In May, I watched a group of high school students pose for pictures before their prom. To prepare for this rite of passage, nearly all the girls — including my daughter — spent hours on tanning beds. My wife and I had tried to talk Laura out of signing up for a three-month promotion at a salon. Your skin is naturally beautiful, we said, don’t risk hurting it. We mentioned a new study that showed an increase in cases of melanoma — the most serious form of skin cancer, particularly among females age 15 to 19. But getting in the way of a 17-year-old and her prom plans is like parking a car on the tracks when the train’s approaching. If “everyone” was going to be bronzed, Laura was, too. It’s tougher than you might think to get teenagers to consider long-term consequences.
For me and a lot of others, those potential consequences are reality. Laura’s prom photos were taken a few hours after a patch of skin cancer was excised from my left arm, probably the result of sun damage inflicted years ago. It’s a procedure I’ve undergone four times.
According to the Skin Cancer Foundation, about 3.5 million new cases of skin cancer are diagnosed each year in the United States. That’s more than the number of breast, colon, lung, and prostate cancers combined. The FDA now wants to strengthen its tanning bed regulations and issue a “strong recommendation” against minors using them. Youths under 18 are banned from using them in places like California and Vermont.
In spite of this, many people still insist a tan makes them look and feel better. To Laura, so focused on her appearance for the prom, it didn’t register that Dad was regularly being sliced open and stitched.
Getting across the message about another unhealthy behavior, cigarette smoking, has seemed easy by comparison. Research on tobacco use has become so damning that it can no longer be counterbalanced by a “cool” factor, even when you throw Mad Men into the mix. There’s nothing appealing about a solitary figure puffing away outside in the winter. But tanning remains appealing, especially among teens: Nearly 1 in 4 high school girls tan. It’s associated with good weather and good times.
I understand. Growing up, I was sometimes treated differently because of my skin color. Nearly everyone living in Boston’s middle-class suburbs was white during the 1970s. I was a little more white. The “fair” complexion came from a mix of Irish and French Canadian blood. Lack of pigmentation wasn’t a liability most months. But when summer dawned, I began to stand out. The Italian-American kids up the street appeared to turn a richer shade of caramel by the hour. The Southern California transplants next door had clearly been sun-kissed at birth. I remained stubbornly pale. Or strawberry-milkshake pink if coaxed into broiling on some North Shore beach where the stench of tanning oil overwhelmed the salty air.
In those days, the aim was to magnify the sun’s effects, not deflect UV rays. A tan was mistakenly believed to offer protection. It symbolized a state of well-being. During one torturous weekend on Cape Cod, a woman I hardly knew poked her crinkled forearm into my face and declared, “He’s so white it’s sick.” She advised my mother to consult a pediatrician. More than once, I was the subject of comments that not-so-delicately equated a tan with masculinity. Eventually, I tried to blend in with the sun worshipers by increasing my exposure in carefully measured increments. Occasionally, this tedious regimen allowed me to achieve a hue that approximated off-white parchment paper. Just in time for Labor Day.
Today, my four scars serve as reminders of those attempts to look “normal.” It sounds alarming, but the type of skin cancer I’ve had — basal cell carcinoma — is the most common and easily curable form. Removing one of the slow-growing tumors usually involves relatively simple surgery in a doctor’s office. The extent of the incision surprised me the first time —it has to be large enough to extend beyond the malignant margins —and the smell of burning flesh during cauterization isn’t pleasant. But as my skilled and sympathetic dermatologist tells me whenever I fuss too much: “If you’re going to be told you have cancer, this is the kind you want.”
During the summer, even those willing to take precautions against sun damage probably don’t follow all the recommended preventive measures, such as avoiding outdoor activities between 10 a.m. and 4 p.m. or at least wearing long-sleeved shirts. I try to strike a compromise by seeking shade, applying sunscreen, and keeping every date with the dermatologist. But my skin has a history that can’t be revised. Continued...