Brazen in the Sun

by by By Dana Reilly

illustration by by Becca Levinson

Twenty some years ago, Jason Neustadter, a student at Atlantic City High School, left the tanning salon with blistering pink skin. Growing up in a shore town, Neustadter aspired to the bronze physique of other body-builders. He used tanning beds for a little over a year, and loved the look of a “healthy tan”—a phrase he now considers an oxymoron.

In 2005, Neustadter was about to start a job as chief resident of radiology at Thomas Jefferson University Hospital when he was diagnosed with melanoma, the deadliest form of skin cancer. His lesion was in-situ, meaning curable by a wide surgical excision and, fortunately, was the most superficial type.

“I never had a blistering sunburn after a jog on the beach and my skin never smelled like burnt flesh after a morning on the boat. In my opinion it was tanning beds, or rather my liberal use of them before the age of 18, that did this to me.”

Neustradter undergoes full body skin examinations every four months. “I still approach each visit with a combination of anxiety, fear and dread,” he said.

This month the Rhode Island General Assembly is hearing a bill that would ban the use of indoor tanning facilities by minors without a doctor’s prescription. An identical bill was passed by the Senate last year, but was never called to a vote in the House because of pressure from local salons in key representatives’ districts. A recent study published in the International Journal of Cancer found that compared to study participants who had never used a tanning bed, the risk of melanoma was 41% higher for those who had; for those who reported more than ten lifetime sessions, the risk was almost doubled.

Sixteen other states are considering prohibiting minors under the age of 18 from using UV tanning beds; on January 1, California became the first state in the nation to enact the ban.

In Providence, where tanning salons outnumber McDonald’s restaurants five to one, the proposed legislation has public health officials facing off against tanning industry advocates. Supporting the ban are Providence public health officials like Senator Rhoda Perry, chairwoman for the Senate Health and Human Services Committee and the bill’s architect. Perry points to testimony like the World Health Organization’s 2009 recommendation that UV radiation found in tanning beds should be categorized as a class-one carcinogen, in the company of arsenic, tobacco, and hepatitis C. “This is a very important public health initiative,” said Perry in an interview. “In the same sense that we have put in place laws that protect minors from smoking and alcohol and other harmful products, it’s about time we address this issue.”

Steve DeToy, a spokesman for the Rhode Island Medical Society, says the indoor tanning industry has been less than honest with the public: “The tanning industry for years used that ploy that it was a healthy way to get vitamin D.” In 2010, the Federal Trade Commission shut down an ad campaign launched by the Indoor Tanning Association to defend its industry against mounting criticism. “They even promoted it for pregnant women who needed vitamin D,” said DeToy. “That was the argument that the Federal Trade Commission found, in a word, bogus.” Just as the FTC charged the cigarette industry with misleading and deceptive advertising in 1950, DeToy believes the FTC verdict has exposed the deception surrounding UV tanning.

Bob Simpson, owner of Sun Sational Tanning, thinks the comparison to tobacco is “completely ridiculous.” A self-described hippie, Simpson has owned the East Providence tanning salon for 17 years. He equates using tanning beds with lying out in the sun, though he does concede exposure to UV rays can increase the risk of skin cancer. “There’s a risk of skin cancer outside [too],” he said, “but nobody’s regulating the sun.” Simpson has a point: the sun is also classified a class-one carcinogen by the World Health Organization.

While he agrees that regulation is helpful for establishing safe industry standards, as in the case of sunlamps and protective eyewear, Simpson sees the bill as an example of government overreaching. “What’s next… if you’re under 18 you can only go to the beach for half an hour? Where does it stop?”

Juliana Walsh and Karson Dellerman, juniors at East Greenwich High School, only go to the salons for spray tans, a requisite part of the beauty ritual for special events like prom. Juliana said she used to frequent the sun-beds at Exotic Tans, a salon near her high school, until her doctor told her to stop because a birthmark under her chin was a risk for melanoma.

Currently, the Rhode Island Department of Health requires parental consent before minors can tan in one of Providence’s 41 salons. But as with anything illicit, teenagers have found a way to work around the restriction. Leaning across the table outside Nordstrom’s Espresso Bar in Providence Place Mall, Juliana said if some girls’ parents won’t sign the consent form, they use other people’s memberships. Karson added that “a lot of people have fake IDs, so you can just show them that.”

The pressure to have a healthy glow extends beyond teenage girls. A bronzed complexion has become mandatory for stepping in front of a camera. The fad originated in the 1920s when Coco Chanel stepped off the Duke of Westminter’s yacht with a caramel tan. Hollywood studios celebrated dark beauties, like Hedy Lamarr and Rita Hayworth in all their Technicolor splendor, and cultivated the fashion for tanning. With the advent of indoor tanning in the late 1970s, the look associated with wealth and exoticism became available and affordable to the middle class. After the royal wedding in England last year, Debenhams (a large UK department store) attributed a spike of more than 200 percent in fake tanning product sales to Kate and Pippa’s bronze glow. In a press release, the store’s beauty director, Sarah Stern, remarked, “Streams of wannabe princesses have been flooding our store looking to achieve their healthy, groomed look.”

Joining the ranks of British royalty, the cast of Jersey Shore has recently brought tanning back into the spotlight. Last fall, Johnston, RI native Paul DelVecchio (more commonly known by his DJ moniker “Pauly D”) released his own brand of tanning lotions called Pauly D’s Sexy Swagg. Lined up on a shelf next to those of his Jersey Shore costars in Sun Sational Tanning (to name just one salon), Pauly D’s Sexy Swagg is packaged in a hot pink zebra striped bottle bedazzled by fake diamonds, with black cursive promoting its anti-aging and skin firming benefits. For dermatologists, the big worry is the revival of UV tanning beds, not the use of lotions or tinting creams to achieve color.

DelVecchio admitted to suffering from “tanorexia” on the Tonight Show in early January. The term, coined in the last three or four years, describes an addiction to indoor tanning beds. “I have to hold a tan at all times,” he said. “If I don’t, I start hyperventilating, I start breaking out in cold sweats, I can’t eat, I can’t sleep.” After being deprived of his UV fix in Italy during Jersey Shore’s fourth season, Delvicchio introduced a tanning spray to his line, called Bronze Beats, to ensure no one ever has to go without.

Despite the facetious nickname, “tanorexia” is real: several recent studies have suggested that UV light exposure is indeed addictive. As with any endorphin-producing activity, frequent use of tanning beds can create a bodily dependency.

Unsurprisingly, the habit has also been linked to underlying mood disorders. Katherine Philips, a professor of psychiatry at Brown’s Warren Alpert Medical School, says obsessive tanning can be a symptom of body dysmorphic disorder.

Still, Juliana and Karson say tanning is an obsession like going to the gym for some girls in their class. “A lot of people at our school go tanning,” Walsh said. “In the winter, people get so obsessed with not being pale.”

Dr. Lionel Bercovitch, the director of Pediatric Dermatology at Hasbro Children’s Hospital, believes adolescents like Juliana and her classmates are particularly vulnerable. “Adolescents tend to live in the moment, and are often oblivious to or unconcerned about the long-term consequences of their actions… Indoor tanning is very much a part of the adolescent risk-taking behavior pattern,” he says. What’s more, Bercovitch said that adolescents often have fragile self-images, striving to look, act, and dress like their peers and emulate those they idolize. If a tan is part of this ideal, then teens will go through great lengths to achieve it—oblivious to long-term risks.

As spring break approaches, students will flock to salons to build up their base. Many salons offer special deals for high school and college students, and Spring Break Tanning in Bristol accepts the Roger Williams University ID card as a means of payment. It takes at least one week to see results from using a tanning bed. The majority of customers—about 70% of whom are females between the ages of 16 and 29—opt for the extra time and money to avoid the orange-tint and potential streaking associated with spray-tanning.

To Neustadter, it is more troubling when people choose to tan while the information about the risks is so available: “None of that stuff was out there when I was tanning.” His diagnosis changed his life. He returned to medical school to pursue a career in dermatology, and is now a resident again at Brown Medical School, thirteen years after graduating from med school the first time. “If I knew then what I know now, I would never ever even though of tanning.”

DANA REILLY B’12 is not a rotisserie chicken.