A large majority of Europeans — and people elsewhere in the world — apparently believe that a suntan is attractive and healthy.
The former is perhaps arguable, but dermatologists say the latter is dead wrong.
Survey results presented at the 31st European Academy of Dermatology and Venereology Congress this week found that 8 in 10 Europeans say that tanned skin is attractive and 73 percent consider a suntan “healthy.”
Both beliefs were also common outside of Europe, including North and South America, Africa, Oceania, and Asia. According to the survey of 17,000 people worldwide, 67 percent of non-Europeans consider tanned skin attractive and 59 percent believe that a suntan is healthy.
However, Dr. Thomas Wang, the director of Dermatologic Oncology for the Hoag Memorial Hospital Presbyterian Melanoma & Complex Skin Cancer Program in California, told Healthline that tanning is the body’s protective reaction to DNA damage caused by the sun’s ultraviolet radiation.
“When you get a tan, there is an indication showing DNA damage has already taken place,” he said.
Somewhat counterintuitively, the survey, conducted by La Roche-Posay Laboratoires and Ipsos, nonetheless found that 92 percent of Europeans and 86 percent of non-Europeans were aware that sun exposure ages skin.
“If you are not worried about skin cancer, just remember that sun exposure can make you age faster,” said Wang.
“Approximately 90 percent of skin aging is caused by sun exposure,” Dr. Angela Casey, a dermatologist at the Center for Surgical Dermatology and Dermatology Associates in Ohio and the founder of the Bright Girl youth skincare company, told Healthline. “Each day that you apply sunscreen helps your skin stay protected from the damage that is caused by the sun. Just like regular exercise and healthy eating for your body, consistent use of sunscreen daily will help your skin stay healthy and strong.”
Most people, including 84 percent of Europeans and 79 percent of non-Europeans, said they do not protect themselves from the sun year-round.
In fact, researchers found that only 10 percent of Europeans and 14 percent of those outside Europe regularly used sunscreen, wore a hat and protective clothing, and tried to stay in the shade year-round in order to avoid sun exposure.
Casey noted that not only can the sun cause skin damage during any season, but even UV rays reflected off of water, snow, and other bright surfaces can be harmful.
Other common misconceptions highlighted in the survey were that a suntan protects the skin from burning — thus eliminating the need for applying sunscreen — and that sun protection isn’t needed when the weather is overcast.
“The extra melanin in tanned skin may render an SPF of 2 to 4, which is slightly better than no SPF at all,” said Casey. “However, an SPF of 2 to 4 is far from adequate sun protection, and skin can easily be burned after a short amount of sun exposure with such little sun protection.”
“This research shows just how entrenched the ‘healthy’ suntan myth is – even in those who have already suffered sun damage or developed skin cancer,” lead researcher Dr. Thierry Passeron, a lead researcher on the survey and a professor and chair of the Department of Dermatology at the Université Côte d’Azur in Nice, France, said in a press statement.
“The belief that suntans are healthy and attractive is a learned and deeply rooted belief that likely started in the 1920s,” said Casey. “Prior to that time, tanned skin was associated with outdoor labor, usually performed by the lower working class. In contrast, the wealthier upper class prided themselves on pale skin, often using parasols to protect their skin from the sun when outdoors. This attitude changed in the 1920s, when fashion icon Coco Chanel, along with revered publications such as Harper’s Bazaar and Vogue, started associating tanned skin with leisure, wealth, travel, and social status.”
Even 72 percent of high-risk individuals, including those who previously had skin cancer, regard a suntan as healthy, the survey found — a figure that’s higher than among those who had no history of skin cancer or other sun-exposure-related skin conditions.
“My patients with a history of skin cancer likely spent more time in the sun compared to their counterparts who have not had skin cancers. As such, skin cancer patients place value on the recreational experiences, vacations, or work that allowed their sun exposure,” Casey said. “Most of them wouldn’t go back and change those experiences for the trade-off of not having skin cancer. They associate tans with important events in their lives. As such, many have linked ‘tans’ with health, vibrancy, fun, leisure, productivity, happiness.”
Such attitudes die hard, Casey said, and require an incremental approach to change.
“My advice is to employ atomic habits. Make small changes in your routine that you can consistently perform,” she said. “For example, wear a hat when you are outdoors at sporting events. Put your sunscreen next to your toothbrush. You don’t forget to brush your teeth and having your sunscreen there helps sun protection stay top of mind. Focus on applying sunscreen to your face, scalp, and ears, since these areas get sun exposure on most days.”
Experts stressed that sunscreen needs to be reapplied every two hours to provide full protection, but half of the survey respondents who used sunscreen only put it on once per day (and 10 percent said they never used sunscreen at all).
“Most individuals don’t apply the amount of sunscreen needed to achieve the SPF rating on the sunscreen products,” said Casey. “In fact, studies show that in general, most of us apply enough to achieve only half of the SPF rating on a sunscreen product.”
The Society for Pediatric Dermatology offers these sunscreen guidelines:
- For younger children, half a teaspoon for the face and one ounce for the body.
- For older children, teens, and adults, use at least nine teaspoons total, including one teaspoon for the face and neck, one for the torso, one for the back, one teaspoon for each arm, and two teaspoons for each leg.
Most sunscreens are only effective for 90 to 120 minutes, experts note.
They say the choice of sunscreen also is important. The Society for Pediatric Dermatology recommends a broad-spectrum (blocking both UVA and UVB rays) sunscreen with an SPF of 30 or higher. Casey said people with lighter skin should use a minimum SPF of 45.
Direct exposure to the sun should be avoided during the peak hours of 10 a.m. to 2 p.m. The American Academy of Dermatology Association recommends wearing protective clothing outdoors, including a wide-brimmed hat to protect the face, scalp, ears, and neck.