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INFORMATION
FOR TANNERS
Who
Should Tan, How and How Often?
Sunlight
is absolutely essential to all life on earth. There are
various reasons, both biological and psychological, why
exposure to light is desirable. In addition, many people
believe they look better with a tan. Thus, having a tan
may provide a psychological uplift for some.
Normally,
a person tans indoors only as well as he/ she is able to
tan outdoors. Yet, those fair-skinned people who generally
cannot tolerate the uncontrollable rays of the sun often
achieve some color when tanning indoors. This can be attributed
to a different spectral output as well as carefully timed
tanning sessions in a controlled tanning environment. Skin
type, heredity, and individual photosensitivities determine
who will have success tanning indoors.
All
exposure, whether indoor or outdoors should be gradual
and moderate. For the commercial tanning salon operator,
it is necessary that each customer's skin type be determined,
and that the corresponding recommended exposure schedule
be strictly followed. More information on the risks and
benefits of UV exposure can be obtained from industry publications,
seminars, trade associations, and suppliers of indoor tanning
equipment.
As
for how often to tan, currently, the Food and Drug Administration
guidelines suggest that a 48 hour time interval should
pass between tanning sessions. Pigmentation and/ or erythemal
(sunburn) may not be fully visible for between 12- 24 hours.
Thus two tanning sessions within this 24 hour period could
cause an unintentional burn. In general, maximum pigmentation
can be built up gradually, following the exposure schedule,
in 8 - 10 tanning sessions.
Should
an indoor tanner experience an adverse reaction after tanning,
one should terminate all exposure until the condition disappears.
Only then should one begin tanning again. If the condition
does not disappear within a reasonable amount of time,
one should consult a physician.
Each
indoor tanner must bear responsibility for his/ her own
tanning priorities. It is the responsibility of those in
the retail business to provide enough information to customers
to enable them to make an informed decision. When in doubt,
the equipment operator should exercise prudence, caution
and good judgment when giving advice on tanning practices.
Recommended
Exposure Schedule
Skin
Type |
Week
1
1-3 Sessions |
Week
2
4-6 Sessions |
Week
3
7-10 Sessions |
Week
4
11-15 Sessions |
Weekly
Maintenance
Sessions |
| II Fair |
4
min |
8
min |
12
min |
16
min |
20
min |
| III Medium |
4
min |
8
min |
12
min |
16
min |
20
min |
| IV Dark |
4
min |
12
min |
16
min |
20
min |
20
min |
| V
Very Dark |
4
min |
12
min |
16
min |
20
min |
20
min |
First
six sessions tobe at 48 hour intervals.
Tan maintenance: 1-2 times weekly at week 4 dosage |
What
are Skin Types?
"Skin
Typing" is a method for determining one's natural ability
to produce melanin. Skin types are hereditary and cannot
be altered by outside influences.
Skin
types range from a Skin Type I (albino) to Skin Type VI (African
American). Skin types are classified according to a person's
tendencies to sunburn and/ or tan. Most indoor tanners are
a skin type II, III or IV. These people tend to burn upon
exposure to varying dosages of UV light, but also have the
ability to develop some pigmentation. While all of us, regardless
of skin type, have about the same number of melanocytes in
our skin, we vary in our ability to produce melanin. It is
this production capability which results in a certain skin
type.
|
Skin
Reactions to Solar Radiation |
Examples |
| I |
Always
burns easily and severely (painful burn); tans
little or none and peels |
People
most often with fair skin, blue eyes, freckles;
unexposed skin is white |
| II |
Usually
burns easily and severely (painful burn); tans
minimally or lightly, also peels |
People
most often with fair skin, red or blonde hair,
blue, hazel or even brown eyes; unexposed skin
is white |
| III |
Burns
moderately and tans about average |
Normal
average Caucasian; unexposed skin is white |
| IV |
Burns
minimally, tans easily and above average with
each exposure; exhibits IPD (immediate pigment
darkening) reaction |
People
with white or light brown skin, dark brown hair,
dark eyes (e.g., Mediterraneans, Orientals, Hispanics,
etc.); unexposed skin is white or light brown |
| V |
Rarely
burns, tans easily and substantially; always
exhibits IPD reaction |
Brown-skinned
persons (e.g., Amerindians, East Indians, Hispanics,
etc); unexposed skin is brown |
| VI |
Never
burns and tans profusely; exhibits IPD reaction |
Blacks
(e.g., African and American blacks, Australian
and South Indian Aborigines); unexposed skin
is black |
Summaries
of Scientific Studies
"Is
Chronic Sunlight Exposure Important in Accounting for
Increases in Melanoma Incidence?" Richard P. Gallagher,
J. Mark Elwood and C. Paul Yang. International Journal
of Cancer, 1989.
Most
attempts to relate sunlight exposure to the increase
in malignant melanoma have concentrated on the positive
association between intermittent exposure to sunlight
and risk of melanoma. The Western Canada Melanoma Study,
however, detected an opposite association between melanoma
and chronic or long-term occupational sun exposure
in men, with the lowest risk in those with the most
occupational exposure. The
findings suggest that sun exposure may be protective.
Data
obtained from Canadian census figures indicated that
since 1961 there has been a substantial reduction in
the number of men who work outdoors in Canada. These
observations suggest that part of the increase in the
incidence of melanoma in low-sunlight areas may be
due to a reduction over the past 40 years of the size
of the group "protected" by
their exposure to UV light. It is known that sun exposure
tends to thicken the epidermis and lead to a year-round
tan. Both of which afford protection of the underlying
melanocytes from the effects of the sun, thus perhaps
providing an explanation for the lower incidence of
melanoma among outdoor workers.
The
Danish Case-Control Study of Cutaneous Malignant Melanoma." A.
Osterlind, M.A. Tucker, B.J. Stone, and O.M. Jensen.
International Journal of Cancer, 1988.
A
population-based case-control study of 474 patients
with cutaneous malignant melanoma and 926 population
controls, conducted in East Denmark over a 3-year period
included an evaluation of the relationship of UV-light
exposure to cutaneous melanoma risk. A significant
decrease in risk was associated with occupational exposure
during the summer in males. No
association was found between the risk of cutaneous
melanoma and exposure to artificial UV-light (fluorescent
light, sun lamps, or tanning beds).
"Vitamin
D3 and Sunlight An Intimate Beneficial Relationship" M.F.
Holick, Ph.D., M.D. Biologic Effects of Light, 1992.
Vitamin
D is absolutely essential for the health and maintenance
of the skeleton. Vitamin D deficiency in children causes
rickets. In adults, it causes metabolic bone disease.
It has been estimated in the United States that about
30 to 40 percent of elderly persons with hip fractures
are vitamin D deficient. Although aging does not decrease
the body's efficiency to absorb vitamin D, the aged
often do not obtain sufficient vitamin D in their diet
to meet their body's requirement. In the United States,
the principal food source for vitamin D is milk. If
an adult does not consume milk or fish oils that contain
vitamin D or take a vitamin D supplement, it then becomes
essential for that person to sunbathe to generate enough
vitamin D to satisfy the body's requirement. When
humans are exposed to sunlight, the high-energy ultraviolet
B photons strike the surface of the skin and a biochemical
reaction forms vitamin D.
"Personal
Risk-Factor Chart for Cutaneous Melanoma" Rona
MacKie, T. Freudenberger, T.C. Aitchison. The Lancet,
1989.
Information
from a case-control study of patients with malignant
melanoma diagnosed in Scotland in 1987 has been used
to derive a personal risk-factor chart that can be
used by both the medical profession and the general
public. The
four strongest risk factors for melanoma were determined
to be the total number of benign pigmented naevi (birthmarks);
a tendency to freckle; the number of abnormal naevi;
and a history of severe sunburn at any time in life.
Although
13 male and 20 female melanoma patients had used artificial
sources of ultraviolet radiation, compared with 1 male
and 7 female controls, the
authors of the study did not find sufficient correlation
between exposure to artificial ultraviolet light and
the incidence of malignant melanoma to include artificial
ultraviolet light exposure as a significant risk factor
for melanoma.
"Vitamin
D and Breast Cancer Risk" Ester M. John and Associates
at the Northern California Cancer Center
The
study shows that casual sunlight, along with other
factors, can help reduce the risk of breast cancer. In
the report the authors stated, " ... we found
that high exposure to sunlight was associated with
a 25 percent to 65 percent reduction in breast cancer
risk among women whose longest residence was in a state
of high solar radiation." The report also says, "No
reductions in risk were found for women who lived in
regions of low solar radiation.
"Geographic
patterns of prostate cancer mortality-evidence for
a positive effect of UVR" by Hanchette and Schwartz
of the University of North Carolina published in the
journal Cancer
The
study supports the hypothesis that UVR may protect
against clinical prostate cancer. Viewed
with other recent data, including those demonstrating
a differentiating effect of vitamin D on human prostate
cancer cells, these findings suggest that vitamin D
may have an important role in the natural, history
of prostate cancer.
In
their article, Hanchette and Schwartz stated a number
of important findings. For instance, they stated, "because
the major source of vitamin D is casual exposure to
UVR, the authors examined the geographic distributions
of UVR and prostate cancer mortality in 3,073 counties
of the contiguous United States." The study found
that "the geographic distributions of UVR and
prostate cancer mortality are correlated inversely.
Prostate cancer mortality exhibits a significant north-south
trend, with lower rates in the south."
The
study's data also showed there was a 20-percent to
40-percent lower incidence rate of prostate cancer
among men in southern latitudes, while men with skin
type 6 skin (African Americans) had a much higher incidence
rate in all areas than did skin type 1-4 men (Caucasian).
"Sunbed
use and risk of melanoma: results from a large multicerntric
European study" by Autier, De Vries, Eggermont,
Coebergh, Ringborg, Bandberg, Bataille and Grivegnee
presented at the Luxembourg Health Institute, Luxembourg,
The Netherlands.
"The
study objective was to assess whether there is an association
between sunbed use and cutaneous melanoma in subjects
18-49 years old. In a case-control design, we compared
past sunbed and sun exposure of 622 incident melanoma
cases, to the exposure experienced by 649 controls
recruited in six European countries, from April 2000
until June 2002. Levels of sunbed used were higher
than in any former study on the same topic. HOWEVER,
NO EVIDENCE WAS FOUND FOR AN ASSOCIATION BETWEEN SUNBED
USE AND MELANOMA. No
result suggested a dose-response curve, and no association
was even present for subjects reporting more than 35
hour of cumulated sunbed use and/or who started their
sunbed use AT LEAST 19 YEARS before the interview. OUR
STUDY DOES NOT SUPPORT THE POSSIBILITY THAT SUNBED
USE COULD INCREASE THE MELANOMA RISK."
Skin
colour and skin cancer - MC1R, the genetic link,
by Sturm RA, published Melanoma Res 2002 Sep;12(5):405-416
Pigmentary
traits such as red hair, fair skin, lack of tanning
ability and propensity to freckle (the RHC phenotype)
have been identified as genetic risk factors for both
melanoma and non-melanocytic skin cancers when combined
with the environmental risk factor of high ultraviolet
light exposure.
"Mutations
in the TP53 gene in human malignant melanomas derived
from sun-exposed skin and unexposed mucosal membranes," by
Ragnarsson-Olding BK, Karsberg S, Platz A, Ringborg
UK. Published in Melanoma Res 2002 Sep;12(5):453-463
Mutations
in the p53 tumour suppressor gene ( ) have been linked
to several types of cancer. We therefore investigated
whether such mutations occur in malignant melanomas
and, if so, whether they are linked to ultraviolet
(sun) light exposure. For the first time, mutations
in mucosal membranes and adjacent tissues shielded
from sunlight were compared with those in cutaneous
melanomas from sun-exposed skin. Archival tissues were
obtained from 35 patients with a primary melanoma taken
from unexposed mucosal areas and from 34 patients with
a primary melanoma located in chronically sun-exposed
head and neck skin. was characterized by means of polymerase
chain reaction amplification and single-strand conformation
polymorphism assay followed by nucleotide sequencing.
The results showed that 17.6% of the primary cutaneous
and 28.6% of the primary mucosal melanomas had point
mutations in. Among the cutaneous melanomas, one showed
three mutations in exon 7, and one had two mutations
in exon 5; the mutation was in the same allele in both
cases. One mucosal melanoma had two mutations in exon
7, both in the same allele, and another had two mutations,
one in exon 7 and one in intron 6, both in the same
allele. C<--T mutations at dipyrimidine sites, considered
fingerprints for ultraviolet light-induced mutations,
were about equally distributed among patients with
melanomas from chronically sun-exposed areas [six out
of nine; 67%) and those with melanomas from unexposed
mucosal areas and adjacent skin [eight out of 14; 57%).
Our data, demonstrating the presence of such mutations
even in melanomas from mucosal membranes, clearly suggest
that factors other than, or additional to, ultraviolet
radiation are operational in the induction of mutations
in melanomas
"Summer
Sun Can't Sustain Vit. D Levels Year-Round" by
M. Janet Barger-Lux, Senior Research Associate, and
Dr. Robert Heaney, Osteoporosis Research Center Creighton
University Medical Center, 601 North 30th Street Omaha,
NE 68131-2197, Sept. 24, 2002
Counting
on the sun alone for vitamin D will leave most people
deprived of adequate amounts of this nutrient, especially
during the winter in the northern parts of the US,
researchers report. This is true even for people who
work outside during the summer and get plenty of sun
in the warmer months but not in the winter, according
to study results presented here at the annual meeting
of the American Society for Bone and Mineral Research.
Vitamin
D is formed in the skin, but it requires ultraviolet
rays of the sun to activate it to a form the body can
use. Vitamin
D, which assists the intestines in absorbing calcium
and phosphorus, is also contained in some fortified
foods.
For
the study, Janet Barger-Lux, senior research associate,
and Dr. Robert Heaney, both from Creighton University,
Omaha, Nebraska, calculated the daily skin dose of
vitamin D that 26 men who worked outdoors during the
summer would have received.
They
brought the men back about 6 months later to assess
how much vitamin D they may have lost over the winter.
The team estimated that the amount of vitamin D that
the group had received from the sun during the summer
was equivalent to approximately 2800 international
units (IU) of vitamin D a day, "which is a pretty
big dose," Barger-Lux noted in an interview with
Reuters Health.
Recommended
daily doses of the vitamin are 200 IU per day for adults
aged 19 to 50, 400 IU for those aged 51 to 70, and
600 IU for those over 70.
When
the men were reassessed during February and March of
the following year, vitamin D levels had fallen to
less than 80 nanomoles per liter (nmol/L) in roughly
half of the group. Vitamin D levels of at least 80
nmol/L are recommended to ensure optimal cellular health.
"We
don't want to promote excessive sun exposure, but from
the standpoint of making vitamin D naturally in the
skin, we need to expose greater areas of the body for
shorter periods of time--for example 15 minutes--because
it's the first 15 minutes that does it," Bargert-Lux
said.
Dietary
sources of vitamin D are relatively limited and include
fatty fish and fortified milk, while multivitamins
tend to contain trivial amounts of vitamin D.
CBS
The Early Show 11/27/02
As
the days get shorter and winter approaches, most Americans
will be soaking in fewer sun rays. But that's not necessarily
a good thing, according to Consumer Reports on Health.
The
body relies on the sun to get most of the vitamin D
it needs to stay healthy. Ronni
Sandroff, editor of Consumer Reports on Health, visited
The Early Show to
explain that its current issue reveals that many people
suffer from Vitamin D deficiencies due to a lack of
sun exposure, and that's a bigger problem than previously
thought.
During
the cold months of the year, Americans in the northern
part of the country are most likely to have insufficient
levels of vitamin D. They are getting less sunlight
and what they are getting from the sun is not enough
to help them. On average, people receive 90 percent
of the vitamin D they need from sunlight and 10 percent
from their diet.
Sandroff
says people should get enough vitamin D by exposing
themselves to the sun for 10 to 15 minutes a day without
sunscreen during the warmer seasons of the year - depending
upon how dark your skin is, how
intense the sun is and the season. The winter sun is
too weak to help. A
recent study estimates that tens of thousands of Americans
die each year of cancers possibly caused by too little
sun exposure and too little vitamin D.
Vitamin
D helps the body absorb calcium from food, which makes
minerals available to the bones. Deficiency of vitamin
D prevents new bone tissue from hardening, a condition
known as rickets in children and osteomalacia in adults.
It can also increase problems with osteoporosis in
women. Moderate insufficient levels of vitamin D, can
increase the risk of fractures.
Research
studies have found that insufficient levels of vitamin
D can also contribute to developing different types
of cancer such as colon and prostate cancer, heart
disease and diabetes.
Sandroff
says the people at the greatest risk of having a vitamin
D deficiency are people 65 or older, African-Americans
and the obese.
Seniors
tend to wear more protective clothing and stay indoors
more than younger people, and their skin loses its
ability to synthesize the vitamin. Also, older people
are more likely to take laxatives and a cholesterol
lowering drug called Questran, which interferes with
the absorption of vitamin D. Questran is the only cholesterol-lowering
drug that has been found to cause this problem.
African-Americans
may suffer from vitamin D deficiency because of their
problem of sun ray absorption. The darker the skin,
the more sunlight is needed to generate vitamin D.
A recent study from the Centers for Disease Control
found that 40 percent of black women had insufficient
levels of it.
Benefits
of UV Light
Antibacterial
-- The antibacterial qualities of the sun's rays and
their exfoliating effect on the skin work to alleviate
the effects of skin disorders such as acne, eczema
and psoriasis.
Cholesterol
Lowering -- Skin contains squalene, a chemical that
is converted to cholesterol if it receives insufficient
sunlight.
Lower
Blood Pressure -- Studies have shown a correlation
between lack of sunshine and increased blood pressure.
Cancer
Prevention -- There is evidence that sunlight can help
to prevent cancers of the breast, colon, prostate and
ovaries, heart disease and multiple sclerosis
Former
American Cancer Society Clinical Fellow Supervises
Health Benefits and Sunshine Study by M. Janet
Barger-Lux Senior Research Associate Office Address
Osteoporosis Research Center Creighton University Medical
Center 601 North 30th Street Omaha, NE 68131-2197 Office
Phone: 280-4465 Fax: 280-5173
Reuters
Health Story
Avoiding
the sun is UNHEALTHY according to a CLINICAL FELLOW
at the AMERICAN CANCER SOCIETY!!!!
Summer
Sun Can't Sustain Vit. D Levels Year-Round Sept. 24,
2002
SAN
ANTONIO (Reuters Health) - Counting on the sun alone
for vitamin D will leave most people deprived of adequate
amounts of this nutrient, especially during the winter
in the northern parts of the US, researchers report.
This is true even for people who work outside during
the summer and get plenty of sun in the warmer months
but not in the winter, according to study results presented
here at the annual meeting of the American Society
for Bone and Mineral Research.
Vitamin
D is formed in the skin, but it requires ultraviolet
rays of the sun to activate it to a form the body can
use. Vitamin D, which assists the intestines in absorbing
calcium and phosphorus, is also contained in some fortified
foods.
For
the study, Janet Barger-Lux, senior research associate,
and Dr. Robert Heaney, both from Creighton University,
Omaha, Nebraska, calculated the daily skin dose of
vitamin D that 26 men who worked outdoors during the
summer would have received. They brought the men back
about 6 months later to assess how much vitamin D they
may have lost over the winter. The team estimated that
the amount of vitamin D that the group had received
from the sun during the summer was equivalent to approximately
2800 international units (IU) of vitamin
Recommended
daily doses of the vitamin are 200 IU per day for adults
aged 19 to 50, 400 IU for those aged 51 to 70, and
600 IU for those over 70.
When
the men were reassessed during February and March of
the following year, vitamin D levels had fallen to
less than 80 nanomoles per liter (nmol/L) in roughly
half of the group. Vitamin D levels of at least 80
nmol/L are recommended to ensure optimal cellular health.
"We
don't want to promote excessive sun exposure, but from
the standpoint of making vitamin D naturally in the
skin, we need to expose greater areas of the body for
shorter periods of time--for example 15 minutes--because
it's the first 15 minutes that does it," Bargert-Lux
said.
Dietary
sources of vitamin D are relatively limited and include
fatty fish and fortified milk, while multivitamins
tend to contain trivial amounts of vitamin D.
Patient
Education Information, National Institute of Mental
Health, Clinical Psychobiology Branch, 1995
Research
on seasonal affective disorder (SAD) and light therapy
has been undertaken since the early 1980s. Since then,
researchers in the United States, Europe and Japan have
reported that light therapy improves the symptoms of
SAD. Researchers at various centers have also found that
light therapy may be helpful for other conditions including:
- Non-seasonal
depression
- Delayed
sleep phase syndrome (a condition in which people
have difficulty falling asleep and waking up at conventional
times
- Premenstrual
syndrome
- Shift
work and jet lag difficulties.
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704-455-7840 ~ 704-455-7846 (Fax) ~ 800-831-7649 or 800-647-8870
Toll Free
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