‘Safe’ tanners who use sprays and lotions less likely to get tattoos and piercings than frequent sunbathers and tanning bed users

"When compared to infrequent tanners, frequent body-tanners -- regardless of whether they are tanned by ultraviolet light from the sun, ultraviolet light from a tanning bed or methods such as tanning sprays that do not involve UV light -- showed significantly higher behavioral intentions to engage in risky appearance-related behaviors overall," said Jay Yoo, Ph.D., associate professor of family and consumer sciences in Baylor's College of Health and Human Sciences.

"Safer tanners, on the other hand, are more concerned about modifying their bodies in ways such as tattoos and piercing that may carry a stigma," Yoo said.

Most skin cancer prevention campaigns have emphasized avoidance of getting sunburned, reducing UV exposure and applying sunscreen, but they have neglected the individual's experience with social and appearance concerns, he said.

But "Excessive tanning can serve as a possible sign of overt concern over body image, with vulnerability to greater health risks," Yoo said.

His research article -- "A Study of the Relationships between Tanning Methods and the Intention to Engage in Risky Appearance-Related Behaviors" -- is published in Family and Consumer Sciences Research Journal. Data for the study was collected from an online survey of 395 female college students in the southern United States.

The major contributor to skin cancer is frequent exposure to ultraviolet rays, with skin cancer the most common -- and one of the most preventable -- types of cancer, according to the American Cancer Society. Ironically, previous research has found that many people choose to tan because they believe a tan makes them look thinner and more fit, Yoo said.

Tanning has gone in and out of fashion, Yoo noted. In the past, tans were associated with lower classes who worked outdoors -- in contrast with the Southern belles of more than a century ago, who used parasols to protect their skin and to look pale and refined.

In the 1920s, fashion designer Coco Chanel started a fad after accidentally getting sunburned while visiting the French Riviera, Yoo said. Tanning remained popular, with high-fashion models often sporting tans, whether from UV exposure or sprays and bronzers. And these days, some people sport tattoos along with their tans, he said.

The study found that:

• Frequent tanners who expose themselves to UV rays through sunbathing or tanning beds have the strongest intentions to engage in a wider range of risky appearance-related behaviors when compared to infrequent tanners or spray tanners. Such behaviors include extreme weight control methods, such as diet pills, self-induced vomiting, laxatives and diuretics; cosmetic surgery and Botox injections; spa treatments, such as hair removal by waxing (which has been associated with rashes and infections) and gel nail polish (done with UV curing and associated with DNA damage to the skin that can result in premature aging and possibly cancer; and tattoos or piercings.
• Infrequent tanners, as well as "safe" tanners who seek to achieve an ideal tan without ultraviolet methods (sprays, lotions or bronzers) are much less likely to engage in behaviors that may convey certain stereotypes, such as tattoos or piercings with visual symbols or messages. But they are willing to try other risky appearance-related behaviors.

Yoo suggested that intervention strategies adapted for healthcare providers to reduce UV exposure and skin cancer could use stigmatization -- perhaps through images of tattooed or pierced individuals who also are tanned.

"A negative stigma attached to UV exposure can create ambivalence in our society about achieving a tanned appearance," Yoo said. "This could decrease the popularity of tanning in much the same way the negative stereotyping of smoking and education about its health risks have reduced the number of people who smoke."

He noted that in the 1940s and 1950s, smoking was idealized, especially in Hollywood movies, but "there has been a cultural shift," he said.

"One way to change the appeal of tanning would be to make it un-cool," Yoo said. "If I tan and people look at me funny, I'm not going to tan anymore."

While another way to stigmatize tanning would be to stress the health consequences, "for young people it may be more effective to emphasize the appearance," Yoo said. "The tanning that makes me attractive now may be counteracted for the long haul because at 50 or 60, I may have leathery skin.

"Given that tanning emerged as a fashion trend, gradual attitudes toward dangerous tanning can be made possible in a similar fashion," he said.