You see them all over, guys lying on the grass, at the beach, in the park, on the rocks, wearing skimpy suits and shamelessly working on their tans. "Not exactly working," joked Jeremy Hilborn, lying on Chicago's beautiful Kathy Osterman Beach midday on a recent summer Sunday. "And it's better than lying on the sofa all day."
"Or washing windows," added his friend Steve Smith.
Even after all the media blitzing about the dangers of tanning—one person an hour dies of skin cancer in the US—there were Hilborn and Smith, lying there, amid a beach full of bodies, waiting for trouble. Why? Because, let's face it, many of us look better with a tan. It's why French fries look so much tastier than naked Idaho spuds.
"When patients tell me about bronzing themselves to look good, I tell them a scar across the face doesn't look so good either," says Dr. Brooke Jackson, medical director of Chicago's Skin Wellness Center. "You'll never hear a dermatologist say it's OK to get a tan— unless it's from a bottle." She should know. Dr. Jackson is a clinical assistant professor at Northwestern University Medical School, a medical ambassador for the American Cancer Society, and an avid runner. She spends a fair amount of time out in the sun herself. "I am vigilant about sun screen and have been for years. I put on a broad-spectrum block 15 minutes before I go outside. Sunburning is your body's alarm system going off. You need to listen to your body."
Of course, a lot of the people you see out there in the sun are also the ones still smoking. So fear of getting cancer is not necessarily much of a deterrent. The US Centers for Disease Control put it this way: "Although most Americans are aware of the dangers of UV exposure, only about one third take measures to protect their skin from the sun." Cancer, from relatively simple basal cell carcinomas to scary melanomas, is not the only danger lurking in the idea of a sexy tan. There is an increased risk of cataracts and plain old premature aging of the skin.
"I saw a patient a few days ago," Dr. Jackson relates, "she is 25 but looks like a leather purse. The number one, two, and three reasons for premature aging of the skin is the sun." Dr. Jackson raises an interesting point: If one spends a lot of time in the gym getting in shape, why squander the hard work's benefits in the sun?
But fundamentally, sun tanning, whether at the beach or in a tanning salon, is all about absorbing ultraviolet radiation, which cooks your skin cells and creates the pigment known as melanin. Melanin makes the skin look dark. Unprotected skin can be harmed by UV rays in as little as 15 minutes. And sun damage is cumulative. "If you are Irish, have fair skin and blue eyes and burn when you stick your finger outdoors," says Dr. Jackson, "you need to understand who you are. You can't change it. There is no way to make somebody who is fair into someone who can handle the sun well. If you don't listen to your body, you will be the one to get skin cancer."
But what about darker-skinned people? "Brown skin does not let you off the hook," Dr. Jackson says. "I ask my patients if they know what Bob Marley died from? Melanoma. The idea that your dark skin will protect you is a false sense of security." What darker skin does give you is a little more initial protection against burning. To better understand the relative dangers for people, dermatologists have created a scale of six types of skin:
|I||Always burns, never tans, sensitive to sun exposure|
|II||Burns easily, tans minimally|
|III||Burns moderately, tans gradually to light brown|
|IV||Burns minimally, always tans well to moderately brown|
|V||Rarely burns, tans profusely to dark|
|VI||Never burns, deeply pigmented, least sensitive|
People with types-I and -II skin are the most at risk for burning and all the other nasty things that come from sun damage. If that describes your skin, you really should think twice about lounging or even working in the sun between 10 am and 4 pm in the spring and summer. Even on cloudy or hazy days those UV rays are getting through.
What about the idea of getting a base tan first from a spa bed so that when you go to the Bahamas you won't burn so quickly? "Ridiculous," says Dr. Jackson, "It's like taking the batteries out of your smoke detector." Despite sophisticated-sounding arguments voiced by tanning-bed owners ("controlled exposure," and so on), beds do the same damage as the sun. They cook you. And any skin doctor will tell you that to preserve your looks (and your life), the less skin cooking the better.
Still—and this is an important point—for many people being in the sun is not just about getting a tan. It can be about working. Or it can be about socializing. "I bear with the winters in Chicago so I can enjoy this for a couple of months a year," said the fit-looking Hilborn. "I enjoy being tan, but there is a social element in it to. We come here to catch up on gossip, people-watch, you know…."
"And to laugh at people," said jokester Smith. "I spend the winters getting my skin cancers cut off." He quickly added that he's never had skin cancer. While Smith is fortunate, the facts are the facts. Skin cancer is the most common form of cancer in the country and, says the US Centers for Disease Control, "it appears to be related to increased voluntary exposure to the sun's UV rays." The CDC predicts that more than a million new cases of skin cancer will be diagnosed this year.
A side note on sun exposure and Vitamin D: Sun worshippers will tell you that they need the sun because it gives them their dose of vitamin D (exposure to the sun causes vitamin D synthesis in the body), which is necessary for calcium absorption and healthy bone strength. The sun is in fact an easy way to make sure you get vitamin D, and sunscreens will reduce vitamin D synthesis. That said, the sun's UV rays are also very carcinogenic. Your best bet? Keep applying the sunscreen, limit your sun exposure, and get your necessary vitamin D from foods such as salmon, tuna, and vitamin-D fortified milk, or in a quality multivitamin.
Getting the Protection You Need—Apply Broad Spectrum Sun Blocks
So if you have to be in the sun, or just really, really want to, how do you go about being as safe as possible? Assuming you don't want to wear too many clothes and a big-brimmed hat, the only solution is sun block. The CDC recommends a sun block with a minimum rating of SPF 15. SPF means "sun protection factor." It works this way: If unprotected skin would start to get red in 20 minutes of direct sun, skin protected with an SPF 15 would be protected 15 times longer, or about 5 hours. SPF 35 means 35 times longer. Dr. Jackson recommends at least a 30 SPF.
SPF numbers are meaningful only if you put enough on and don't sweat or swim it off. Most people don't put enough on to start with. Then they sweat or go into the water. "Even though a lot of sun blocks say they are water proof or sweat proof, they're not," says Dr. Jackson. "You have to reapply them. If you are out two hours or more, reapply your sun block."
One other annoying detail about SPF ratings: They don't tell you all you need to know. To get the protection you think you are getting, you have to read product labels. SPF ratings cover only one type of ultraviolet radiation, UVB. Meanwhile, UVA radiation penetrates the skin more deeply than UVB, and is considered the chief culprit behind wrinkling, leathering, and other aspects of "photoaging." Recent studies show that UVA not only increases UVB's cancer-causing effects, but may directly cause some skin cancers, including potentially deadly melanomas.
You need to know that UVA radiation isn't included in an SPF sun block unless the product says it is "broad spectrum." Even then you need to read carefully. These days many sunscreens claim broad-spectrum protection, but their effectiveness is not complete unless they contain avobenzone plus zinc oxide or titanium dioxide. (Outside of the US, Tinosorb and Mexoryl SX are also approved UVA-protecting ingredients.)
So what's the best way to get a tan from a health perspective? In the end, if you really, really want to look tan, Dr. Jackson says, "Get it from a bottle. Spray tans are fine too. They really have improved the color."
But even then, when you go out in the sun, don't forget the sun block. Below you'll find some readily available sun-screen products with broad UVA protection. And remember, when buying any sun block/sunscreen products, read the labels!
- Aveeno (Aveeno Sunblock Lotion, Continuous Protection, SPF 55)
- Banana Boat (Banana Boat Ultra Defense Broad Spectrum Sunblock, SPF 50)
- Coppertone (Coppertone Sunblock Lotion Oil Free, SPF 30)
- Hawaiian Tropic (Hawaiian Tropic Faces Oil Free Sunblock, SPF 30)
- Neutrogena ("Helioplex" products such as Neutrogena Ultra Sheer™ Dry-Touch Sunblock SPF 55)
- You can also find a line of men-centric sunscreens at the Sir Spa website.