Protecting Your Future

Protecting Your Future

by Michael Caswell, Ph.D.

The Centers for Disease Control and Prevention (CDC) and the American Academy of Dermatology (AAD) are out to change the way people of all ages think about sunlight. The CDC is an arm of the U.S. government; the AAD is the most powerful medical lobby on Capitol Hill. Together, they are organizing a coordinated approach among the media, sunscreen companies and physicians. Their crusade is called Sun Safety: Protecting Our Future and preaches strict sun avoidance.

Included in Sun Safety: Protecting Our Future are priorities specifically related to tanning industry restrictions (J. Amer. Acad. Dermatol. 38(1998)774-780), such as: Discourage intentional tanning by changing the perception that having a suntan is cool; attempt to decrease the use of tanning salons among teens; and, advocate locally for policy changes that potentially can have a national impact on tanning bed regulations.

It is time for the tanning industry to develop and to support the expertise necessary to protect the tanning salon business against such powerful forces.

Suntan is "Cool"

The AAD and CDC coalition seeks to reverse the attitude that tanned skin is healthy. For many years, tanned skin has been perceived as a mark of a healthy, active lifestyle. My grandparents used to spend their winters in Florida where they would practice modest exposure to the ultraviolet radiation of the sun. They avoided overexposure and sunburn, and returned home with a golden, brown color. Almost 100 years old, my grandmother has never had skin cancer.

The coalition believes in reversing the attitude toward tanned skin by promoting skin cancer awareness for all age groups, from infants to grandparents. They suggest that controlling overexposure to ultraviolet radiation will reduce skin cancer. One arm of their approach is to educate people about a link between ultraviolet radiation and skin cancer. The other arm of their approach is to reverse the attitude toward tanning of any type, even responsible tanning. For example, they want to promote a nationwide contest to develop a sun protection mascot, to provide interactive videos about sun safety and to sponsor one day each year when all schools focus on sun safety.

Many of these efforts I applaud. The tanning industry should support moderate, responsible tanning as a part of a healthy, active lifestyle. With that, people also must understand that irresponsible, acute overexposure to ultraviolet radiation may lead to skin cancer and is not part of a healthy, active lifestyle. Studies have shown that severe sunburn in childhood may contribute to skin cancer later in life. Scientists know that extensive PUVA therapy in a physician's office also may lead to skin cancer approximately 15 to 20 years later.

The tanning industry should support moderate, responsible tanning because it's healthy. First, scientists consistently have shown that the risk of melanoma to outdoor workers is less than the risk of melanoma to indoor workers. This suggests that people who retain a tan year-round through modest ultraviolet radiation exposure significantly decrease their risk of melanoma. Second, scientists have shown that a tan offers significant protection against overexposure to ultraviolet radiation. This suggests that a tanned person who is inadvertently overexposed has less risk of skin damage than an untanned person who is inadvertently overexposed.

Tanning Salons and Teen-agers

The AAD and CDC coalition also seeks to decrease the use of tanning salons among teens. A survey conducted by the AAD, Seventeen magazine and the Nivea Sun Skin Protection Program found that 78 percent of teens know overexposure to the sun damages skin and that 66 percent believe they look healthier with a tan. This data would suggest that teens like to tan, and avoid sunburns. Perhaps teens know that moderate, responsible tanning is appropriate.

The coalition will attempt to decrease the use of tanning salons among teens by using the media to educate teens about the "dangers" of tanning bed use. If a quantifiable danger existed from tanning bed use, then perhaps dissemination of the information would be worthwhile. Presently, however, modest responsible tanning in a controlled situation like a tanning bed can impart health benefits with negligible risks.

At the same time, the coalition will attempt to use the mass media to portray the use of sunscreens as cool and acceptable. Manufacturers of sunscreens have been trying to do this for more than 30 years with limited success. Indeed, the coalition wants to "persuade manufacturers to make products non-greasy and fun." The tanning industry should support efforts to make sunscreens more acceptable to a wider audience because we promote and sell sunscreens and should be delighted to have better products to sell customers.

Tanning Bed Regulations

Finally, the AAD and CDC coalition seeks policy changes that will have a national impact on tanning bed regulations. The U.S. Food and Drug Administration regulates tanning beds as a Class I Medical Device, so changes in tanning bed regulations must be approved by the FDA. The FDA is empowered to determine if a medical device is safe and effective for its intended use. However, the FDA is subject to political pressure from various interests, including Congress and special interest groups such as the AAD and the CDC.

The tanning industry should protect its business interests with scientific information and with political activities. South Carolina has decided to strictly enforce the tanning bed exposure schedule beyond reasonableness. A new customer has their Fitzpatrick skin type determined by a trained salon employee. Armed with that skin type and a specific bed type, an exposure schedule (for example, three minutes) is developed to ensure a modest exposure that will preclude a sunburn. After a year at one salon during which time the customer has developed a good base tan, the same customer chooses to tan at a new salon. Under South Carolina's present regulatory attitude, the customer must begin anew with a 3-minute exposure. They do not obtain the benefit of their base tan. Even Tom Fitzpatrick, who developed the Fitzpatrick skin type system, knew that a person with a base tan could tolerate more UV radiation than a person without a base tan. Has the South Carolina regulatory agency abandoned scientific reason in the face of political pressures?

Perspective

My perspective is that manufacturers in the tanning industry must enter the political arena to support your salon against ever-increasing political pressure. I suggest that tanning bed manufacturers and tanning bulb manufacturers create and vigorously support an organization devoted to the promotion of their industry. Simultaneously, lotion manufacturers and distributors should join and support organizations such as the Cosmetics, Toiletries, and Fragrances Association (CTFA) and the Independent Cosmetic Manufacturers and Distributors, Inc. (ICMD).

Salon owners and operators must become politically active as well. Each of you must support your industry by becoming vocal at the local, state and national level. My perspective is that you should make contact by letter or telephone call with three groups each month.

1. Write to your congressman and describe your business. Include any newsletters you supply to your customers. Ask him to visit your business.
2. Write to your state regulatory agency so they know you are doing your best to conform with all existing regulations. Advise them about your opinions regarding pending regulations at the local, state or national level.
3. Write to organizations of people that would benefit from the tanning industry such as the American Association of Retired Persons (AARP). Older people are less efficient at manufacturing vitamin D from UV exposure, so they lose bone mass and suffer more bone fractures. Increasing their vitamin D levels through modest tanning would represent one method to reduce fractures. Write to the AARP and tell them of your concern.

As an industry, we can have a powerful voice if we speak frequently, clearly and reasonably.