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PATIENT INFORMATION
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Opinion: Save your hide — skip the tanning bed
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Public Health Advisory on Para-phenylenediamine (PPD)
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Patient Information- Weblinks
Opinion: Save your hide — skip the tanning bed
Don't buy what the indoor tan industry is selling: Lies, wrinkles and cancer
COMMENTARY
by Arthur Caplan, Ph.D., Director of the Center for Bioethics at the University of Pennsylvania.
A couple of high school students in my neighborhood recently told me they are getting ready to hit the beach this summer by tuning up their suntans inside tanning beds.
When I asked one of my colleagues here at Penn, Dr. William James, a professor of dermatology, if the high school students had the right idea about getting a head start on a tan, he laughed out loud. A tan, he said, represents nothing more than damage to the skin. It is the body trying to defend itself against an environmental hazard — too much UV light. In other words, indoor tanning gets you ready for the beach in the same way that getting scalded in a hot tub gets you ready to be boiled alive.
So who is to blame for the idea that damaged skin is beautiful? Why do so many societies view a tan as a sign of radiant health rather than as a sign that you are starting to resemble a charcoal broiled steak? The main culprit, of course, is the fashion industry.
Prior to the 20th century women were fanatical about avoiding exposure to the sun. Umbrellas and parasols went everywhere with any woman who could afford them. The French fashion designer Coco Chanel changed all that.
Back in the 1920s, Coco, looking to create a new “healthy” look to promote summer wear, popularized tanned skin. Women began sunbathing and those with a tan were seen in high society as beautiful. Voila! Skin damage as fashion accessory. You’ve gotta love an industry that has made anorexia and damaged skin cool.
Other interests piled on to make dough out of burnt skin. The beauty and suntan lotion businesses make billions every year selling goop so we can lounge in the sun with far less protection then the industry would have you believe their nostrums provide.
The travel industry also likes this look. Having a tan in the winter means the toasted soul has taken a vacation in an exotic, warm climate. That’s why hotels and travel promoters regale us with images of people with brown, damaged skin frolicking around pools and beaches without a hat, a coverup or an umbrella in sight.
But worst of all in promoting pre-cancerous tissue as healthy is the indoor tanning industry, led by its corporate arm the Indoor Tanning Association.
This outfit actually launched a PR campaign earlier this year, and I am quoting now, titled “Attacking Melanoma Hype.” The press release contains a quote the likes of which has not been seen since Big Tobacco was lying through its teeth to Congress about the safety of smoking. Sarah Longwell, spokeswoman for the ITA, actually said in a recent press release: “Both the sun and tanning beds have been unnecessarily demonized by special interests using junk science and scare tactics.”
Just so we all understand what is going on here, the alligator-skinned guy who runs the tanning parlor down at the local strip mall has formed an association with other wrinkle promoters. This leathery cabal has declared that the industry they run is legitimate, that the machines they use are great, that kids should use their services, too, and that there is no problem getting tanned year-round and, oh yeah, you should stop paying attention to those doctors, cancer societies and grieving family members mumbling about melanomas.
Don’t get me wrong. There is nothing good about outdoor tanning either. Whether you bake your skin on the beach or in a tanning parlor, the evidence that both are bad for you is overwhelming.
Half of all cancers in the United States are skin cancers. Melanoma, the most serious type of skin cancer, accounts for about 60,000 cases and causes 11,000 deaths every year in the U.S. We spend nearly a billion dollars each year treating melanomas.
So who are you going to listen to — a bunch of folks in white coats* with lots of degrees who make money sawing cancerous bits off sun worshippers — or the guy with a store full of coffins with light bulbs at a strip mall?
Don’t buy what the tanning industry is selling. Save your hide.
*According to the American Cancer Society, unprotected and/or excessive exposure to ultraviolet (UV) radiation causes skin cancer. Add to the list: the Working Group of the International Agency for Research on Cancer IARC, the American Academy of Dermatology, the Canadian Cancer Society, the Skin Cancer Foundation, the British Medical Association, the Australian Medical Association and the Cancer Society of New Zealand.
Caplan, Arthur (June 27, 2008). "Save your hide — skip the tanning booth". MSNBC.com. Retrieved on 2008-07-02.
Public Health Advisory on Para-phenylenediamine (PPD)
(Additive in Black Henna Tattoos)
The Academy has written this notice to inform and warn the public that para-phenylenediamine (PPD), a common hair dye, is being added to henna to make black henna for use as temporary tattoos. The warning statement below recommends that this practice be stopped because there is the potential for long lasting allergy.
Warning Information
Henna tattoo artists are currently adding PPD to henna to make black henna. PPD has long been known to cause allergy and the concentrations used to make temporary black henna tattoos are significant.
Persons who become allergic to PPD may also demonstrate allergy to significant medically necessary medications (diabetic medications, hypertensive medications and anesthetics), in addition to hair dye and dyes used in clothing.
Health care providers should be aware of this adulteration of henna (which is brown) by PPD and warn patients and parents of the possibility of this long lasting allergy, which includes both anaphylactic and delayed types of allergy. Furthermore, PPD can have detrimental and permanent skin adverse effects (such as blisters, pigment changes and scarring).
Heath care providers should carefully evaluate patients in whom reactions have occurred and provide educational information, so that persons do not receive these black henna applications in the future.
Background
Paraphenylenediamene (PPD) is an oxidative chemical frequently used as a permanent hair coloring agent. Serious reactions to this chemical prompted a revision of the obsolete Food and Drugs Act of 1906 and development of the Food, Drug, and Cosmetic Act (c. 1938). The new act extended regulatory control of cosmetics for the first time and its first action was to remove Lash Lure™ (eyelash cosmetic with PPD) from the consumer market and the prohibition of PPD in cosmetics directly applied to the skin.
A recent increase in pediatric consumers using PPD-adulterated henna for temporary tattoos has likewise come with an increase in serious cutaneous inflammatory and scarring reactions. In addition to scarring, there is the potential for persons sensitized to PPD to have lifelong allergic intolerance of dyes in hair products, rubber chemicals, inks and textile dyes and to some medications to treat hypertension and diabetes (e.g. hydrochlorothiazide and sulfonylureas). To draw attention to the practice of PPD-henna tattooing, the journal Dermatitis, official journal of the American Contact Dermatitis Society (ACDS), named PPD as the “Allergen of the Year” in 2007. Despite this, the temporary tattooing practice continues to flourish, unregulated.
Health Canada, the federal department responsible for helping Canadians maintain their health, has alerted its citizens to avoid “black henna” temporary tattoo ink and paste containing PPD. Section 16 of their Food and Drugs Act prevents the sale of cosmetics that may harm the consumer, including “black henna” temporary tattoos containing PPD.
The Scientific Committee on Cosmetic Products and Non-Food Products (SCCPNFP) has assessed the use of PPD and similar chemicals as hair coloring agents, and made appropriate recommendations on the use concentrations, restrictions, and warnings for such application in the European Community Cosmetics Directive. This states that “When PPD and similar chemicals are used for skin staining (temporary tattoos), active sensitisation may occur within a few weeks, and the reactions can be very severe. Pigmentary variegation may persist for a prolonged period following such reactions. The sensitisation will be life long.” Notably “The SCCNFP is of the opinion that PPD and similar chemicals should not be used in skin stains (temporary tattoos).”
The American Academy of Dermatology, American Contact Dermatitis Society, and the Society for Pediatric Dermatology endorse the ban set forth by the Food and Drug Administration that paraphenylenediamine should not be applied to the skin and recommend that the practice of applying paraphenylenediamine-adulterated henna tattoos to the skin be stopped.Jacob SE, Zapolanski T, Chayavichitsilp P, Connelly EA, Eichenfield LF. p-Phenylenediamine in black henna tattoos: a practice in need of policy in children. Arch Pediatr Adolesc Med. 2008 Aug;162(8):790-2
Patient Information - Weblinks
Take two minutes to examine your skin now! Learn how to examine your skin so you can detect melanoma early. Note: Thanks to the Melanoma International Foundation for use of this video and Martin Weinstock, PhD, MD, creator of the video (with the American Cancer Society).
www.melanomaintl.org/melanoma_info/examine.html
Information on skin cancer prevention and treatment:
www.mdanderson.org/diseases/skincancer
Find out more about how to protect you and your family from the damaging rays of the sun while still enjoying your outdoor activities.
www.skincancer.org
Learn about the dangers of indoor tanning and why this is not a safe way to get a tan.
www.skincancer.org/tanning
Learn about Melanoma an increasingly common form of skin cancer that can affect people of all ages. With early detection the outlook for most patients with Melanoma is very good.
www.skincancer.org/melanoma/index.php
Information on skin tanning, Ultraviolet (UV) exposure, UV emitting products, and skin protection:
http://www.fda.gov/cdrh/tanning/
Indoor Tanning in Youth:
http://indoortanningreportcard.com
Attention Teachers
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