The Skin Cancer Foundation Journal

MAY 2015

The 2012 edition of The Skin Cancer Foundation Journal features medically reviewed, reader-friendly articles such as tanning, the increasing incidence of skin cancer diagnoses among young women, & the prevalence of melanoma among white males over 50.

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VITAMIN D TANNING BEDS ARE A SAFER WAY THAN SUN EXPOSURE TO GET VITAMIN D. Since it is UVB rays that stimulate the body to produce vitamin D, and since tanning beds today mainly produce UVA, this argument for tanning beds doesn't hold true. The only study to support UV tanning beds as a source of vitamin D production was basically meaningless because study subjects also had done significant sunbathing. Furthermore, these machines are anything but safe. Tanning salon proprietors have long maintained that UVA rays are safer than UVB, but we now know that UVA rays actually penetrate into deeper layers of the skin than UVB, unleashing molecules called free radicals that are both aging and carcinogenic. Tanning proponents also like to say that the dose of UV in tanning salons is more controlled than sun exposure, but the truth is, frequent tanners using new high-pressure sunlamps may receive as much as 12 times the annual UVA dose compared to the dose they receive from sun exposure. 10 The bottom line is that study after study has linked tanning beds to all three major skin cancers. More than 419,000 cases of skin cancer in the US each year are linked to indoor tanning, including about 245,000 basal cell carcinomas, 168,000 squamous cell carcinomas, and 6,200 melanomas. 11 In 2009, the Inter- national Agency for Research on Cancer (IARC), an affiliate of the World Health Organization, moved tanning beds into its highest cancer risk category—carcinogenic to humans—alongside the likes of sun exposure, cig- arette smoking, and plutonium. 12 Similarly, in 2014, the FDA upgraded these machines from fairly benign Class I devices to moderate-to-high risk Class II devices that must carry a black box warning to consumers. 13,14 VITAMIN D HAS MANY IMPORTANT HEALTH BENEFITS THAT OUTWEIGH ANY POTENTIAL HARM TO THE SKIN BY UVR. According to a 2010 Institute of Medicine study (IOM), the need for vitamin D supplementation is scientifically supported only for bone health and musculoskeletal (muscle and bone) diseases. 15,16 Many claims have been made in recent years about Vitamin D's ability to boost the immune system and help prevent any number of diseases, but these remain controversial and unproven. To date, the results of large-scale clinical trials using vitamin D supplementation for conditions ranging from heart disease, diabetes, and cancer to neurologic disorders and infectious diseases are far from conclusive. 17 In contrast, the link between skin cancer, premature skin aging, and both indoor and outdoor tanning are now definitively proven. AMERICANS ARE DANGEROUSLY DEFICIENT IN VITAMIN D, AND UV EXPOSURE IS THE ONLY WAY TO GET ENOUGH. THUS, SUNSCREEN IS CONTRIBUTING TO VITAMIN D DEFICIENCY. Studying this issue in its 2010 investigation, the IOM found that most North Americans take in adequate vitamin D and require no supplementation beyond what they obtain through their regular diet. 15,16 Since then, other groups such as the Harvard School of Public Health have said that the IOM's standards are too low, and that vitamin D deficiency is indeed a problem in the population at large. 18 However, to date the IOM numbers still prevail as the standard recommendations for daily vitamin D intake. [See "How Much Vitamin D Do You Need?" ] Regardless what the numbers are, dermatologists are in near virtual agreement that the long-term dangers of UV exposure dictate against it as your source of vitamin D, that sunscreen and other forms of sun protec- tion should continue being used on a daily basis, and that the safe, healthy way to attain sufficient levels is through D-rich food and vitamin supplements. [See "Remember to always EAT YOUR D's".] MY TAKE-HOME MESSAGE IS SIMILAR: 1. Avoid UV tanning devices – their risks far outweigh any benefit. 2. Prac- tice daily sun protection. A "healthy tan" is a contradiction in terms – there is no such thing. 3. Most of the claims about vitamin D's health benefits remain to be conclusively determined. What constitutes adequate levels of vitamin D also remains the subject of debate, but there are official standards in place established by the Institute of Medicine. 4. Since vitamin D is known to be essential for bone health, individuals at high risk for vitamin D deficiency (such as people of color, whose skin allows in less UV, and people living in very northern latitudes) should be screened, and those who prove deficient should up their intake through diet and vitamin supplementation rather than UV exposure. MYTH # 2 MYTH # 3 MYTH # 4 References on pages 105-107. 70

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