5 Warning Signs of Melanoma

There’s never a bad time of the year to check your skin for melanoma, but as the weather heats up and we head outside to soak up some vitamin D, it’s vital. Plus, you can do it yourself in just five or 10 minutes. All you need to do is memorize these five warning signs of melanoma.

RELATED: How (and Why) to Do a Self-Exam for Skin Cancer

The first photo of every set is normal and the second is suspicious.


If you drew a line down the middle, the two sides wouldn’t match.

Photo: Skin Cancer Foundation

Photo: Skin Cancer Foundation

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Uneven, squiggly edges can be a sign of early melanoma.

Photo: Skin Cancer Foundation

Photo: Skin Cancer Foundation

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Check for subtle shading differences within the mole, or colors other than brown or black, like red or blue.

Photo: Skin Cancer Foundation

Photo: Skin Cancer Foundation

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A mole 1/4 inch across (about the size of a pencil eraser) or larger should set off red flags.

Photo: Skin Cancer Foundation

Photo: Skin Cancer Foundation

RELATED: 10 Things You Don’t Know About Melanoma


Any changes—in size, shape, color or more—can tip you off that something’s going on in there.

Photo: Skin Cancer Foundation

Photo: Skin Cancer Foundation

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'I Got Skin Cancer at Age 18'

Back in 2005, I was just starting my freshman year at Western Carolina University when my mom noticed that a dark brown mole about the size of a pencil eraser had appeared on the back of my left calf. She’s a nurse, so she scheduled an appointment a couple weeks later with a dermatologist to look at it. I said to a friend, “What if this is something serious?” but I also thought, Skin cancer isn’t something that happens to young people.

My appointment was for 5 o’clock, after my classes ended for the day. When my mom and I walked in, I saw a tray with a needle on it. I said to her, “Is that for me?” and she said no. But as soon as the physician’s assistant saw the mole, he said, “We’re going to remove that right now.” That needle was for me—they used it to numb the area. Caught off guard, I was like a deer in the headlights while they cut it out.

RELATED: 6 Spots Your Doc Should Check for Skin Cancer

The doctors said they would call my mom in a week with the biopsy results. I returned to school, terrified. The day we were supposed to hear, Friday, September 23, my mom never phoned, which was strange. Finally she called to say that she and Dad were in their car outside my dorm; they had driven an hour to school to have dinner with me. I knew it was bad news.

As we were driving to the restaurant, they talked about everything else except what I was waiting to hear. Finally I couldn’t stand it any longer and I said, “So—what is it?” What happened next is such a blur, but basically the news was: It’s cancer. You will have to have surgery. I was angry. I felt like, I’m in college, this isn’t fair, this is not supposed to happen to someone my age!

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The following Monday, I took a medical withdrawal from school, and less than two weeks later, surgeons cut out an area of tissue about two inches wide on my calf, all the way down to the muscle. Because the mole had appeared out of nowhere, was so big and dark, and turned out to be a Stage III Clark’s melanoma, they were worried it was very fast growing and might have spread, so they also removed four lymph nodes. Fortunately the biopsy found no cancer there.

I had a big hole in my leg, so about a week later, after I had healed a bit, a plastic surgeon put staples all around the hole and ran metal thread through the staples, which they slowly tightened, week by week, to shrink the hole. It was so painful.

I took that entire semester off; I was stuck at home while my friends were going on with their lives, being normal 18-year-olds and having fun. But I fought the urge to feel bad for myself—what good would it do to sit around and mope? And I focused on the positives, like the fact that the cancer had not spread. I also found out who my good friends were—the people who kept in touch the whole time I was out and then acted like nothing had changed when I got back to school the next January.

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The funny thing is, I was never a sun person, because I sunburned easily, and I had always worn SPF 20 growing up. But it turned out that I had a great-uncle who’d died of melanoma—my family knew about it but I didn’t because he died before I was born—and the doctors think that my genes, and the fact that I used a tanning bed a handful of times in high school, may have been enough to cause this.

I still see a dermatologist every six months, but I have been cancer-free for 10 years! I also have a noticeable scar on my leg, but that doesn’t bother me. It’s a reminder of what I went through and how strong I know I can be. Now, when I hear younger people say they want to be tan, I think: Looking cool is not worth your life.

RELATED: 6 Things Your Dermatologist Wants You to Know About Skin Cancer

Special thanks to the Skin Cancer Foundation.

What You Must Know About the Chemicals in Your Sunscreen

You probably don’t need to be told (again) how important wearing sunscreen is for reducing your risk of skin cancer, not to mention sunburns and signs of premature aging (think wrinkles). But go ahead and Google “best sunscreens” or even “sunscreen,” and plenty of articles pop up suggesting that the ingredients in many of these products could be harmful or even toxic, leaving you to worry about what’s really going on your skin. And maybe even wonder whether it’s actually safer to go outside without a protective spray or lotion?

The answer: No. In fact, the skin experts Health talked to were adamant that we should be more worried about shielding our skin from the sun’s harmful UV rays than about the chemical makeup of the products we’re using to do that.

“Five million Americans are treated for skin cancer each year, and an estimated 9,940 people will die of melanoma”—the deadliest type of skin cancer—”in 2015,” Steven Wang, MD, head of dermatological surgery at Memorial Sloan Kettering Basking Ridge in Basking Ridge, New Jersey, told Health. “The biggest precaution that you should be taking is using sunscreen. There is enough research at this point from various credible bodies that say sunscreens are safe and, when used appropriately, will reduce skin cancer.”

RELATED: 6 Things Your Dermatologist Wants You to Know About Skin Cancer

Why you might have heard that sunscreen could be dangerous

So, where are people getting the idea that the chemicals in certain sunscreens are potentially hazardous?

For starters, there has been much concern about chemicals thought to be endocrine discruptors in our everyday environment in recent years. Proven endocrine disruptors, which include bisphenol-A and pesticides like DDT, can mimic the hormone estrogen in the body, which may increase risk in humans for low fertility, endometriosis, and certain cancers.

Most recently in regards to sunscreen, a report this year from the Environmental Working Group (a non-profit advocacy organization) once again made reference to “worrisome ingredients like oxybenzone and Vitamin A” commonly found in these protective products.

But the thing is, the actual research on the effects of these “worrisome” ingredients in sunscreen may have been blown out of proportion.

Take this 2008 study in the journal Environmental Health Perspectives, for example, which examined concentrations of benzophenonone-3 (a.k.a. BP-3, or oxybenzone) in residents of the United States. The researchers concluded that while exposure to the chemical was prevalent in the population studied, “human exposure to BP-3 has not been associated with adverse health effects.”

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Some studies do suggest that the chemical could potentially have effects on the endocrine system, but, the scientists explain, that research was conducted on animals—including some in which mice and rats were fed oxybenzone orally—and animal tissue isolated in labs.

In 2011, Dr. Wang and colleagues published a research letter in JAMA Dermatology titled: “Safety of Oxybenzone: Putting Number into Perspective.” For that paper, the researchers, took the dose used in one of the most worrisome studies on oxybenzone in rats and determined that an equivalent dose in humans would amount to almost 35 years of daily, full-body application.

And even though there is evidence that oxybenzone does get absorbed by your skin and excreted via urine, the authors of another 2004 paper concluded that despite the presence of the chemical in participants’ urine, they observed no hormonal changes that could be traced back to the sunscreen exposure.

As for vitamin A, commonly found in products like sunscreen in the form of retinyl palmitate, the backlash stems from findings from the National Toxicology Program (NTP), which is a U.S. government program that tests and evaluates chemicals in our environments. One of the NTP’s oft-cited experiments found that retinyl palmitate cream applied to hairless mice exposed to UV radiation in a lab increased the incidence of skin tumors as well as the speed at which the tumors developed, compared to control groups of mice that weren’t covered in the cream.

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But again, this isn’t comparable to the effects of this additive in human skin because, for one thing, the researchers looked at retinyl palmitate “in isolation,” according to a 2010 critical analysis in the Journal of the American Academy of Dermatology. Retinyl palmitate is an antioxidant naturally found in human skin, along with vitamins C and E. And these three actually work together in a way that neutralizes any negative effects, the researchers report.

On top of that, as the researchers write in response: “It is important to mention that the mice in the above NTP study are highly susceptible to develop skin cancer after UV exposure… mouse epidermis is significantly thinner than that of human beings, hence resulting in higher percutaneous absorption. Therefore, extreme caution is needed when extrapolating these animal study results to human beings.”

The bottom line from the Skin Cancer Foundation: “[C]onsumers should rest assured that sunscreen products including the ingredients oxybenzone and retinyl palmitate are safe and effective when used as directed. Both oxybenzone and retinyl palmitate”—which is a form of vitamin A—”are approved for use in sunscreens by the U.S. Food and Drug Administration (FDA). The Skin Cancer Foundation’s position is based on years of clinical data.”

RELATED: 5 Best Ways to Protect Against Skin Cancer

How to choose the right sunscreen for you

First, a little skepticism can be helpful. “A lot of these articles [about sunscreen] are A+B = Z. There’s so many steps in between the science that they don’t discuss,” Ellen Marmur, MD, a New York City-based dermatologist, explained to Health. “You have to look at your sources, you have to trust that they are referencing their articles correctly. If it seems really radical, it’s probably not the whole truth.”

The very best sunscreen to use is simply the one you like and will actually reapply, often. So if that means you’d rather not use chemical sunscreens for whatever reason, that’s your call. There are plenty of sunscreens that rely on zinc oxide and other physical blocks that work just as well to protect your skin.

Dr. Wang, who’s also a spokesperson for the Skin Cancer Foundation, encourages the use of a water-resistant broad-spectrum sunscreen with an SPF of 30 or higher and reapplying every two hours or after swimming or sweating excessively. Be sure to apply two ounces of sunscreen—to help you visualize, that’s the amount that would completely fill two shot glasses—to your entire body 30 minutes before heading outside, coating every part of your skin. When you reapply, use one ounce (so, one shot glass full) each time.

And don’t forget: sunscreen is just one part of a complete sun-protection regimen, our experts add. Don’t be shy about seeking shade between the hours of 10 am and 4 pm, wearing a wide-brimmed hat, and UV-blocking sunglasses in addition to using sunscreen, all in the service of lessening your exposure to UV radiation. Says Dr. Wang: “That is the real threat, not whether or not sunscreen is safe.”

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Dermatologist Doris Day, MD, a professor at NYU Medical School, answers a Health magazine reader’s question about sun protection.

Q: I’ve noticed a lot of sunscreens touting sky-high SPFs like 70 and 80. Do they work better than lower numbers?

A: They do work slightly better—if used properly. Let me explain: An SPF 15 blocks 93 percent of UVB rays, SPF 30 shields 97 percent, and SPF 50 fends off 99 percent. (SPF measures only UVB protection, so scan labels for terms like “UVA/UVB protection” or “broad-spectrum protection” to ensure your sunscreen also guards against UVA rays.) The difference between these numbers may seem small, but it can be significant for people who are sensitive to the sun (i.e., those who are fair-skinned, prone to skin cancer, or have melasma or other pigmentation problems); they should absolutely choose a sunscreen with the highest possible SPF. Everyone else should look for photostabilized formulas (meaning their UV filters don’t break down as rapidly), no matter what the SPF. Coppertone, Aveeno, Neutrogena, and Banana Boat all offer high-SPF products with stable broad-spectrum protection.

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YouTube: Tanning Beds Touted as Healthy

By Anne HardingTired of hearing that tanning is bad for you? Click on over to YouTube. According to a study published Monday in Archives of Dermatology, videos touting the benefits of roasting one’s skin in a tanning bed outnumber those warning of ultraviolet dangers by nearly 3 to 1 on YouTube.

So, what’s the problem? Ultraviolet-light exposure from tanning beds and booths is just as likely to cause skin cancer and wrinkles as the real thing, the scientific community now agrees.

“The moral of the story is people shouldn’t be getting health-care information from YouTube, and this is coming from a guy who loves YouTube,” says James Spencer, MD, a dermatologist in St. Petersburg, Fla., and an American Academy of Dermatology (AAD) spokesman.

In all, 28 U.S. states have laws regulating indoor tanning businesses; those laws require that businesses warn of health risks, though enforcement is spotty at best. While the indoor tanning industry cannot legally make health claims to customers, there’s nothing stopping them from doing so on YouTube, Dr. Spencer points out.

Inspired by two recent investigations—which looked at how immunization safety and tobacco use are portrayed on YouTube—Eric W. Hossler, MD, a dermatologist at Geisinger Medical Center in Danville, Pa., and his colleague Michael P. Conroy, MD, decided to take a look at videos that featured indoor tanning.

Dr. Hossler and Dr. Conroy found 72 YouTube videos that commented on the pros and cons of tanning beds or booths; of those, 49 videos (68%) had a positive spin, with 47 citing “appearance” as a benefit of indoor tanning.

Only 17 videos were negative; nine named sunburn as a risk, eight mentioned skin cancer, three talked about wrinkles, and another three complained of “lack of cleanliness of tanning salons, booths, and/or beds.” Twenty-five of the videos were ads for tanning salons, while just one was sponsored by the AAD. (The professional group has since put up three more.)

Nevertheless, “traditional medicine has to recognize that messages on health are being communicated in novel ways,” says Kumanan Wilson, MD, a researcher in public health policy at the Ottawa Health Research Institute in Canada.

Dr. Wilson, who helped author an analysis of YouTube information on immunization published in the Journal of the American Medical Association last year, says he and his colleagues found the anti-vaccine videos were a lot slicker and more attention-grabbing than videos from the pro-vaccine forces, which tended to be rather dull.

While indoor tanning risks don’t carry the emotional freight of the vaccine debate for most people, misinformation about tanning can still be damaging, largely because people simply don’t know whether tanning beds and booths are dangerous, Dr. Wilson says. Getting hip to YouTube is something the AAD and other public health groups must begin to do if they want to keep up with better-funded groups like the indoor tanning lobbyists, he adds.

This means making videos that are “a bit more nuanced, maybe a little funny,” and “not looking like a bunch of old people lecturing,” Dr. Wilson says. “That’s the way people have to start thinking about this.”


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Gear Guide: Women's Sun

By Su Reid-St. JohnA few years ago, Health magazine’s art department named a color after me: “As tan as Su will ever get.”

This color was a very pale, pinky beige. I burn like a marshmallow over a campfire, so I never leave the house without slathering my exposed skin with sunscreen. Until recently, though, I’d never really given thought to the protection my clothes gave me.

Turns out the average white T-shirt only provides a UPF of about 5—not much of a shield, especially for someone like me. Seems I’m the perfect person to check out the new trend of UPF clothes.

What is UPF, you ask? It’s basically SPF for fabrics. So if, say, a shirt has a UPF of 50, that means the cloth only allows 1/50th of the sun’s damaging UVA and UVB rays to get through, which significantly reduces your skin’s exposure. And while I’ll admit that I’ve never gotten much of a sunburn on skin covered by my clothing, I know these rays can do a lot of other damage, like causing your skin to age faster and raising your risk of skin cancer.

Not being a big fan of wrinkly, cancer-prone skin, I sunproofed my body from head to knees with these on a recent sunny hike: ASICS Favorite Short Sleeve Top (50+ UPF), Mountain Hard Wear La Rambla Short (50 UPF), and Outdoor Research Solar Roller Hat (30+ UPF). I’m no scientist and have no way to prove the UPF content of the fabrics, but these are all from well-regarded companies, and I have no reason to doubt them. So I felt comfortably protected.

But let’s face it: When it comes to what you’re wearing, there’s much more to consider than just sun protection. So how did these stack up purely as hiking togs? Here’s a quick rundown:

ASICS topI’d buy this in a second, even if sun protection weren’t an issue. It’s super-light, flattering, and buttery soft. The best parts, though, are the mesh insets on the sleeves, under the arms, around the neck, and down the middle of the back—in other words, the main sweat zones. I perspire like mad, especially in the sun, and this shirt kept me cool and relatively dry. Any downsides? Not that I could find.

Mountain Hard Wear shortsThese manage to sport six pockets (some zippered, some snapped) without looking like a pair of bulky guy cargos. Why’s that important? Well, if you choose to hike without a pack, you need somewhere to put your stuff, preferably without resembling a pack mule.

There’s more worth mentioning here, too: The brushed polyester strips along the inside of waistband and down the inner thighs (ingenious!) act as effective sweat absorbers, and the couple-inches-above-the-knee length is flattering.

My only quibble is that the stitching on the outer back waist looks like a sort of double yoke, which didn’t really flatter my upper butt. But hey, unless you tuck your shirt in or wear a crop top (I do neither), no one’s going to know.

Outdoor Research hatThe sky-blue color and embroidered flower on the front give this hat significant style points over the other dull, safari-looking sun hats out there. Sure, it’s got the wide brim needed to keep the rays off my face, but it’s actually cute.

Other things to like: the wicking band to absorb copious forehead sweat, breathable material and air holes to keep my head cool, a drawstring to adjust the size, and total crushability. I only discovered one drawback, when I stuffed the hat in a bag with my hiking shoes: The blue hue doesn’t hide dirt very well.

When I was a kid, the highest SPF you could get in a “suntan lotion” was 8, and there were no UPF clothes. We’ve learned a whole lot since then; nowadays, I never buy sunscreen with an SPF less than 30. And now, companies like ASICS, Mountain Hard Wear, and Outdoor Research are trying to convince me that my whole body deserves that kind of protection. Luckily for them, they’re adding that protection to clothes I’d like enough buy anyway. I’m sold.

Products: ASICS Favorite Short Sleeve Top, Mountain Hard Wear La Rambla Short, Outdoor Research Solar Roller Hat

Category: Apparel

Cost: Top, $40 at ASICSRunning.com; shorts, $50 at Altrec.com; hat, $29 at OutdoorResearch.com

Red Is For Winners, Troubling Breast Cancer Drug News, and What Britney Spears Can Teach Us About Alzheimer's

A scary new study shows that women who use the breast cancer prevention drug Tamoxifen for more than five years are actually more likely to develop new tumors. The frightening results don’t have doctors 100% convinced, so don’t write off the drug just yet—after all, it has been proven to fight recurrent breast cancer. [The Frisky]

Earlier this summer, we found out that tanning beds are bad for us. (Duh.) Activist Lexi Lewis is also spreading the word about the dangers of the fake-n-bake, even though she was once a devotee. Check out her cautionary tale of skin cancer caused by tanning and find out what she’s doing to prevent other girls from making the same mistake. [Lemondrop]

Every once in a while, we all have those nights when we just can’t get any shut-eye. But it’s when your lack of z’s becomes a habit that it’s hardest to treat. Don’t wait for sleep problems to become the norm; instead, nip insomnia in the bud. [USA Today]

Just in time for your fall fashion updates and back-to-school shopping sprees, we’ve got a healthy reason to add some red to your wardrobe. Not only does it boost your sex appeal, but donning some crimson may also make you more confident and successful. [Telegraph]

If yesterday’s plan to analyze changes in typing style doesn’t pull through as the new way to detect dementia, perhaps Britney Spears can lend a hand: Scientists may be able to identify people most at risk for Alzheimer’s by monitoring the way their brains react when trying to recognize celebrities. [Time]

Previous news from Around the Web:Women Care More About Water Than Sex, Why College Dorms Trigger Asthma, and America’s Worst Hygiene CrimesWhen Healthy Eating Becomes a Disorder, Our 26th Food You Should Never Eat, and Why Some Men Think Chlamydia Is ManlyChewing Gum Can Improve Memory, Foods That Zap Your Energy, and Why Maggots Are Good for You

Study: Frequent Tanning


By Lynne Peeples

THURSDAY, MAY 27 (Health.com) — People who regularly use tanning beds may double or even triple their risk of developing melanoma, the deadliest form of skin cancer, according to a new study.

The study found that people who have ever tanned indoors have about a 75% higher risk of melanoma, on average, than people who have never tried it.

But the risk of melanoma was much higher among frequent and long-term indoor tanners. Compared to those who had never touched a tanning bed, people who spent more than 50 hours under the lights were three times more likely to develop melanoma, according to the study, which is the largest of its kind to date. People who frequented tanning salons for more than 10 years or who logged more than 100 sessions were about 2.5 times more likely to develop the cancer.

The study comes as an FDA advisory panel is pondering tougher regulations on indoor tanning, including use restrictions (if not an outright ban) for people under age 18. At a meeting in late March, the panel discussed strengthening skin-cancer warnings at tanning salons and moving tanning beds to a class of medical devices that includes CT scanners, among other measures.

Amy Waldrop, of Clifton, Va., who was 41 years old when she first learned she had melanoma skin cancer, told the FDA panel that her doctors said her use of tanning beds as a teenager was likely responsible.

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“Even after seeing my surgical scars, my teenage daughters have expressed an interest in using tanning beds,” says Waldrop. “They’ve told me that if tanning beds were that bad, they wouldn’t be legal.”

The testimony the FDA panel heard in March was “pretty compelling,” says Lynn Drake, MD, a dermatologist at Massachusetts General Hospital, in Boston, and a nonvoting member of the panel. “This new study adds to the body of evidence supporting the fact that indoor tanning poses significant risks.”

Teens, however, do not seem to be more susceptible than adults to artificial ultraviolet (UV) rays. The study results suggest that a person’s melanoma risk is more closely linked to total exposure than to the age at which he or she first tans indoors.

“Given our findings, the age you start indoor tanning may matter less than how much you do it,” says the lead author of the study, DeAnn Lazovich, PhD, a professor of epidemiology at the University of Minnesota. “Maybe a ban should also be considered for adults.”

Nearly 70,000 people in the U.S. were diagnosed with melanoma in 2009 and more than 8,000 died from the disease, according to estimates from the National Cancer Institute. Melanoma is deadly because it can invade deep into tissues and spread to other parts of the body, unlike other types of skin cancer, which are relatively easy to remove. Melanoma is the second most common cancer among people ages 15 to 29, and appears to be on the rise overall.

Next page: Findings likely to bolster regulation efforts

The new study, which appears in the journal Cancer Epidemiology, Biomarkers and Prevention, included nearly 1,200 melanoma patients in Minnesota and a cancer-free control group. Of the melanoma patients in the study, 63% had tanned indoors at least once, compared with 51% of the melanoma-free individuals.

Lazovich and her colleagues also measured the melanoma risk associated with different types of tanning machines. Compared to people who had never tanned indoors, those who tanned in high-speed and high-pressure machines had roughly three and 4.5 times the risk of developing melanoma, respectively. High-speed machines use higher amounts of ultraviolet-B (UVB) light while high-pressure machines use more ultraviolet-A (UVA).

However, the researchers couldn’t say definitively that one type of machine is more dangerous than the other, because few study participants could remember the exact machines they used and because UVA and UVB output can depend on factors such as maintenance, not just the model of the machine.

The new findings seem likely to bolster the government’s efforts to regulate indoor tanning. When the FDA panel met in March, the foremost scientific evidence was a review of 19 studies conducted by a World Health Organization (WHO) working group, which found that tanning indoors at least once increased a person’s risk of melanoma by 15%. (For people who started tanning at age 35 or younger, the increase in risk rose to 75%.)

The WHO group later deemed tanning devices to be carcinogenic. But the organization emphasized some shortcomings in the research, such as the inability of most studies to tease apart the effects of indoor tanning versus sunbathing or to pinpoint how the extent of tanning-bed use—also known as the “dose”—affects skin-cancer risk.

Lazovich’s study was specifically designed to fill these gaps in the existing research.

John Overstreet, a spokesperson for the Indoor Tanning Association, a trade organization representing tanning facilities and suppliers, said in an email that unanswered questions remain. He noted that vitamin D, which is produced by the skin with moderate UV exposure, may have cancer-fighting benefits.

“Science is still wrestling with this issue and there’s certainly still more to learn,” Overstreet said. “We welcome a more complete body of research that will allow us to advise our customers how to achieve their goals without unnecessary risk of exposure.”

The Federal Trade Commission recently charged the Indoor Tanning Association with exaggerating the benefits of indoor tanning and falsely denying the associated skin-cancer risks.

According to Dr. Drake, the health benefits of tanning—as opposed to limited sun exposure—are a myth. “A healthy tan is an oxymoron,” she says. “A tan is simply a response to injury, whether it’s obtained indoors or outdoors.”

Despite Controversy, Sunscreen Is Safe Doctors Say


By Anne Harding

TUESDAY, June 22, 2010 (Health.com) —  It’s that time of year again. As the weather heats up, people across the country are dusting off their barbecues, breaking out the swimsuits—and working themselves into a frenzy over the latest sunscreen-related health concerns.

Each year since 2007, a consumer watchdog organization known as the Environmental Working Group (EWG) has been issuing a report on sunscreen safety as summer gets under way. The reports tend to be a bit alarming, and this year’s was no different.

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The group gave its stamp of approval to just 39 of the 500 sunscreens it evaluated this year, and it says that some common sunscreen ingredients may disrupt hormone function or even increase the risk of melanoma—the deadliest form of skin cancer.

The hazards outlined in the report have generated headlines and even caught the attention of Charles Schumer, a U.S. Senator for New York. Last week, in response to the report’s mention of a possible link between skin cancer and a type of vitamin A (retinyl palmitate) found in many sunscreens, Sen. Schumer called for the FDA to evaluate the data on the vitamin and map out new sunscreen regulations.

In addition, the EWG stated that sunscreen may be giving sunbathers a “false sense of security” regarding their skin cancer risk, and could even be contributing to vitamin D deficiency.

But don’t cancel that beach vacation just yet. Dermatologists say that while the group does raise some valid concerns, it shouldn’t discourage people from using sunscreen.

Next page: Evidence of harm in humans is lacking

Take retinyl palmitate, for instance, which the EWG identified in 41% of the sunscreens it tested. In one study, lab animals slathered with the substance and exposed to sunlight developed skin tumors faster than animals coated with a placebo cream.

But evidence of harm in humans is lacking. In fact, vitamin A-based drugs are key weapons in the battle against wrinkles (Retin-A), acne (Accutane), and even skin cancer, notes James Spencer, MD, a professor of clinical dermatology at the Mount Sinai School of Medicine, in New York City. He adds that the majority of studies support the safety of vitamin A-based sunscreens. (Dr. Spencer has served as a consultant to Neutrogena and L’Oreal, which make sunscreen in addition to other skin-care products.)

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Vitamin A and its cousins help normalize the growth of sun-damaged skin cells, according to Dr. Spencer, who is also a dermatologist in private practice in St. Petersburg, Fla. “The retinoids have been around for 20 to 30 years,” he says. “They’re remarkably effective medications both systemically and topically.”

Nneka Leiba, MPH, a research analyst at EWG, acknowledges that the risks retinyl palmitate may pose to humans aren’t clear. “Although the evidence is strong, it’s not yet conclusive,” she says. “We want people to be precautious.”

Another chemical cited in the EWG report, oxybenzone, has been a key sunscreen ingredient for decades. Animal research suggests that oxybenzone could disrupt hormonal function, which prompted the EWG to discourage the use of products containing it.

But as with retinyl palmitate, there’s no evidence that the substance hurts humans, says Darrell Rigel, MD, a clinical professor of dermatology at New York University. The chemical’s safety is studied “every weekend in the summer, when tens of millions of Americans are using sunscreen with oxybenzone without any problems,” Dr. Rigel says.

Dermatologists do agree with the EWG that people who use sunscreen—especially products with sky-high sun protection factor (SPF) ratings—shouldn’t feel that they are immune from skin cancer.

Sunscreen alone won’t prevent skin cancer no matter how high the SPF, so people should also use hats, clothing, and shade for sun protection, Leiba says. The American Academy of Dermatology recommends the same two-pronged approach: an SPF 30 sunscreen, combined with protective clothing and shade.

Next page: Too much sunscreen, too little vitamin D?

For most people, using a sunscreen with an SPF above 30 won’t give them much added protection, says Martin Weinstock, MD, a professor of dermatology at Brown Medical School, in Providence.

“It’s sort of diminishing returns as you get to the higher SPF numbers,” says Dr. Weinstock, who chairs the American Cancer Society’s skin cancer advisory committee. “For some people with particular problems very high SPF numbers may be important, but for most people SPF 30 is pretty good.”

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In its report the EWG also noted that people may be risking vitamin D deficiency by using too much sunscreen. “We basically just laid out the different arguments, because it is so controversial,” Leiba explains.

Vitamin D is “a super controversial area,” Dr. Spencer agrees. But, he adds, most people can get all the vitamin D they need by eating a healthy diet and taking supplements. (Vitamin D is added to foods such as milk.) “If you didn’t eat and you never took your vitamin pills, then sun avoidance would be a problem,” he says.

The medical community is itself divided on whether sunlight should be used as a source of vitamin D. While the American Academy of Dermatology advises against unprotected exposure to UV light as a vitamin D source, the American Medical Association recommends that people get a few minutes of unprotected sunlight daily.

Staying safe in the sun isn’t complicated. Both the EWG and dermatologists agree that you should use plenty of sunscreen (SPF 15 to 30 is best), reapply it often, and cover up with hats and protective clothing too.

“We’re not telling people to stay in a cave,” says Dr. Spencer. “We’re just using common protective measures so you can go out and enjoy life.”

Study: Spray Tans, Tanning Bed Use Often Go Hand

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By Denise Mann

MONDAY, September 20 (Health.com) — Eden Lewis prefers to be “a bronzed goddess instead of a pasty Snow White,” so she gets a spray tan before a vacation or an important social event.

The 18-year-old college freshman in Boston likes the convenience and instant results of spray tans. “And most of all,” she says, “I know I won’t look like a shriveled prune when I’m older because of careless sessions in a tanning bed.”

Lewis is typical in many ways. According to a new study in the Archives of Dermatology, 11% of teens in the U.S. have used spray tans and tanning lotions. And the teens who use these so-called sunless tanning products tend to be older teenage girls who, not surprisingly, think the sun-kissed look makes them look more attractive.

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But many people who get tans from a bottle don’t share Lewis’s aversion to tanning beds. In fact, the study showed that people who use sunless tanning products are about 2.5 times more likely than those who don’t to visit tanning salons and get five or more sunburns during the summer—both of which raise the risk of skin cancer and prematurely aged skin.

In short, many teenage spray tanners are a bit like a cigarette smoker who chews nicotine gum to supplement—rather than kick—her habit.

“If you want to look good for prom, sunless tanning could be helpful and [could] deter you from indoor tanning or staying longer at the beach or pool for that tan look,” says the lead author of the study, Vilma Cokkinides, PhD, a researcher at the American Cancer Society, in Atlanta.

However, Cokkinides adds, the findings suggest sunless tanning products may be just another way for diehard tanners to get that coveted bronzed look. “There are also those that are more chronic users, so we need to understand how these products are used by different groups,” she says.

Most sunless tanning products contain dihydroxyacetone, a naturally occurring substance that interacts with amino acids in the skin to create the appearance of a tan, minus the cancer and cosmetic risks associated with ultraviolet light.

Next page: Sunless tanning may reduce unsafe sunbathing

Another study in the same issue of the Archives of Dermatology suggests encouraging women to use sunless tanning products may reduce unsafe sunbathing if the women are warned about the risks of tanning.

In that study, researchers at the University of Massachusetts recruited 250 women who were sunbathing on public beaches. The women were divided into two groups. Half of them received free cosmetics, while the other half received free sunless tanning products and information about skin cancer and the benefits of sunless tanning. They also posed for ultraviolet photographs—a type of photography that reveals skin damage not visible to the naked eye.

After two months, the women who were urged to use sunless tanning products were sunbathing less frequently, had experienced fewer sunburns, and were more likely to wear protective clothing in the sun compared to the women in the control group. After one year, the women who received sunless tanner were still sunbathing less frequently, but there were no other differences between the two groups.

June K. Robinson, MD, a dermatologist at the Northwestern Feinberg School of Medicine, in Chicago, says that sunless tanning may be an effective “harm-reduction strategy for event tanners and those who tan because they feel it looks good.”

However, urging the use of sunless tanning products is not likely to be an effective strategy for people who tan for other reasons, such as to socialize or to relieve stress, says Dr. Robinson, who wrote an editorial accompanying the pair of studies.

Heidi Waldorf, MD, the director of laser and cosmetic dermatology at Mount Sinai Hospital, in New York City, tells her patients about the dangers of UV light and recommends spray tans to her patients—especially those who insist on being tan for a prom or wedding. But she’s not sure diehard tanners are getting the message.

“The benefits may only be short term for teens,” she says. “Even with the emphasis on education in my practice, some girls still show up tan.”