Getting under the skin: The darker side of tanning

The people who walk out of Hot Tamale Tanning and Massage all have one thing in common: They’re tan. Whether in the dead of winter or in the middle of summer, they look as if they’ve spent hours on the beach.
The tanning salon, located in its tropical location 10 minutes south of downtown Pittsburgh, is owned by Shannon Morgan, who herself sports a tan year-round. As owner, she caters to a diverse clientele.

“Right now a lot of people are coming in to get ready for vacations and to get a base tan before they get completely fried,” Morgan said. But not everyone goes tanning as a means of pre-vacation prep.

“A lot of people tan because they feel better about themselves,” Morgan said. “I can’t explain it, but you just feel better when you’re tan. I know I do.”

Having a slight tan used to be a sign of good health. But research conducted by the U.S. Food and Drug Administration suggests that tanning, whether in the sun or in a bed, can significantly increase a person’s chance of getting skin cancer, leaving some doctors to question just how healthy a “healthy tan” is for your skin.

Out of all human organs, skin has the greatest surface area. It’s also the heaviest, typically accounting for nearly 15 percent of a person’s body weight. On average, a square inch of skin contains 650 sweat glands, over 1000 nerve endings, and up to 60,000 melanocytes.

Melanocytes are cells that produce the pigments eumelanin and phaeomelanin, which are responsible for brown and yellow skin tones, respectively. When a person tans, he or she exposes him or herself to ultraviolet (UV) radiation, either from the sun or from a tanning bed’s UV bulbs. After short periods of exposure to UV rays, melanocytes begin to produce melanin in order to protect themselves against future UV exposure. The more UV exposure, the more melanin, and the darker a person’s tan is.

Beginning tanners can run the risk of getting too much UV exposure because some do not have enough melanin built up in their skin. This only applies to Caucasian tanners, because those with darker skin already have high levels of melanin.

When tanners are exposed to UV rays for too long, they experience what is typically known as sunburn, a condition that leaves the skin red and painful. This is because the human body’s response to intense UV exposure is to pump blood into the base of the skin, known as the capillary bed. As the capillary bed fills with blood, skin becomes noticeably red.

But sunburn isn’t all that a new tanner needs to worry about. Medical research shows that there is strong correlation between having sunburn early in life and the development of skin cancer later on. And that goes for veteran tanners, too.

There are three different types of skin cancer: basal cell, squamous cell, and melanoma. Out of the three, melanoma is the most aggressive form because it can spread from the skin to other places in the body.

The Census Bureau’s most recent statistics indicate that during last year alone, 60,000 new cases of melanoma were reported in the U.S. That’s approximately the equivalent of filling Heinz Field with people and diagnosing them with a potentially fatal condition. But there are some who are more at risk than others. Judith Arluk, a dermatologist in Forest Hills, just east of Pittsburgh, said that burns are more common in people who are fair- skinned. Arluk also said that a person’s skin type determines how the sun affects him or her.

There are six different skin types, ranging from extremely fair to extremely dark. The fairer a person’s skin, the greater the risk of being burnt by overexposure and the greater the risk of developing cancer later in life. As a result, doctors like Arluk see patients daily who used to get burned and have developed melanoma.

“I see it every single day,” said Arluk. It is because of her experience that she discourages her patients from tanning. “I tell my patients to just burn their money, because it’s not any better to burn their skin.”

Arluk has seen other effects of tanning as well. Devoted tanners often end up with thin skin, and they tend to bruise easily. “They get all kinds of problems,” Arluk said.
So how does all of this relate to people like clients of Shannon Morgan’s Hot Tamale?

Tanning beds use UV bulbs to emit rays similar to those from the sun. When they went on the market in the late 1970s, tanning beds used UV B bulbs, which emit short-wave radiation and can actually cause burning. When this was discovered, the tanning industry began replacing the original UV B bulbs with UV A bulbs, which emit long-wave radiation and are less likely to cause burning.

But research from the Federal Trade Commission suggests that there is a strong link between UV A radiation and melanoma occurrence. UV A rays have also been proven to weaken the immune system. But what about all those people who tan because it makes them feel better?

A 2004 study conducted by researchers at Wake Forest University Baptist Medical Center suggests that exposure to UV light may produce a relaxing effect. For six weeks, 14 subjects went to tanning sessions on Mondays and Wednesdays. The subjects spent half of their sessions in one bed and half in another. The difference between the two beds was that only one actually emitted UV rays.

Mood was measured before and after sessions. The results suggested that greater stress relief and relaxation occurred after UV exposure compared to non-UV exposure. Further proponents of tanning say that tanning makes them feel good because exposure to UV rays replenishes vitamin D.

But John Zitelli tells a different story. “Tanning bed people encourage others to do more tanning because they need vitamin D, which is ridiculous. You really need only minimal exposure to get enough,” Zitelli said. “If you walk to your car and it’s sunny out — that’s all the exposure you need to get enough vitamin D.”

Zitelli called himself an “end-of-the-line” doctor. Over the past 27 years at his practices in Shadyside and South Hills, he has seen the most serious cases of skin cancer.
Zitelli makes sure his family avoids overexposure to UV protection, and tells his patients to do the same.

“I’ve seen the ones where the cancer invades through the bones and into the brain,” Zitelli said. “I’ve had to cut off hands, limbs, and even noses because of skin cancer.”

And with approximately 60,000 new cases every year, the price of tanning could mean a lot more to a lot of people than just dollars and cents — it could mean a trip to an “end-of-the-line” doctor.