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Confused about what to put on your skin to protect it from the sun? Is a tanning bed a safer way of maintaining that "healthy glow"? How much sun is good for us? How much sun is bad? Is it better to get natural sunlight or controlled exposure through a tanning bed?
It's easy to get lost in the myriad of claims bombarding us from print and television media. There are more tanning outlets in the United States than there are McDonald's fast food restaurants. It's an industry that brings in $5 billion dollars a year[i]! We read ongoing discussions about the risk of UV rays vs. the risk of vitamin D deficiency. We read connections between sun exposure and melanoma, and research declaring tanning bed UV rays as carcinogenic.
It almost seems that we should hide inside and protect ourselves from the sun's damaging rays – but then, what about vitamin D? We spend our time indoors for a good chunk of the year. Finally, summer comes and we're lured outside by warm weather and sunshine. Too much, too soon and the next thing you know, you're burnt to a crisp. Or, we spend our weekdays inside in an air-conditioned environment and when the weekend arrives, we're in the garden, at the beach or participating in a variety of outdoor activities. This is also an ideal way to char pale skin – and not an ideal way to get Vitamin D!
Information and Misinformation about the Sun and Skin Cancer
Outdoor sun exposure has been safe for centuries. In 1930, skin cancer was rare. Today, one in every five Americans develops skin cancer. 3.5 million cases are diagnosed every year, and the incidence of melanoma has increased by 1800% over the last 30 years[ii]. No wonder we are so afraid to go out in the sun.
We have seen arguments about depletion of the ozone layer and its impact on the incidence of skin cancer. The premise is that a thinning of the ozone layer allows more intense damaging rays through the atmosphere, increasing our risk of sunburn and the increased risk of cancer[iii]. Truthfully, that link is weak, in that the ozone layer depletes seasonally in winter and spring, which is generally not when we spend time in the sun. And the depletion is largely over the Arctic and Antarctica, and at the equator, yet cancer rates are not higher in those geographic regions[iv]. And should that exposure equal an 1800% increase in the incidence of skin cancer over the past 30 years? Until this argument is resolved, let's look at the issues over which we have some control.
Genetically, humans require sunlight exposure for vitamin D, required for wellbeing and cellular function. Research is clear about the healthy benefits of sun exposure. It is, however, sunburns that potentially raise cause for concern[v].
Most studies examining sun exposure and its connection to melanoma, or skin cancer, show that it is the incidence of burns that are related to the appearance of melanoma[vi]. However, some studies are unable to "find lifetime routine sun exposure or sun exposure via recreational outdoor activities or occupations to be associated with melanoma risk"[vii]. Not only does this suggest that every day exposure is less of a concern than a burn, these results were also not changed "by detailed examination of sun exposure according to season, decade age, type of outdoor activity, indoor tanning status, or tumor site"[viii].
What does this tell us?
- There are people every year who get melanoma on random parts of their body, less exposed to the sun than others. How do we explain the case of melanoma on the plantar surface of the heel? Clearly, there are many other factors to be considered.
- Indoor tanning vs. types of outdoor activity are neither to blame, definitively. There are people every year who get skin cancer who never use a tanning bed.
Further, the incidence of melanoma in the United States follows no pattern whatsoever[ix]. Certainly, number or length of days in the sun, or one's proximity to the equator, can't be to blame.
In an assessment of this current research, Dr. James Chestnut proposes that while sunburn is a causal factor in skin cancer, the body is most limited in its ability to defend itself from a scorching when intensely tanning indoors[x]. It would only make sense that the body is best able to utilize its antioxidants and regenerative healing abilities when a burn is acquired in an outdoor environment, over time, as opposed to in a manufactured environment, indoors, in which the body has less of an ability to defend itself – and you are less likely to even realize that you're getting burned. Our body is configured to manage natural sun, not the artificial sun of a tanning bed.
Regardless of the amount of time we spend in the sun or in a booth, what should be avoided at all costs is the burning of our skin from intense overexposure. It's not sun exposure, not UVB exposure, but exposure beyond our body's limitations that raises most (but not all) cause for concern.
One's goal in sun exposure is to not get burned – definitely not in a tanning bed, and preferably not in the fresh air. While the risk of cancer related to tanning bed burns is indeed clear, though the risk of fresh air burns is not, no one loves a burn from either setting.
Avoiding sunburn – What are the best options for sunscreen?
Commercial sunscreens and their ingredients are terrifying. Just as we erroneously hear that anything "low fat" must be good, we've been taught that the higher the SPF in a sunscreen, the better it must be. There are two reasons this statement could not be any further from the truth.
First, your body needs to produce vitamin D as a result of having sun exposure. A higher SPF means reduced exposure to the benefits of the sun and the less vitamin D your body will utilize. Research shows that incidence of melanoma increases in those not exposed to the sun, and the depletion of vitamin D has a strong correlation to the rise in melanoma[xi].
Second, generally speaking, the higher the SPF, the more synthetic chemicals are contained in the lotion to create its formula. The biggest problem with the lotions and creams we slather all over our bodies is not how much they protect us from the sun, but what's in them that pollutes our bodies in the interest of blocking the sun's rays. After all, it has been stated that 80 percent of all cancers are attributed to environmental factors, including exposure to carcinogenic chemicals[xii].
Further, a summary of research in 2008 showed that only 5–10% of all cancer cases can be attributed to genetic defects, whereas the remaining 90–95% have their roots in the environment and lifestyle[xiii]. Notably, whereas only up to 10% of total cancer cases may be induced by all forms of radiation (of which UV is just a small part[xiv]), there are a multitude of environmental agents, mainly chemicals, associated with specific cancers[xv]. In older studies, some cancers have been linked to exposure to arsenic in medicines. In fact, the strongest link has been found with skin cancer[xvi]. Arsenic can be found in older pressure treated lumber, some pesticides, leather preservatives, and some glass.