Posted : 02/01/2002

Posted : 02/01/2002

The Skinny Skin On
A Refresher Course In Skin Typing And Photosensitivity

by Judie Bizzozero

It's February, and your tanning salon is busy with clients clamoring for their tanning sessions. Many of you are experiencing a rush of new customers who may never have tanned indoors before.

While you are busy cleaning beds, handing out protective eyewear and discussing the importance of lotions, your responsibility to your customers involves much more than that. It means helping them develop a skincare regime. To accomplish this, you and your staff must identify a customer's skin type and help them chart a course for their tanning adventure.

Prior to their first session, every tanner should be skin typed and asked if they are taking any medication. Write this information in your salon records and advise them to read the list of photosensitizing medications and agents that is posted in your salon.

Skin typing helps tanners determine how many sessions it will take to establish a base tan and how long they can be in the tanning unit without experiencing erythema or sunburn.

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 the lightest and working up to the 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.

For liability reasons no one should be allowed to exceed the maximum exposure time posted on the tanning unit, no matter how dark their skin tone. The six classes of skin types are listed on the chart below. Follow this formula, but remember that it is only one variable in the tanning equation. It is a common assumption that because indoor tanning equipment is designed to produce a fast tan without burning, tanning for a longer period of time will generate a faster tan. This assumption is incorrect. The best tanning performance will be achieved by adhering to the maximum recommended exposure time of the individual tanning unit.

The Sensitive Side

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 usually are cosmetic or therapeutic in nature. Sometimes the chemical changes that occur reduce the skin's ability to defend or heal itself. Some medications specifically are designed to enhance the immune system or reduce the immune response. There also are medical conditions that cause a similar response.

Hopefully, your tanning customers will be aware of any medical condition and will have 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 unit.

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 only may 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 likely to cause a severe reaction.

As responsible salon operators, 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. Refer to the complete list of photosensitizing drugs and agents on page 140 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 sunburns. 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.