College Tanners: Hard Lessons Learned

When Courtney McClanahan enrolled as a freshman in college in 2006, she was impressed by her school’s newly renovated, state-of-the-art recreation center with a hot tub, steam room, smoothie bar and ultraviolet (UV) tanning salon. “It had everything you wanted in one place,” McClanahan recalls.

The Communications major had tried tanning beds a few times in high school before her senior prom, but in college she developed a full-fledged bronzing habit. Naturally pale-skinned, she went for twice-weekly tanning sessions with her girlfriends, using an unlimited tanning pass debited monthly to her student account. “Looking back, I see they made it easy for students to tan,” says McClanahan, now 26. “If a sorority formal or dance was coming up, I wanted to be darker to look nice in a dress. I thought it made me look better. But now I look at pictures of myself from then, and I see I was bright orange or burnt.”

For many young adults, using UV tanning devices is firmly rooted in college culture. Despite the well-established link between tanning beds and skin cancer, more than half of all US college students have tried these devices at least once, according to a 2014 meta-analysis published in JAMA Dermatology.1 Young white females ages 18-25 are among the most vulnerable:2 they are the most frequent tanners, and their skin cancer rate has been rising rapidly. In young people ages 15 to 39, melanoma incidence among females more than doubled between 1973 and 2004.3

McClanahan

The Pressure to Be Pretty

When young women are living away from home for the first time, and the pressure to fit in and feel beautiful is strongest, many coeds become habitual indoor tanners. Whether it’s to achieve a so-called “base tan” before spring break or maintain a glow for campus formals, the lure of tanning is constant. In a 2014 survey of sorority members at the University of North Carolina, 45% of respondents had used tanning beds.4 Asked why, the young women said they did it to improve their appearance (to look thinner and more toned, and to hide skin imperfections); many also reported that it reduced stress and relaxed them. A majority of the students admitted knowing the health risks, but tanned anyway.

McClanahan was well aware of the hazards of tanning. “What’s crazy is how bad I knew it was; my dad had skin cancer and so did grandpa,” she says. But she felt more confident with a tan, and didn’t think skin cancer could happen to her.

At 25, just three years out of college, her perspective abruptly changed, when a scab-like growth on her forehead was diagnosed as a basal cell carcinoma. Her doctors performed minimally invasive Mohs surgery to remove the tumor, leaving an inch and a half vertical scar that has since faded. Since this wake-up call, McClanahan shuns any form of tanning, has become vigilant about sun safety and sees her dermatologist for a skin check-up every six months. Today, working as an entertainer aboard a cruise ship, she packs a large stash of sunscreens, which she constantly shares with colleagues. “I’m very vocal about sun safety now. It hurts me to see people lying out in the sun. And tanning in tanning beds is not worth it! Embrace your natural color and protect yourself. Your skin will thank you 20 years from now.

Bonding in the Sunbed

As a freshman at Amherst College in Massachusetts, Kirby Williams started tanning with her girlfriends during regular trips to a salon in town for manicures, waxing and other beauty treatments. “It was a fun group activity. And during the long winters, it would give you a high, like you had been out in the sun,” said Williams, who has red hair and light skin.
Her skin was so fair that tanning salon operators allowed her to tan for only three-to four-minute sessions. “My friends and I would laugh about it,” she says. “I tried to get them to let me do more. It was ridiculous. I was burning my skin.”

A few years out of college, Kirby noticed a mole on her leg that had suddenly increased in size and turned dark brown. She put off seeing her dermatologist for a few months, but when she did, she learned it was an early melanoma that had to be removed immediately.

While “improving appearance” remains the main reason people say they tan indoors, social factors also drive this choice. After conducting a focus group of college-aged female tanners, Jerrod Stapleton, PhD, a behavioral scientist at Rutgers Cancer Institute in New Jersey, was surprised to see how large a role peer influence played in tanning. “A lot of women talk to their friends and engage in conversations about tanning to a level I found surprising. They compare their tans to friends’ and go on tanning dates.” Stapleton observed some women tanning three to four times a week, beyond what they needed to maintain a bronze. “If it were only about having a tan appearance they’d go once a week, so I think there’s more to it.”

Identity and Addiction

For some frequent tanners it can be especially hard to quit because it’s so tied up not just in their idea of beauty but in their very identity. “These women have internalized tanning as an important way they need to look and part of who they are,” said Stapleton. “To hear them talk about how they monitor their looks and compare how tan they are really speaks to the power of tanning.”

Influenced by images of bronzed celebrities and models, Lauren Beloff, of Hoboken, NJ, became hooked on tanning in college after she won a one-month tanning pass in a contest. With the tanning salon near her school, she and her girlfriends dropped in for quick sessions between classes or after working out. “A lot of my friends went. We didn’t talk about the dangers of tanning back then,” said Beloff, now 31. “College students can be insecure; everybody was trying to fit in. The more I tanned, the more compliments I got. I loved the way I looked,” she said.

At one point, Beloff was visiting the salon up to three days a week. For some frequent users, whether they know it or not, the “power of tanning” may amount to both a physical and psychological dependency. Researchers have found that a segment of habitual tanners are addicted to UV light much like those addicted to drugs or alcohol. Frequent ultraviolet light exposure releases endorphins in the pleasure centers of the brain, creating feelings of relaxation and wellbeing that reinforce the behavior.5 A 2010 study of 229 college tanners found that 39% met the scientific criteria for addiction to indoor tanning.6

The tanning pull affected Beloff so strongly that she continued to visit tanning salons even after she was diagnosed in 2007 with a stage I melanoma on her chest. “I went tanning the day after I had a biopsy showing melanoma. I had to be tan,” she said. She feared being “a pasty white girl” and prided herself on not having to wear makeup with her bronzed skinIn the end, it wasn’t the potentially deadly melanoma on her body that made her give up tanning, but a far less dangerous cancer on her face, because this time the cancer was visible to others. She quit the habit in 2012, when she had a BCC removed below her lower right eye. Doctors had to scrape down to her muscle to remove the tumor, and young, single Beloff feared she would have an unattractive scar on her face for the rest of her life. “I knew at that moment I would give up tanning.”

Fortunately, she was left without a major scar, and today Beloff accepts her naturally porcelain skin. She takes pride in telling people her skin cancer survivor story and realizing that her health is much more important than a bronzed hue. “It was a horrible experience to go through. I get very annoyed now when I see people walk into tanning salons. I was that girl, and it didn’t work out well for me.”

Published on August 18, 2015

Making It Too Easy

Diana Schmitz, a senior at Texas Tech University in Lubbock, Texas, has a long scar by her elbow from an early but high-risk melanoma removed earlier this year. As a freshman, she had convinced her parents to buy her a tanning pass to achieve a glow in time for a spring sorority formal. No tanning salons are available on her campus, but the nearby town has up to five salons, which she visited regularly, she said. Occasionally, she would also use the free tanning beds available at her friends’ off-campus apartments. “Pretty much every apartment complex has a tanning bed,” said Schmitz.

That summer, home in Dallas, she noticed a mole on her arm that looked different. Her dermatologist checked it but didn’t seem concerned. He took a biopsy, just in case. A week later she received a call saying it was melanoma. “It was surreal,” said Schmitz. “It was instant regret that I had used tanning beds.”

Back at school, people started to ask Schmitz about her scar, and she made a point to tell them about her tanning experience. “It affected me deeply. It’s so scary and traumatic to have to go through. A lot of my friends have listened and stopped using tanning beds."

She also thinks colleges need to do more to protect their students. “I look at tanning as something that is so dangerous and unnecessary. To make it that easy to have tanning beds where students live makes me really angry.”

  • > References

    Wehner MR, Chren MM, Nameth D, et al. International prevalence of indoor tanning: a systematic review and meta-analysis. JAMA Dermatol 2014; 150(4):390-400.

    Morbidity and Mortality Weekly Report: Use of indoor tanning devices by adults—United States 2010. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6118a2.htm Published May 11, 2012. Accessed March 5, 2015.

    Purdue MP, Freeman LEB, Anderson WF, Tucker MA. Recent trends in incidence of cutaneous melanoma among US Caucasian young adults. J Invest Dermatol 2008; 128:2905-2908.doi:10.1038/jid.2008.159; published online 10 July 2008. Last checked June 4, 2014.

    Noar SM, Myrick JG, Morales-Pico B, Thomas NE. Development and validation of the Comprehensive Indoor Tanning Expectations scale. JAMA Dermatol 2014; 150(5):512-521.

    Hornung RL, Poorsattar S. Tanning addiction: the new form of substance abuse. The Skin Cancer Foundation Journal 2010; 28:28-29.

    Mosher CE, Danoff-Burg S. Addiction to indoor tanning: relation to anxiety, depression and substance abuse. Arch Dermatol 2010; 146(4):412-417.7. Roth AJ. FDA accepts sBLA for adjuvant ipilimumab in melanoma. OncLive March 2, 2015. http://www.onclive.com/web-exclusives/FDA-Accepts-sBLA-for-Adjuvant-Ipilimumab-in-Melanoma