Tans — even from a new drug — aren’t the way to prevent skin cancer

The media had fun reporting on a new tanning drug that causes the skin to darken in much the same way that the sun does. Headlines told us that “Scientists have created a safe sun-free tan,” proclaimed “Suntans for all,” and predicted “Tanning drug could prevent skin cancer.” The science is interesting. But what it means for sun-loving humans remains to be seen.

Last month, a team of Boston-based researchers reported that applying a compound called topical salt-inducible kinase (SIK) inhibitor to skin cells stimulated them to produce melanin, the pigment that determines skin color and provides some protection against cancer-causing ultraviolet radiation. The team had previously used this technique to give mice a tan and now has successfully used it in human skin cells.

This work may prove helpful for people born with little or no natural melanin, such as redheads, since melanin has a sun protection factor (SPF) of about 3 to 4. But a boost that small may not be meaningful for the rest of us. It also pales in comparison to current recommendations to use sunscreen with an SPF of 30 or higher.

Although lead scientist Dr. David Fisher said, “This is not a toy, it’s not a cosmetic,” the market for a tanning drug is huge. Tanning beds are a $2 billion a year industry, and the market for sunless tanning creams and sprays has reached $1 billion annually.

If people with little to no melanin were to use a tanning drug in addition to conscientious use of sunscreen and protective clothing, that could be a public health win. But we worry that people who routinely protect themselves from the sun might also buy into the idea that a chemical will help them tan — and the tan would protect them from skin cancer. That would be a public health loss if a false sense of security caused them to ease up on using sunscreen and wearing protective clothing, resulting in an unintended increase in skin cancer risk.

Fisher suggested combining the tanning drug with sunscreen. But the devil is in the details. For example, sunscreen should be applied every two hours whereas a tanning drug applied that often could create a pretty intense tan. By combining a tanning drug with sunscreen, it might be impossible to know if your tan appeared because of shoddy sunscreen application or the drug. After all, tans from the sun and the drug look identical.

Contrary to popular belief, tanning from the sun is not a good way to protect against skin cancer. That’s because DNA is damaged by ultraviolet radiation in the process.

In fact, ultraviolet radiation from the sun and from tanning beds is the No. 1 preventable risk factor for skin cancer, which affects more than 1 million Americans every year. Skin cancer is more common than breast, prostate, lung, and colon cancers combined. Melanoma is the most deadly form of skin cancer, killing nearly 10,000 Americans a year. Skin cancer is one of the few cancers that have been on the increase over the last few decades. Melanoma is twice as common today as it was in 1973, which points to environmental causes.

Preventing skin cancer would save both lives and dollars, but that would require people to stop wanting to be tan.

The origin of our national obsession with tanned skin is lost in the mists of time. Coco Chanel is rumored to have popularized the tan in the 1920s, shifting its association from outdoor labor to a lifestyle of wealth and leisure. It’s been nearly a century, and the nation’s love for the tan persists. Just visit any beach this summer. Or take a look at the tanning salons in every other strip mall. One study found that tanning salons actually outnumber McDonald’s in major U.S. cities.

America’s obsession with the tan is enormously ironic. The desire of white Americans to be darker-skinned coincides with a long history of oppressing those who are naturally dark-skinned. African-Americans never once reaped the social benefits of Coco Chanel’s campaign. Even the word “tan” as a description of melanin-enhanced white skin is puzzling. The biologically identical melanin in African-American skin is referred to as “black.” At some point, we need to do some soul searching about what this desire to be tan really means.

Researchers have a long way to go before a tanning drug hits the market. In the meantime, it’s important to keep in mind the escalating skin cancer epidemic, the dangers of tanning, and the fact that all skin colors are beautiful.

Sherry Pagoto, Ph.D., is a professor of medicine at the University of Massachusetts Medical School in Worcester, Mass., and president-elect of the Society of Behavioral Medicine. She reports having performed a literature review for Johnson & Johnson regarding motivation to use sunscreen. June Robinson, M.D., is a dermatologist at Northwestern University Feinberg School of Medicine in Chicago.