CHICAGO -- Photographs that reveal hidden skin damage from ultraviolet (UV) exposure from the sun, combined with information on sunless tanning alternatives, was effective in encouraging sun protection behaviors in a small group of college students, according to an article in the March issue of the Archives of Dermatology, one of the JAMA/Archives journals.
Although most cases could be prevented, the incidence of new skin cancer, including the most deadly form, melanoma, is increasing more rapidly than that of any other type of cancer, according to background information in the article. Public education has been successful in raising awareness about the dangers of UV exposure, but has been less successful in motivating protective behavioral change. The authors suggest that young adults in particular are likely to be more interested in the appearance-enhancing benefits of tanning than the possibility of developing skin cancer in the distant future.
Heike I. M. Mahler, Ph.D., of the University of California, San Diego, and colleagues tested an intervention designed to address individuals' concerns about appearance in a small group of college students. One hundred forty six undergraduates (114 women and 32 men) were invited to participate in a study titled "Health Attitudes" for which they completed a questionnaire that assessed their sunbathing and sun protection practices.
The intervention group (95 students) had two photos taken of their faces, one under normal light and one with a UV filter. Underlying skin damage caused by chronic UV that can result in wrinkles and age spots is visible in the UV photographs but not in the ordinary photos. The intervention group received information on the aging effects of the sun as well as the other risks of UV exposure. Half of the intervention group were given a sample of a sunless tanning lotion. All the students filled out a second questionnaire on their intended future sunbathing and sun protection behaviors. The students were contacted a month later in a "surprise" telephone follow-up, of which they had not been informed.
"Neither the intervention alone nor the intervention plus sunless tanner use significantly reduced these [previous] already low sunbathing rates..." the authors report. "However, the intervention significantly increased use of sun protection during incidental sun exposure." Thirty-seven percent of those who received the sunless tanner reported using it. Sixty one percent of the participants told at least one friend or family member about what they had learned from the study about UV damage and sun protection, while those in the intervention group talked to significantly more friends and family about what they had learned.
"Assuming that future work confirms the efficacy of the intervention using more objective indicators of behavior, this appearance-based intervention can have important practical applications," the authors conclude. "Ultraviolet instant cameras are readily available, relatively inexpensive, and simple to operate. ... In addition, it is likely that the endorsement by a physician or nurse of sunless tanning lotion as a safe and effective alternative to UV exposure would induce more individuals to try it. Based on the trends observed in this experiment with the small percentage of participants who tried the sunless tanning lotion, this might lead to additional sun protection behaviors."
(Arch Dermatol. 2005;141:373-380. Available post-embargo at archdermatol.com)
Editor's Note: This research was supported in part by grants from California State University, San Marcos, Calif., a grant from the Cancer Research and Prevention Foundation, Alexandria, Va., and a grant from the National Cancer Institute, Bethesda, Md.
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