If the national media is a circus parade, the clown in the ultraviolet spotlight last month was 44-year-old Patricia Krentcil of New Jersey, who was arrested for allegedly bringing her five-year-old daughter to a tanning salon. But far from white-faced, this big-tent star had the dark, leathery visage of a tanning fanatic. The little girl, who sustained a burn, was much younger than New Jersey's legal tanning-booth age of 14—but the collective conversation soon turned from "What did this woman do to her child?" to, um, wait a minute, "What did she do to herself?" While Krentcil denied the charges and claimed that her daughter was sunburned while playing outside, media watchers gazed in amazement at the mother's unnaturally tropical, prematurely aged complexion—soon the fodder for TV comedians who likened it to a baseball glove in one monologue, a Slim Jim in another. Showered with judgment and catty chatter, the woman that newspapers dubbed the Tanorexic Mom could hardly run for cover.
As beaches and swimming pools open across the country, tanning devotees as well as casual sunshine enthusiasts can get their fix for free, almost anywhere. Of course, there's a bright side to sun exposure: It's linked with improved mood, better sleep, and the vitamin D production that's essential to good health. Yet reaping these benefits in excess can have dire consequences. Ultraviolet rays from sunlight carry the carcinogenic effects responsible for the most common form cancer in America today. Skin cancer, affecting some two million people a year, accounts for nearly half of all diagnosed cancers. Most episodes involve the less deadly basal or squamous cell carcinomas, yet melanoma—the most vicious form of skin cancer in the pack—plagued about 75,000 Americans in 2011.
The numbers are rising while the age of patients is dropping. "Typically, I had seen people in their 50s, 60s, and older with skin cancer, but that has shifted," says Dr. Hendrick Uyttendaele [pronounced "Yoo-ten-dale"] of Hudson Dermatology, with offices in Poughkeepsie, Fishkill, and Kingston. "Now it starts earlier. Seeing people in their 40s with skin cancer is becoming routine, and it's creeping into the 30s and 20s. I saw a 24-year-old who thought she had a zit on her upper lip, but no, it was skin cancer. She was going to get married and had to postpone the wedding to get surgery." These days, Uyttendaele tells his immortal-feeling younger patients, "This can happen to people in your age group."
Sunshine, the New Moonshine
Ideas of beauty come and go, set in motion by the tastemakers of the era. It was grand dame Coco Chanel who made the sun-kissed look fashionable in the 1920s, and the notion of a tan's attractiveness remains lodged in the cultural psyche. Yet some people take sun worship too far—and a new wave of research is revealing that there may be more to the story than mere vanity. Ultraviolet (UV) light, whether from the sun or tanning beds, can be addictive, says Dr. Steven Feldman, a dermatologist as well as a professor at Wake Forest Baptist Medical Center in North Carolina. When skin cells in culture are exposed to UV light, says Feldman, "They release a melanocyte-stimulating hormone which can bring on a suntan. But along with this, a larger protein is also made which contains endorphins, the natural opioid known as the feel-good hormone."
With funding from the National Institute on Drug Abuse, Feldman led a series of small studies to explore subjects' responses to UV light. In a 2004 study, 12 frequent and infrequent tanners were offered a session each in two identical-looking tanning beds—but in one bed, unbeknownst to subjects, the UV rays were blocked. Offered a third session in their choice of beds, tanners requested the bed with UV light 95 percent of the time. They invariably told Feldman, "This one relaxes me more." In a 2006 follow-up study with 16 tanners, Feldman's team gave subjects endorphin blockers; as a result, the subjects could no longer tell the difference between the two beds, and several tanners exhibited withdrawal symptoms. Moreover, in an unrelated study at UT Southwestern Medical Center in 2011, researchers scanned tanners' brains and found that the same pleasure centers that light up with an opiate high also light up during tanning.
In his own practice, Feldman has seen many tanners keep up their habit long after a healthy glow has given way to mottled skin, sunspots, and wrinkles—and even after they've developed skin cancer. "Addiction is a complex issue, with different factors at work," says Feldman. "If people think they're going to get a date because they look darker, or they're going to have a better prom experience, then that, combined with the opioids, is going to drive the behavior."