In Young Tanners, Fear of Wrinkling Is Worse than Cancer

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How do you get a teenager to comply? Appeal to her vanity.

A new study finds that the best way to get young women to cut back on indoor tanning — which is known to increase the risk of skin cancer — is to warn them about the risk of wrinkly skin, not the risk of deadly melanoma.

“They’re not worried about skin cancer, but they are worried about getting wrinkled and being unattractive,” said Dr. June Robinson, a professor of dermatology at Northwestern University Feinberg School of Medicine and an author of the study published May 17 in the Archives of Dermatology, in a press statement.

The study involved 430 women, average age 19. At the start, they were given a battery of questionnaires to determine their motivations for indoor tanning: among the frequent, “pathological” tanners, some said they did it for mood-enhancing reasons (studies have shown that UV exposure may boost production of endorphins, the body’s feel-good hormones); others did it because they thought their natural, pale skin color was ugly.

A random half of the participants were then given a 25-page booklet that explained the aging effect of UV radiation on skin, and offered readers alternative ways to improve appearance: exercising, using sunless tanning products or choosing outfits that don’t need a tan to look good.

The booklet seemed to work: at a six-month follow-up, women who read the warnings reported having done a lot less indoor tanning than the control group. Overall, women in the control group averaged about 30 sessions per year, while the intervention group tanned an average 20 times. Some women quit tanning altogether. “Young women spend a lot of time worrying about their appearance,” says Joel Hillhouse, the lead author of the study and a professor of community health at East Tennessee State University. “By pointing out how [indoor tanning] will actually hurt their appearance, we are able to get them interested and thinking about the behavior in a new way.”

The warnings even reduced tanning in women who used tanning beds for relaxation and stress relief, rather than appearance — possibly because, regardless of their reason for tanning, women still want to look good. Also, after reading about the hazardous effects of indoor tanning, the study notes, many of the participants reported feeling anxious and having negative thoughts during tanning sessions — which is not exactly relaxing.

The key to any behavior-changing strategy, says Hillhouse, is to avoid talking down to people or diminishing their concerns. “By offering [women] alternative, healthier ways to improve their appearance, we are able to provide them with viable choices to accomplish their ultimate goal, looking better,” he says in regard to the booklet on tanning, which he authored. In follow-up tanning prevention studies, he is planning to target high-school girls and the mothers of preteens to try to get them to help prevent dangerous behaviors in their children from the start.

So, if vanity is such an effective motivator, could other similar public health campaigns be far behind: anti-teen-pregnancy ads that warn girls of the risk of weight gain, for instance? “Actually, similar messages are already being used,” says Hillhouse.Think about the ad campaigns focusing on the idea that smoking or drinking or having sex is ‘not cool.’ These are focused on the teens’ image, which is a form of appearance.”

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