Motivating teens not to tan, on teens’ terms

Dr. Cindy Firkins SmithWhen dermatologist Cindy Firkins Smith, M.D., was doing research on the topic of teens and tanning for a presentation earlier this year at 42nd Annual Meeting of the Society for Pediatric Dermatology, she says it surprised her that her assumptions about children’s tanning behavior were not always correct. And Dr. Smith, a clinical professor of dermatology at University of Minnesota, Minn., is more aware of the issue than most. She and colleagues worked for 11 years on legislation to prevent minors from using tanning booths.

So, what surprised her?

“I assumed that everyone tanned because they wanted their skin to be darker. But in doing the research, I discovered that not everyone’s motivations are the same,” Dr. Smith tells Dermatology Times. “In order to encourage people to stop doing this specific behavior, you really have to know what motivates them.”

Mirror, mirror

She cites research by Robinson JK et al published in the Archives of Dermatology 2010 as being among the studies to suggest that the primary reason teens tan is because they think it makes them look better.

“Maybe it’s the difference in their skin color; maybe it’s the difference in the way their clothes look on them; maybe it’s that they look thinner. It’s different for everybody,” she says.

Dermatologists who understand what’s motivating their young patients to tan can appeal to patients’ desires and send more effective messages about the alternatives. For example, Dr. Smith says that talking about tanning and skin cancer risk isn’t generally something to which kids will respond. They’re more likely to respond to warnings about how the tan will make them look--what the UV exposure is doing to increase pigmentation and wrinkles that will start to become etched on their faces in their early 20s, she says.

So, offer alternatives that satisfy their desire to look better. Some options: sunless tanners, a change in makeup or hairstyle or a change of clothing colors that look better against pale skin.

“My mantra is, ‘Love the skin you’re in,’” she says.

Dr. Smith makes it a point to tell pediatric patients of all ages-even toddlers-that their skin color is gorgeous, and she gives them and their parents’ recommendations about how to keep it free of damage for the long term.

“I tell them they should do a really good job of keeping that skin gorgeous,” Dr. Smith says. “But, if a teenager is committed to having darker skin, then we talk about sunless tanners. I’ve had pretty good success with some of my really fair kids.”

While tanning was all the rage in the 1970s, today’s celebrities often flaunt light, sun-damage-free skin. Some examples are Anne Hathaway, Nicole Kidman, Taylor Swift and Katy Perry. Dermatologists can give those examples to their patients, she says.

There are other reasons that kids say they want to tan.

“We learned from Jersey Shore that sometimes tanning is considered a group activity. People might do it for social interaction. If that’s the motivation, suggest better alternatives that don’t involve damaging their skin,” Dr. Smith says. “Some people do it to relax. We’ll point out that this really isn’t a good way to relax because of the damage it does to your skin, [and ask] ‘Have you considered trying yoga?’ ‘Meditation?’…”

There’s still other data that UV exposure is an addictive behavior, stimulating areas of the brain that are stimulated by narcotics.

“So, there are people who may think they can’t give it up. And I try to find out why they can’t and address that issue,” she says.

It can take as little as a minute….

It might take a minute during a clinical appointment to complement a young patient on her skin and way she looks. Dermatologists should never miss the opportunity, regardless of the reason for the patient’s visit, according to the dermatologist.

“I want them to embrace who they are. And what they are. They’re beautiful in the skin they’re in,” Dr. Smith says.

It’s important to address teens’ tanning motives, she says, because, despite public awareness campaigns and even legislation that is now in some 13 states banning teens under 18 from accessing tanning booths, the desire to tan remains stronger than the threat of skin cancer.

One of the things that drives Dr. Smith is a young female patient she lost to melanoma.

“She was diagnosed with melanoma in her 30s. She was a big tanning booth user. Before she died, she asked me to do anything I could to prevent the same thing from happening to others,” Dr. Smith says.

The patient’s story, alone, has resonated with legislators and young patients in the practice, Dr. Smith says.

Other messages that seem to resonate and make a difference, in Dr. Smith’s experience, include talking to young girls about how the color of a prom dress might be just the right color to show off their beautiful skin. The dermatologist says in her 26 years of practice, she’s had scores of kids come back and say how a recommendation she made about how to complement their skin made them realize they didn’t need a tan.

“Sometimes, as a dermatologist, we think we’re powerless, but we’re really not,” she says. 

Disclosure: Dr. Smith reports no relevant disclosures.