WHO ups ante: Sunbeds now classified as bad as ‘tobacco’ for cancer risk.
A new study conducted with mice that the WHO has latched onto and that I’ve yet to read, now classifies sunbeds specifically and all UV exposure at the highest risk of causing skin cancer (on par with Tobacco). I’m not sure what prompted this change in view, other than a single study, but they have made this change. Clearly, one study is not enough to make this determination, but that is exactly what the World Health Organization is doing. There must be some subtext here that’s prompting this change. Perhaps the sunscreen industry is losing more money to people choosing to tan rather than buy and slather on the sunscreen.
The WHO claims that “It has been estimated that a sunbed tan offers the same protective effect as using a sunscreen with a sun protection factor (SPF) of only 2-3.” I’d guess that most lighter skinned people can only produce a tan (in a sunbed or outdoors) that protects you 2-3 times the amount you normally could stay outside. Without a tan, if you can stay out 1 hour without burning/tanning, then with a tan you can stay outside 2-3 hours without burning or substantially tanning. That’s fairly significant. The WHO shrugs it off as miniscule. Compared to SPF 50, it is miniscule. But realize, that even at 15 minutes max time outdoors without sunscreen, there aren’t 12.5 hours of sunlight in a day when using SPF 50. So, SPF 50 is overkill for most people. I’d also venture to guess that the WHO’s SPF 2-3 tan protection estimation is on the low side. Yes, if you only tan once a week in a bed and get only a very light tan, that might only make an SPF of 2-3. But, if you get a darker tan, then it will be a lot more protective perhaps up to 4-6 depending on color. Of course, how much melanin you can produce will also dictate how strong your protection is. Note that all skin colors will eventually burn, even the darkest tones. The question is, how long does it take?
The WHO’s SPF arguments completely discount the fact that a tan is full spectrum UV protection and, instead, suggests reliance on the sunscreens to protect you. What is this nonsense? Sunscreens are nowhere near full spectrum protection. In fact, most suncreens only really protect you from UVB and many provide limited or non-existent protection to UVA. Many UVA blocking chemicals wear off or degrade far faster than UVB protection. So, even while you may not burn with the UVB protection, your UVA protection may have worn off 10 minutes ago. A tan is visible, you can see it. Sunscreen is invisible, you can’t see it. A tan that you can see, you know is working. A sunscreen that you can’t see, you can’t know that it’s working. So, you have to reapply at least every 30 minutes to 1 hours to ensure constant protection.
For SPF, consider this. There are 8-10 major sunlit hours in the day. If you have an SPF of 3 and can stay out 1 hour without burning, that means you can stay out 3 hours without burning with SPF 3 protection. How often do people stay outdoors longer than 3 hours in direct sunlight? Of the places that come to mind, I see an amusement park, a waterpark or perhaps at the beach surfing. These three situations can easily kill more than 4 hours outdoors. So, in these instances, you wouldn’t want to rely on a tan alone to protect you even if you had an extremely dark tan. But, of the three, two are water activities where sunscreens don’t really work well. So, with outdoor water activities, having a tan is far more helpful than using sunscreens that continually wash off.
Benefits outweigh Risks
William B. Grant (Sunlight, Nutrition, and Health Research Center (SUNARC), San Francisco, CA, USA) suggests in his December 2008 article that the benefits of UV exposure outweigh any risks that UV might impose. For example, he states,
“Humanity’s relation to solar UVB and vitamin D should first be put into the biological perspective. Solar UVB has always been the primary source of vitamin D for life on Earth. On the other hand, UV can damage DNA and generate free radicals, as well as destroy folate in the skin. As a result, skin pigmentation adapted to prevailing solar UV doses where people lived for many generations: very dark in equatorial plains regions, brown in tropical forests and subtropical locations, and very light in high-latitude European locations (Jablonski and Chaplin, 2000). Many people now may live where their skin is too light for prevailing UV doses, resulting in increased risk of skin cancer, or too dark, leading to vitamin D deficiencies.”
Assuming that UV and skin cancer are linked conclusively, his argument suggests another reason for higher incidence of skin cancer. Because the world is literally an open travel destination, peoples from all over the world are now moving to regions they would not normally inhabit. Thus, lighter skinned people are moving to regions with more UV exposure than normal for their protection level. Darker skinned people are becoming vitamin D deficient because UV isn’t strong enough when they move to less sunny areas.
Of UV exposure, Mr. Grant also writes,
“The benefits of UVB irradiance and vitamin D extend well beyond cancer. There is mounting evidence that vitamin D also reduces the risk of cardiovascular diseases (Dobnig et al., 2008). The benefits for UVB irradiance accrue even in youth, as reported for bone development (Lamberg-Allardt and Viljakainen, 2008), multiple sclerosis (Grant, 2008; van der Mei et al., 2003), breast cancer (John et al., 2007b), and prostate cancer (John et al., 2007a). One reason for an early-life benefit is that vitamin D increases absorption of calcium, which reduces the risk of cancer (Lappe et al., 2007; Peterlik and Cross, 2005).”
On the one hand, you have the WHO claiming ‘tanning beds’ are the highest risk for cancer (especially for those under 30) and on the other you have the benefits of vitamin D (especially during early years) that help reduce your chances of cancer and aid in health. These statements are very opposing. In fact, evidence suggests that UV exposure also aids in the reduction of other illnesses. Of the benefits of Vitamin D, Mr Grant again states,
“Also, vitamin D strengthens the innate immune system against both bacterial and viral infections through the production of human cathelicidin, LL-37 (Aloia and Li-Ng, 2007; Hewison, 2008), thereby reducing the risk of viral infections such as Epstein–Barr virus that lead to other diseases such as multiple sclerosis and several types of cancer (Grant, 2008).”
And he states that 1000-2000 IU of Vitamin D per day can aid in the reduction of other diseases and of contracting viruses including “… seasonal influenza and the common cold (Aloia and Li-Ng, 2007).” I can attest to that. UV exposure has kept me from getting the flu or a cold for the last two years running.
Sunlight
Humans have enjoyed sunlight since the beginning. To now claim that natural sunlight is more dangerous than a chemical bath in sunscreen products is basically ridiculous. Let’s actually do some studies to determine if sunscreen chemicals are truly long-term safe, shall we? I digress. If sunlight were truly as carcinogenic as the WHO puts forth in their very alarmist announcement, then humans would not exist today and we would have been one big heap of skin cancer. Yet, that hasn’t happened. So, then the question becomes, what has changed? What are we now doing that we weren’t doing years ago? I think the answer is in the all of the manmade products and foods that we consume. The unnaturalness of working in closed indoor spaces instead of being outdoors. Of course, this includes Mr. Grant’s argument of inhabiting regions with higher doses of UV. So, when we do go outdoors to play, we get badly burned and we effectively have no protection.
Other sources of UV
There are other incidental sources of UV that you may also not be aware. If you work in an office building or perhaps even in your home, fluorescent bulbs have become extremely common place. While the UV that emanates from these bulbs is not as strong as those in tanning beds, they still give off UV. Haven’t you ever wondered why plants love to be under fluorescent lights? That’s the answer.. UV. So, while there isn’t enough UV exposure from these fluorescents to actually tan you, there is enough exposure throughout an 8 hour day to account for higher incidence of skin cancer in individuals. These fluorescent lamps may even be in your home in the new ‘energy saver’ bulbs. So, you may also be further exposing yourself to additional UV without even knowing it.
WHO warns only targeted UV sources
If the WHO wants to exclaim warnings, they need to exclaim them in the proper places. Right now, they are unfairly targeting tanning beds and tanning salons when natural sunlight falls directly under their warning. They make no mention of UV from office building flourescent bulbs. Awardspace.com describes standard fluorescent lamps:
“Fluorescent lamps illuminate 71% of the commercial space in the United States. Most fluorescent lighting gives off UV radiation. Inside the tube, fluorescent lights are pure ultraviolet (UV). Passing through the coating of the tube, they change to visible light (spikes of violet, green and blue) and are not “supposed” to give off UV radiation, but some leaks out. There are special filters that can be purchased to block UV light, but most businesses don’t install the filters because of cost. The filter is a panel that allows light through, but blocks the UV radiation. [Sewell]”
Note that UV exposure is cumulative. So, sitting under fluorescent lights every day for 8-10 hours is probably equivalent to being out in the sun for several hours. Note that what’s blocked appears to be mainly UVB or else everyone would go home sunburned every day. So, what’s left that comes out of the bulbs is likely the longer UVA waves. These are the UV sources that account for skin aging and sun damage and potentially skin cancer.
William B. Grant quotes from the WHO’s very own web site:
“Ultraviolet radiation (UVR) exposure is a minor contributor to the world’s disease burden, causing an estimated annual loss of 1.6 million (disability-adjusted life-years (DALYs)); i.e. 0.1% of the total global disease burden. A markedly larger annual disease burden, 3.3 billion DALYs, might result from reduction in global UVR exposure to very low levels.” –WHO Review via William B. Grant
Let”s read that again… diseases from UVR exposure (i.e., skin cancer) account for 0.1% of the total global disease burden! Yet, from the WHO’s announcement, they would have you think that it’s nearly all of the world’s disease burden. The bottom line is, even if the WHO could manage to get every tanning salon in the world closed, the incidence of skin cancer would not likely drop as dramatically as they would think. First, sunlight is still readily available. Second, there are plenty of other unexpected UV sources (like office lighting) that go unchecked. But, even the WHO cautioned that reducing UVR exposure to very low levels might result in a ‘markedly larger annual disease burden’ (due to the lack of vitamin D). So, the timing of this increase in the risk levels is odd and must have some other subtext that’s pushing it through. One thing is quite clear, this warning clearly targets tanning beds and tanning salons. Because this notice clearly intends to target tanning salons and tanning beds, the question then remains as to the motivation behind this announcement at this time.
Spray tans and Self-Tanners
As a follow up to Sunscreens vs Natural Tanning, I thought I would discuss spray tans and self-tanners. Because suntanning is now almost considered taboo (thanks to the sunscreen and medical industries), many people opt to use a Mystic, Magic or Mist-On spray tanning booth to get that golden glow. A lot of people, for whatever reason, feel these are safer alternatives to sunlight produced color (melanin). Here’s some information that you may not know about these spray tan and self-tanners.
Spray Tan Booths
How safe are spray tans? Well, let’s start with what’s in these spray tanning formulations. Obviously, there’s water in the solution. The active ingredient (that tans you) is Dihydroxyacetone (known as DHA) and possibly even Erythrulose. Both of these ingredients provide color, but in different ways. Both Erythrulose and DHA are the ingredients in most off-the-shelf self-tanning products that you can find in the drug store. I say ‘most’ because there are other alternatives that can provide skin color without self-tanners (although, these are simply dyes, colorants, coatings or powders). Inactive ingredients include temporary bronzer colors (to give immediate color gratification) and possibly other chemicals to aid in delivery. There are some spray tan booths that provide clear solutions instead of bronzed solutions (which can mark up clothing). The benefit to the spray tan is that they tend to spray on very evenly and help prevent blotchy, streaky and uneven application. The drawback to spray tanning is that it aerosolizes the DHA and other ingredients so that you inhale it. Most spray tanning booths offer no ventilation systems during the spray tanning process. In fact, they don’t want the ventilation because the floating particles may help you tan better. But, because the solution is aerosolized, you are now inhaling these ingredients. Yes, you wanted your skin surfaced tan, but did you realized that you are now tanning your lungs and nasal passages? This is not a good thing.
DHA, Erythrulose and the dyes and colorants are not intended to be inhaled in mist particles. So, while the spray booths are great for even application, they don’t really offer the necessary ventilation to prevent inhalation of these potentially problematic chemicals. Salons are supposed to provide nose plugs that may help filter out these chemicals. Too many times, however, salons are out of the plugs and you end up inhaling anyway. In fact, because of the time it takes to spray tan, you really can’t easily hold your breath. So, you will eventually breathe in the chemicals.
Note that salons that have spray tan booths may opt to purchase third party DHA solutions. These are solutions not made by the original manufacturer. As a result, some people have experienced orange or yellow tones from spray tans in salons. If you spray tan and your color is highly orange, it’s possible that your salon has opted to buy cheaper refills with cheaper ingredients.
Self-tanners: How they work
The two self-tanners listed above include Erythrulose and Dihydroxyacetone (DHA). Erythrulose takes up to 5 days to fully appear. Erythrulose provides a yellowish color to the skin. The Erythrulose color is used to offset the oranges that DHA provides. DHA begins developing in 4-6 hours reaching maximum color by 12-15 hours. DHA’s color actually looks reasonably natural between 4-6 hours after application. Once DHA begins to darken, however, it begins to show the familiar orange and unnatural look by the 12 hour mark.
Airbrush Tan
For the same reason as a booth is a problem, so is an airbrush. The airbrush provides finer control and finer particles, but that doesn’t equate to safer inhalation risks unless they provide an active vent hood which can reduce inhalation risk. Airbrush tans, though, do provide better and more even coverage than a spray tan booth.
Safest Way to Apply Self-tanners
The lotion versions are, in fact, the safest way to apply a self tanner. While an aerosol makes it even and fast, it also makes it more dangerous for inhalation problems. So, opting for a lotion prevents the inhalation issues. The difficulty with lotions is uneven application and the possibility of an orange color.
Why do self-tanners turn orange?
Part of the reason for this is color theory. If you have a bluish undertone to your skin or are very pale, that mixes with the developing color to produce an orange-ish tone. If you have a tanned tone, the self-tanner enhances the tan and produces a much more natural color and deepens the tan. Another reason that DHA turns orange is because of the base ingredients with which it’s mixed. The lotion base that most brands use are cheap. As a result, the lotion ingredients change the color of the developing DHA to become more orange. To avoid this, you want to find a high quality lotion base or alternatively find a self-tanner mixed in a gel base. Some lotions that work well and keep their proper color are Dave’s Famous Moisture Tan and L’Oreal’s Sublime Bronze Gelee. Dave’s lotion is made in a white base and has a very light nutty scent. L’Oreal’s product has the typical nasty self-tanner scent, but it spreads on incredibly even (not streaky) and gives very good color.
What skin tones can use self-tanners?
While I know that dermatologists recommend self-tanners, you don’t want people to know you fake bake simply by looking. So, you need to assess your present skin tone to determine if a self-tanner is right for you. Certain skin tones do not do well with self-tanners. For example, the white-bluish skin tones do not fake bake well. The self-tan will likely make you orange or yellow very fast. The best you can hope for is getting a very light self-tanner, applying it and then washing it off right as the color develops. Washing immediately as the color develops lets you stop the color development at a point before it gets too dark. You will also need to find a self-tanner that gets you to the proper color. Some ‘light’ self-tanners still get way too dark, so you should be cautious. If at the 12 hour mark you are getting too dark, take a shower and lightly soap and rinse to stop further development.
Why do self-tanners smell?
The developing process between the DHA and the skin’s protein gives off an aroma as a result of the developing process. The smell has been described as ‘wet dog’, ‘musty’, or ‘earthy’ . The smell comes to its height at about the 12 hour mark after application. It begins to subside after the 24 hour mark (when the color begins to wear off). Because of the smell, this is a very telltale way of knowing when someone has used a self-tanner. Frankly, I find the smell offensive and refuse to use self-tanners for this reason alone.
Note that Dave’s self-tanner is made with limited fragrance, so it pretty much smells like the lotion mixed with DHA (it has kind of a nutty scent). The good thing about this is that there is no fragrance to mix with the developing odor to make an even nastier smell. Too many self-tanners on the market include entirely horrible fragrances to mask the DHA smell. So, when the color (and odor) develops and mixes with the fragrance, it can sometimes be a nauseating combination. You want to shower just to get the smell off. With Dave’s lotion, the light nutty fragrance dissipates rapidly so there is no fragrance left when the DHA color and odor develops… and that’s a blessing in disguise.
Self-tanners make my skin rough and dry
Yes, they do. The best way to resolve this issue is to use a moisturizer frequently. If you must use DHA to color your skin, your skin texture will change as a result. You may find that you don’t like the texture that a self-tanner leaves on your skin. If that’s the case, you may have to abandon use of DHA.
Flaking, peeling and splotchy uneven wear
Self-tanners don’t wear off evenly. It can wear off to make your skin look splotchy or odd colored. This is a lot more apparent when you try to go too dark and your skin is very light. The good thing, though, is a fake bake usually wears off completely by 7-10 days. That means, if there was a problem during application, it’s gone pretty fast. The downside, of course, means that you have to reapply the color every 7-10 days to keep your skin tone. The problem with reapplication is that you need to completely scrub the color off before adding more. Otherwise, the new color won’t adhere to your skin well enough. To make your self-tan last as long as possible, here are some tips.
- Scrub your skin with a exfoliating buff pad thoroughly prior to application (to remove as much dead dry skin as possible).
- Let your skin dry completely before application
- Apply a small amount of moisturizing (non-tanning) lotion to the backs of your hands, knuckles, knees, elbows and ankles to prevent full strength DHA absorption
- Once the color appears, apply lotion daily to keep the tan as long as possible
- Remove the tan fully with a buff-pad once the tan begins to noticeably flake
Always fully remove any previous self-tan before applying a new tan. If you don’t do this, your tan will become uneven and may go on too dark. So, remove the old tan first.
Removing the old self-tan
To remove a self-tan, the best way is to wait until most of it has worn off. Then, use a body exfoliating buff pad to rub the rest off. The benefit if using a buff pad is that it will get all of the old color off and, at the same time, prep your skin for a new tan. You should always prepare your skin by exfoliation prior to using a self-tanner. Otherwise, it may wear unevenly and/or turn way too dark in places.
Tips for working with self-tanners
Self-tanners will tan any skin surface or hair. So, be careful with it around the plams of your hands and your nails. Always wear gloves when applying and use a sponge applicator if possible. For ease of application, buy a lotion with a dark guide. The guide will aid getting it on evenly. Gels with oil are reasonably easy to get applied evenly because you can see where the oil is. The problem with the gel type with oil is that the oil dries slowly. Lotions dry much faster. Guides can stain clothing, so be careful. Do not swim, shower or sweat within 4-7 hours of application. This can wash off parts of the DHA and cause splotchy or uneven color. Wait until the color develops before doing swimming or other activities that make you sweat.
If you choose to go the route of a drug store lotion, look for reviews on the Internet first. People who like a product will usually recommend it. Amazon is a good place to get reasonably honest reviews of products. To get self-tanner off your palms, fingernails or cuticles, use a cotton swab and some bleach. The bleach will lighten the self-tanner and make it far less noticeable.
Overall
Finally, expect to spend between 1-3 hours prepping, applying and waiting to dry. Then, 4-6 hours before color begins to develop. So, this is not a fast process by any stretch. Be sure to fully exfoliate before you apply a self-tanner (whether from a bottle or in a salon). You should moisturize daily to keep the skin moist and preserve the look of the tan. There’s little you can do to mask the developer odor, so just try to keep yourself from getting wet (when it smells the worst).
Finally, I would like to point out the following possible health issues with self-tanner chemicals:
- A DHA tan does not protect you from UV. Do not use it thinking that you won’t get burned outdoors. In fact, DHA offers no UV protection at all. So, if you must be outdoors with your DHA tan, apply sunscreen to fully protect your skin from a burn.
- DHA has no long term toxicity studies for its use on the skin. It is a possibility that DHA leeches into the bloodstream on application. So, applying DHA may not be healthy to your skin or body… which may take years before it’s ultimately linked to any injury.
- Aerosolized DHA in spray tanning booths will be inhaled. You should be cautious of inhaling aerosolized DHA when using a spray tanning system. Inhaling DHA into the lungs has not been tested for possible health issues.
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