal and natural” photo-protection comes from our natural skin color and is considered to be permanent because our skin type/subtype doesn’t change over our lifetime. Individuals with higher skin types/subtypes have a darker genetically-determined natural skin color and therefore have an increased TUVR and a decreased SUVR. Individuals with lower skin types/subtypes have a lighter geneticallydetermined natural skin color and therefore have a lower TUVR and a higher SUVR.

B. Facultative pigmentation. This form of “normal and natural” photo-protection is better known as an acquired/ adaptive “tan” and has a temporary effect on TUVR/ SUVR. As the tan darkens, TUVR is increased and SUVR is decreased; conversely, as the tan lightens, TUVR is decreased and SUVR is increased.

C. Photosensitizing substances. Various medications, foods, soaps, cosmetics and lotions temporarily can increase an individual’s SUVR and decrease TUVR.

D. Sunscreens with UVB filters. A sunscreen with a UVB filter applied to the surface of the skin temporarily and artificially increases TUVR and decreases SUVR by absorbing the erythemal (sunburning) wavelengths.

Note: Sunscreens with UVA filters absorb the longer wavelengths of UVR that induce facultative pigmentation (a tan) and should be avoided because a) by preventing the development of a tan they make the individual dependent upon using them forever, which is good for the sunscreen manufacturer but bad for the person; and b) these longer wavelengths are the ones that stimulate our immune system, which means that use of a sunscreen with a UVA filter can weaken our immune defense capability.

The three graphs on the next page reveal how photo-protective properties provided by our skin type/subtype and level of tan work synergistically to increase our tolerance to UVR and decrease our sensitivity to UVR.

The top graph shows the TUVR (blue line) and SUVR (red line) for a person with no tan; the middle graph for a person with a medium tan; and the bottom graph for a person with a maximum tan. Note: We will use subtype 3B—the most common skin type/subtype in the United States and where the two lines cross—as our primary example for each of the three graphs.

The top graph shows that our example skin subtype 3B with no tan has a 2.5 TUVR, i.e., their genetically-determined skin color makes it possible to tolerate a dose/exposure time 2.5 times greater than a subtype 2A (with no tan) and their SUVR is reduced to 40 percent—a reduction of 60 percent. A subtype 2A with no tan has a 1.0 TUVR and a SUVR of 100 percent; a skin type 5 has a 5.0 TUVR and a SUVR of 20 percent.

The middle graph shows that our example skin subtype 3B with a medium tan has a 5.0 TUVR, which means they can tolerate a dose/exposure time 5.0 times more than a skin subtype 2A (with no tan) and the SUVR is reduced to 20 percent—a reduction of 80 percent. A skin subtype 2A with a medium tan has a 2.0 TUVR and a SUVR of 50 percent while a skin type 5 has a 10.0 TUVR and a SUVR of 10 percent.

The bottom graph shows that our example skin subtype 3B with a maximum tan has a 10.0 TUVR, which means they can tolerate a dose/exposure time 10.0 times more than a skin subtype 2A (with no tan) and the SUVR is reduced to 10 percent, a reduction of 90 percent. A skin subtype 2A with a maximum tan has a 4.0 TUVR and a SUVR of 25 percent while a skin type 5 has a 20.0 TUVR and a SUVR of 5 percent.

Skin type 1 individuals cannot develop facultative pigmentation and always will have a TUVR value of 1.0. A skin subtype 2A with no tan has the same TUVR value as a skin type 1, but the difference is that the skin subtype 2A can develop a tan and increase TUVR.

The two graphs on page 48 show how constitutive and facultative pigmentation work synergistically to reduce cumulative annual UVR dose (J/m^2) to a lower biological equivalent cumulative annual UVR dose. We will compare indoor workers and outdoor workers with a) no tan; b) a medium tan; and c) a maximum tan by skin type/subtype. An increase in TUVR resulting in a decrease in SUVR significantly reduces the biological equivalent cumulative annual UVR dose (J/m^2).

The top graph compares an indoor worker who takes a two-week vacation to a sunny climate and who patronizes an indoor tanning salon 100 times during the year (in order to maintain their tan) for an individual with no tan; a medium tan; and a maximum tan. A subtype 2A individual with no tan will be exposed to a cumulative total of 60,000 J/m^2; the same individual with a medium tan will reduce the net effect of that amount to the biological equivalent of 30,000 J/m^2; and the same individual who maintains a maximum tan level during the year reduces their exposure to the biological equivalent of 15,000 J/m^2.

Our example subtype 3B with no tan accumulates 24,000 J/m^2; 12,000 J/m^2 with a medium tan; and 6,000 J/m^2 if they maintain a maximum tan level. A skin type 5 will have 12,000 J/m^2 with no tan; 6.000 J/m^2 with a medium tan; and 3,000 J/m^2 if they maintain a maximum tan level.

The bottom graph compares an outdoor worker who takes a two-week vacation to a sunny climate and who patronizes an indoor tanning salon 100 times during the year (in order to maintain their tan) for an individual with no tan; a medium tan; and a maximum tan. A subtype 2A individual with no tan (i.e., who is “unprotected”) will be exposed to 120,000 J/m^2; the same individual with a medium tan will reduce the net effect of that amount to the biological equivalent of 60,000 J/m^2; and the same individual who maintains a maximum tan level during the year reduces the net effect of this exposure to the biological equivalent of 30,000 J/m^2. A subtype 3B with no tan accumulates 48,000 J/m^2; 24,000 J/m^2 with a medium tan; and 12,000 J/m^2 if they maintain a maximum tan level. A skin type 5 will accumulate 24,000 J/m^2 with no tan; 12.000 J/m^2 with a medium tan; and 6,000 J/m^2 if they maintain a maximum tan level.

The bottom line is that an individual who augments the photo-protection provided by their genetically-determined skin color by maintaining a tan year-round significantly reduces their biologically equivalent cumulative annual UVR dose (J/m^2).

A subtype 3B indoor worker who maintains a medium tan year-round lowers their cumulative annual UVR dose to the biological equivalent of 12,000 J/m^2, which is less than half of what they normally would experience during an “unprotected” (i.e., without a tan) two-week vacation in a sunny area. A subtype 3B outdoor worker who maintains a maximum tan year-round also will lower their cumulative annual UVR dose to the biological equivalent of 12,000 J/m^2.

The dermatology community and sunscreen industry knows, or reasonably should know, that only skin type 1 individuals (and subtype 2A individuals with no tan) accumulate the maximum cumulative annual dose of UVR and, therefore, must rely upon the use of a sunscreen for protection. All other skin type/subtypes reduce their biologically equivalent cumulative annual UVR exposure in direct proportion to their genetically-determined skin color and all skin type/subtypes—except for skin type 1s—also reduce their biologically equivalent annual UVR exposure in direct proportion to the level of acquired/adaptive tan they maintain year-round.

Therefore, the claim by the dermatology community that facultative pigmentation (an acquired/adaptive tan) provides only minimal protection from UVR-induced skin damage is shown to be yet another in a long series of their self-serving lies made for the express purpose of financially damaging the indoor tanning industry. Unfortunately, their lies also have the unintended consequence of damaging the health and welfare of the American public.

The bottom line is that maintaining facultative pigmentation (an acquired/ adaptive tan) year-round to augment the protection provided by our genetically-determined skin color (constitutive pigmentation) helps reduce our biologically equivalent cumulative annual UVR dose and does so in direct proportion to the level of tan that is maintained year-round.

Individuals who maintain a medium or maximum year-round tan will have a much higher likelihood of maintaining an optimal level of vitamin D, i.e., 120-150 nmol/L, which should be thought of as a “free bonus”, that is as valuable as the protection from UVR-induced skin damage. Together, these two benefits have the potential to dramatically improve our health and well-being; a “win-win” proposition.

It is time for everyone except skin type 1s to realize that depending upon sunscreen as their first line of defense against UVR-induced skin damage a) doesn’t pass the commonsense test; b) doesn’t work primarily because most people only use less than half of the dose of sunscreen required to get the protection promised by the label; and c) only benefits the large pharmaceutical companies that market sunscreens. A new photo-protection paradigm to protect against UVR-induced skin damage should be as follows:

1. Our first line of defense should be our constitutive pigmentation, i.e., our genetically-determined skin color.

2. Our second line of defense should be our facultative pigmentation, i.e., an acquired/adaptive tan.

3. Our third line of defense should be the use of an SPF 4-8 sunscreen when we are exposed to UVR for long periods of time. Note: Use of a sunscreen with SPF 15 or higher prevents the stimulation of vitamin D and should be avoided because there is no need for an SPF higher than 4-8.

We request that unless and until the dermatology community provides facts to refute this article, they cease and desist with any and all attempts to introduce legislation and/or regulations restricting the rights of any citizen—including teenagers—to patronize an indoor tanning salon for the purpose of developing photo-protective facultative pigmentation.

Restrictive legislation/regulations, as shown by the data in this article, are counterproductive if the goal is to reduce the potential for skin damage. In fact, legislation and regulations that discourage the American public from maintaining photo-protective facultative pigmentation (an acquired/adaptive tan) year-round will have the “unintended consequence” of increasing UVR-induced skin damage in the citizens these legislators are responsible for protecting.

Salons can help by making sure that everyone in their market area—clients, potential clients, the media, regulators and elected officials—understand that a) the benefits of sensible, moderate and responsible UVR exposure significantly outweigh the minimal and manageable risks involved; b) maintaining facultative pigmentation (an acquired/adaptive tan) year-round to augment the photo-protection afforded by their genetically-determined skin color significantly reduces their biologically equivalent cumulative annual UVR dose and reduces the potential for damage to their skin; and c) a year-round tanning regimen that makes it possible to maintain a medium or maximum tan level will result in the “free bonus” of helping to maintain an optimal (120-150 nmol/L) level of vitamin D.

It is time for the truth about the benefits of maintaining facultative pigmentation (a “tan”) year-round, i.e., the “greatest story never told” to be told. 

Patricia E. Reykdal owns and operates four tanning salons in Tucson, Ariz. Her husband, Donald L. Smith, is director of research of the Non-Ionizing Radiation Research Institute. Together, they have written more than 250 articles promoting sensible, moderate and responsible exposure to ultraviolet radiation. You can e-mail comments or questions to reyksmith@aol.com.