Teen Tanners: The New Faces of Melanoma

While it’s no secret that the number of people developing melanoma has long been climbing, one group has had a disproportionately meteoric rise. Women aged 18 to 39 are now eight times more likely to be diagnosed with this potentially deadly skin cancer than they were just 40 years ago.1

This rise in skin cancer rates happens to coincide with the growth of indoor tanning, which was first introduced in the US in the late 1970s, and is now a $5 billion a year industry here.2 People who tan indoors are 74 percent more likely to develop melanoma,3 2.5 times more likely to develop squamous cell carcinoma, and 1.5 times more likely to develop basal cell carcinoma than non-tanners.4

Young women are by far the most frequent users of tanning machines: 71 percent of tanning salon patrons are girls and women aged 16-29.5 Here are the stories of three of them, in their own words. They talk about their experiences, first as indoor tanners — and then as melanoma patients.


Natalie, 23, started tanning regularly when she moved from Florida to Boston. “I tanned because I felt like it made me look prettier and skinnier,” she recalled. “My grandmother begged me not to tan because she was scared I’d get skin cancer. I was like, ‘No, it’s not going to happen to me…’” 

 I tanned indoors for the first time when I was 16, but not regularly until my freshman year of college in Boston, when I went about once every two weeks. During my sophomore and junior years, my friends and I usually tanned 12-15 minutes at least once a week. During summers in Florida, I just lay out. I never used sunscreen, just lathered up the tanning oil. I don’t think I used sunscreen once in seven years! 

Since the end of my teens, I’ve been vigilant about getting my skin checked once a year, because I’m pretty mole-y. The first time I went it was fine. The second time, when I was 21, the doctor biopsied one suspicious lesion on my back, and another on my foot. The spot on my back turned out to be a melanoma in situ, meaning it hadn’t gone past the skin surface, so it was 100 percent curable with surgery. But I couldn’t believe I had done that to myself by tanning — there was no one else to blame. I had to tell my mom, and hear her cry.

It was a three-hour surgery. I took a really long time to recover, and it was very painful. I couldn’t sit, stand, or sleep, and my mom had to take care of me. It was like being a baby again. For a year after the surgery, I had to go to the dermatologist every three months. Now I see him every four; he’s taken photos of all my moles so that he can monitor my skin for changes.

Before my last check-up, I noticed a mole on my upper right thigh scabbing over and itching a lot, and some moles on my upper back were also itchy. My dermatologist had told me to tell him about moles like this. The mole on my upper back had grown a little, so he biopsied that and the one on my leg. Both were diagnosed as atypical moles, which can turn into melanomas, so they are being removed. Developing them after not stepping into a tanning bed since my diagnosis was a little disheartening. It made me realize that the damage has already been done. 

Not a day has gone by since my original diagnosis a year-and-a-half ago that I don’t convince myself a mole somewhere on my body will become a melanoma. Melanoma robbed me of my youth — I was a carefree college student and basically thought I was invincible. In fact, I joked about it once, saying that I might get skin cancer someday, but as long as I was pretty and tan for the moment, it was okay. How stupid and naive of me to say or even think such a thing. My scars now make me look like some Frankenstein. Tanning isn’t worth it.


Kate, 21, started tanning indoors at 16 and worked at a tanning salon after graduating from high school. “I really believed in what I was doing. We [salon staff] were sent to seminars with scientists who told us that tanning beds prevented cancer. I was brainwashed.” 

As a teenager I wanted to be tan, but for someone with naturally red hair and Fitzpatrick Skin Type 1 — the lightest skin type — a tan isn’t natural or sustainable, especially not in winter living in Canada! At 16 I was legally permitted to tan indoors. My parents were against it, but I started tanning anyway, at first weekly, then 2-3 times a week. I ended up tanning up to 16 times a month for approximately 12-15 minutes a session. 

After graduating high school I went straight to the salon to apply for a job. When I was hired I signed a contract saying I would maintain a tanned appearance, and in return I’d get 12 free sessions and one Mystic spray tan a month. I worked at this salon for two-and-a-half years, and was top salesperson for over a year. 

In April 2011 I moved to Ottawa, Ontario for school. A few weeks later my mother noticed that the freckle on my stomach had changed, and she wanted me to have it looked at. I went to see a dermatologist, who thought it looked fine. But he did a biopsy, which left an inch-long scar. I was scared, but convinced myself that everything would be fine. 

Three weeks later the doctor called to tell me that the “freckle” was a melanoma, the deadliest kind of skin cancer. I dropped the phone, and broke down. I had truly believed what I’d been taught by the industry — that tanning prevented certain cancers and that the industry had the documents and scientists to back up these claims. Over the next six weeks I had many doctors’ appointments, three more biopsies for lesions on my breast, leg, and arm — and finally excisional surgery to remove the melanoma, which fortunately was at an early stage, and non-invasive. Today I have a 6-inch scar on my stomach and so much fear. 

I always have new spots appearing and changing. I recently had a couple of biopsies and one came back last week as precancerous, but they got it. I’m going for surgery soon on my left breast, as my doctors recently found two spots they are very concerned about. I’ll never forget going to the surgeon’s office the first time with my mom — he thought she was the patient. When he realized I was the patient, he told me I was the youngest person he’d ever treated for melanoma. I’m only 21.


Chelsea, 24, used tanning beds for years. While the Virginia native knew skin cancer was a possibility, “It wasn’t until after my first surgery, when I found out melanoma had spread to my lymph nodes, that I truly realized it’s a serious, serious disease.”

I’m surrounded by people who have always loved tanning salons. Both of my grandmothers tanned indoors and my aunt actually had a tanning bed in her home. I visited my first tanning salon at age 14. For about six years I tanned for approximately 12 minutes three to four times a week for a month before major events, like prom. Tanning was a social event for me: my college friends and I would carpool to the salon. I didn’t want to be dark, I just wanted to have a “healthy glow.” (I hate that phrase now!) I thought if I only went a few times a year, I’d be fine. 

When I was 23, I scratched an itch on my back that felt like a scab. My boyfriend looked at it and said that the mole on my left shoulder had scabbed over and was leaking a clear fluid. I knew that wasn’t normal, so I called a dermatologist the next day. The dermatologist did a full body check and thought I was OK, but decided to remove the suspicious mole, just to be safe.

Ten days later I was having the stitches taken out and joking with my boyfriend when the dermatologist walked in and blurted out that I had melanoma. He scheduled me to see an oncologist and a surgeon, and prepared me to hear that the melanoma had spread, and that I would need treatment. 

Less than a month later, I had surgery to remove the lymph nodes* under my arms and either side of my neck. The doctors also took about five inches of skin out of my back. They found melanoma in the lymph nodes under my left arm and in the right side of my neck. I was diagnosed with stage III melanoma.** Since then, I‘ve had two more pretty invasive surgeries, and I’m currently enrolled in a clinical drug trial at Memorial Sloan-Kettering Cancer Center in New York City.***

So many people — myself included, when I was first diagnosed — assume that once a doctor removes the melanoma, you’re good to go. Many people assume that I am in the clear now because I currently show no signs of disease. What they don’t know is that my life is planned in three-month spans: I have skin checks, CT scans, and treatments every three months. I am scared to plan past those three months because I never know what the next scan will show. 

My whole life has changed. I went from living on my own in Roanoke, VA, with a full-time job, a huge circle of friends, and a great boyfriend, to moving back home with my parents for months because I couldn’t take care of myself after the surgeries. My life revolves around doctors and blood work and needles and chemotherapy. It’s nothing like what a 24-year-old should be experiencing. Tanning is not worth what your life becomes, how your life totally changes. It’s not “just” skin cancer. It can kill you.

Footnotes to Chelsea’s Story:

* Lymph nodes are immune system glands located throughout the body. They are hubs for the lymphatic system, catching bacteria and other unknown materials and filtering them out as wastes via the lymph fluids. Unfortunately, if melanoma cells reach them, they can pass throughout the body, so doctors often remove nodes closest to the tumor to see if the cancer cells have reached them.

** Cancers are staged I to IV The higher the stage, the more advanced the disease. A stage III melanoma has spread beyond the original tumor site, usually to the local lymph nodes.

*** Patients in clinical trials test the efficacy and safety of new therapies or combinations of therapies before they can be approved by the FDA for general use.


References

  1. Reed K, Brewer JD, Lohse CM, et al. Increasing incidence of melanoma among young adults: an epidemiological study in Olsted County, Minnesota. Mayo Clinic Proceedings April 2012; 87:4:328-334. http://www.mayoclinicproceedings.org/article/ S0025-6196(12)00209-1/abstract. Accessed April 17, 2012.
  2. Demierre MF. Time for the national legislation of indoor tanning to protect minors. Arch Dermatol 2003; 139:520-4.
  3. Lazovich D, Vogel RI, Berwick M, Weinstock MA, Anderson KE, Warshaw EM. Indoor tanning and risk of melanoma: a case-control study in a highly-exposed population. Cancer Epidem Biomar Prev 2010 June; 19(6):1557-1568.
  4. Karagas MR, Stannard VA, Mott LA, Slattery MJ, Spencer SK, and Weinstock MA. Use of tanning devices and risk of basal cell and squamous cell skin cancers. J Natl Cancer Inst 2002; 94:224; doi:10.1093/jnci/94.3.224.
  5. Swerdlow AJ, Weinstock MA. Do tanning lamps cause melanoma? An epidemiologic assessment. J Amer Acad Dermatol 1998; 38:89-98.