Should You Pop a Zit?

Tempted to pop that annoying zit? See what happens when you do, and why your best bet is to leave it be.

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The Basics: How to Deal With Ingrown Hairs

You just waxed, shaved, or tweezed, but instead of smooth skin, you’ve got little bumps! Here’s how you can avoid pesky ingrown hairs and which danger zones are prone to bumps.

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How to Make a Sugar Face Scrub

Exfoliating and softening your skin is a cinch! Mix these ingredients together for a DIY sugar scrub face mask that will leave your skin soft and you feeling refreshed.

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Skin Biopsy: MedlinePlus Lab Test Information

 

What is a skin biopsy?

A skin biopsy is a procedure that removes a small sample of skin for testing. The skin sample is looked at under a microscope to check for skin cancer, skin infections, or skin disorders such as psoriasis.

There are three main ways to do a skin biopsy:

  • A punch biopsy, which uses a special circular tool to remove the sample.
  • A shave biopsy, which removes the sample with a razor blade
  • An excisional biopsy, which removes the sample with small knife called a scalpel.

The type of biopsy you get depends on the location and size of the abnormal area of skin, known as a skin lesion. Most skin biopsies can be done in a health care provider’s office or other outpatient facility.

Other names: punch biopsy, shave biopsy, excisional biopsy, skin cancer biopsy, basal cell biopsy, squamous cell biopsy, melanoma biopsy

What is it used for?

A skin biopsy is used to help diagnose a variety of skin conditions including:

  • Skin disorders such as psoriasis and eczema
  • Bacterial or fungal infections of the skin
  • Skin cancer. A biopsy can confirm or rule out whether a suspicious mole or other growth is cancerous.

Skin cancer is the most common type of cancer in the United States. The most common types of skin cancer are basal cell and squamous cell cancers. These cancers rarely spread to other parts of the body and are usually curable with treatment. A third type of skin cancer is called melanoma. Melanoma is less common than the other two, but more dangerous because it’s more likely to spread. Most skin cancer deaths are caused by melanoma.

A skin biopsy can help diagnose skin cancer in the early stages, when it’s easier to treat.

Why do I need a skin biopsy?

You may need a skin biopsy if you have certain skin symptoms such as:

  • A persistent rash
  • Scaly or rough skin
  • Open sores
  • A mole or other growth that is irregular in shape, color, and/or size

What happens during a skin biopsy?

A health care provider will clean the site and inject an anesthetic so you won’t feel any pain during the procedure. The rest of the procedure steps depend on which type of skin biopsy you are getting. There are three main types:

Punch biopsy

  • A health care provider will place a special circular tool over the abnormal skin area (lesion) and rotate it to remove a small piece of skin (about the size of a pencil eraser).
  • The sample will be lifted out with a special tool
  • If a larger skin sample was taken, you may need one or two stitches to cover the biopsy site.
  • Pressure will be applied to the site until the bleeding stops.
  • The site will be covered with a bandage or sterile dressing.

A punch biopsy is often used to diagnose rashes.

Shave biopsy

  • A health care provider will use a razor or a scalpel to remove a sample from the top layer of your skin.
  • Pressure will be applied to the biopsy site to stop the bleeding. You may also get a medicine that goes on top of the skin (also called a topical medicine) to help stop the bleeding.

A shave biopsy is often used if your provider thinks you may have skin cancer, or if you have a rash that’s limited to the top layer of your skin.

Excisional biopsy

  • A surgeon will use a scalpel to remove the entire skin lesion (the abnormal area of skin).
  • The surgeon will close the biopsy site with stitches.
  • Pressure will be applied to the site until the bleeding stops.
  • The site will be covered with a bandage or sterile dressing.

An excisional biopsy is often used if your provider thinks you may have melanoma, the most serious type of skin cancer.

After the biopsy, keep the area covered with a bandage until you’ve healed, or until your stitches come out. If you had stitches, they will be taken out 3–14 days after your procedure.

Will I need to do anything to prepare for the test?

You don’t need any special preparations for a skin biopsy.

Are there any risks to the test?

You may have a little bruising, bleeding, or soreness at the biopsy site. If these symptoms last longer than a few days or they get worse, talk to your health care provider.

What do the results mean?

If your results were normal, it means no cancer or skin disease was found. If your results were not normal, you may be diagnosed with one of the following conditions:

  • A bacterial or fungal infection
  • A skin disorder such as psoriasis
  • Skin cancer. Your results may indicate one of three types of skin cancers: basal cell, squamous cell, or melanoma.

Is there anything else I need to know about a skin biopsy?

If you are diagnosed with basal cell or squamous cell cancer, the entire cancerous lesion may be removed at the time of the skin biopsy or soon after. Often, no other treatment is needed. If you are diagnosed with melanoma, you will need more tests to see if the cancer has spread. Then you and your health care provider can develop a treatment plan that’s right for you.

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What’s Living on Your Skin?

Take a closer look at the human body and the billions of bacteria that live on our skin.

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Skin conditions by the numbers

 

Acne

  • Acne is the most common skin condition in the United States, affecting up to 50 million Americans annually.1
  • Acne usually begins in puberty and affects many adolescents and young adults.
    • Approximately 85 percent of people between the ages of 12 and 24 experience at least minor acne.2
  • Acne can occur at any stage of life and may continue into one’s 30s and 40s.3-5
    • Acne occurring in adults is increasing, affecting up to 15 percent of women.3-5
  • In 2013, the costs associated with the treatment and lost productivity among those who sought medical care for acne exceeded $1.2 billion.6
    • More than 5.1 million people sought medical treatment for acne in 2013, primarily children and young adults.6
    • The lost productivity among patients and caregivers due to acne was nearly $400 million.6

Atopic dermatitis

  • Atopic dermatitis affects nearly 28 million Americans of all ages.7
    • It affects up to 25 percent of children and 2 to 3 percent of adults.8
  • An estimated 60 percent of people with this condition develop it in their first year of life, and 90 percent develop it before age 5. However, atopic dermatitis can begin during puberty or later. 8-9
  • In 2013, the costs associated with the treatment and lost productivity among those who sought medical care for atopic dermatitis was $442 million.6
    • The total medical cost of treating atopic dermatitis was $314 million, for an average of $101.42 per treated patient.6
    • The lost productivity among patients and caregivers due to atopic dermatitis was $128 million.6

Hair loss

Psoriasis

  • Approximately 7.5 million people in the United States have psoriasis.13
  • Psoriasis occurs in all age groups but is primarily seen in adults, with the highest proportion between ages 45 and 64.6
  • Up to 40 percent of people with psoriasis experience joint inflammation that produces symptoms of arthritis. This condition is called psoriatic arthritis.14-16
  • Approximately 80 percent of those affected with psoriasis have mild to moderate disease, while 20 percent have moderate to severe psoriasis affecting more than 5 percent of the body surface area.13
  • The most common form of psoriasis, affecting about 80 to 90 percent of psoriasis patients, is plaque psoriasis. It is characterized by patches of raised, reddish skin covered with silvery-white scale.13
  • In 2013, the total direct cost of treatment associated with psoriasis was estimated to be between $51.7 billion and $63.2 billion.6

Rosacea

  • Rosacea is a common skin disease that affects 16 million Americans.17-19
  • While people of all ages and races can develop rosacea, it is most common in the following groups:
    • People between age 30 and 60.20
    • Individuals with fair skin, blond hair and blue eyes.20-21
    • Women, especially during menopause.20
    • Those with a family history of rosacea.21
  • In 2013, the costs associated with the treatment and lost productivity among those who sought medical care for rosacea was $243 million.6
    • More than 1.6 million people sought treatment for rosacea in 2013.6
    • The total medical cost of treating rosacea was $165 million, for an average of $102.26 per treated patient.6
    • The lost productivity among patients and caregivers due to rosacea was $78 million.6

Skin cancer

  • Skin cancer is the most common cancer in the United States.22-23
  • It is estimated that more than 9,500 people in the U.S. are diagnosed with skin cancer every day.24-26
  • The majority of diagnosed skin cancers are NMSCs. Research estimates that NSMC affects more than 3 million Americans a year.6, 24
  • The overall incidence of BCC increased by 145 percent between 1976-1984 and 2000-2010, and the overall incidence of SCC increased 263 percent over that same period.27
    • Women had the greatest increase in incidence rates for both types of NMSC.27
    • NMSC incidence rates are increasing in people younger than 40.27
  • More than 1 million Americans are living with melanoma.28
  • It is estimated that 178,560 new cases of melanoma, 87,290 noninvasive (in situ) and 91,270 invasive, will be diagnosed in the U.S. in 2018.25-26
    • Invasive melanoma is projected to be the fifth most common cancer for men (55,150 cases) and the sixth most common cancer for women (36,120 cases) in 2018.25-26
  • Melanoma rates in the United States doubled from 1982 to 2011.23
  • Caucasians and men older than 50 have an increased risk of developing melanoma compared to the general population.25-26
  • Melanoma is the second most common form of cancer in females age 15-29.29
    • Melanoma incidence is increasing faster in females age 15-29 than in males of the same age group.30
  • Skin cancer can affect anyone, regardless of skin color.
    • Skin cancer in patients with skin of color is often diagnosed in its later stages, when it’s more difficult to treat.30-31
      • Research has shown that patients with skin of color are less likely than Caucasian patients to survive melanoma.32
    • People with skin of color are prone to skin cancer in areas that aren’t commonly exposed to the sun, like the palms of the hands, the soles of the feet, the groin and the inside of the mouth. They also may develop melanoma under their nails.31
  • On average, one American dies of melanoma every hour. In 2018, it is estimated that 9,320 deaths will be attributed to melanoma — 5,990 men and 3,330 women.25-26
  • The five-year survival rate for people whose melanoma is detected and treated before it spreads to the lymph nodes is 99 percent.25-26
  • The five-year survival rate for melanoma that spreads to nearby lymph nodes is 63 percent. The five-year survival rate for melanoma that spreads to distant lymph nodes and other organs is 20 percent.25-26
  • The annual cost of treating skin cancers in the U.S. is estimated at $8.1 billion — about $4.8 billion for NMSC and $3.3 billion for melanoma.22

1Bickers DR, Lim HW, Margolis D, Weinstock MA, Goodman C, Faulkner E et al. The burden of skin diseases: 2004 a joint project of the American Academy of Dermatology Association and the Society for Investigative Dermatology. Journal of the American Academy of Dermatology 2006;55:490-500.

2Bhate K, Williams HC. Epidemiology of acne vulgaris. The British journal of dermatology 2013;168:474-85.

3Holzmann R , Shakery K. Postadolescent acne in females. Skin pharmacology and physiology 2014;27 Suppl 1:3-8.

4Khunger N , Kumar C. A clinico-epidemiological study of adult acne: is it different from adolescent acne? Indian journal of dermatology, venereology and leprology 2012;78:335-41.

5Tanghetti EA, Kawata AK, Daniels SR, Yeomans K, Burk CT , Callender VD. Understanding the Burden of Adult Female Acne. The Journal of Clinical and Aesthetic Dermatology 2014;7:22-30.

6American Academy of Dermatology/Milliman. Burden of Skin Disease. 2017. www.aad.org/BSD.

7Adelaide HA. Review of Pimecrolimus Cream 1% for the Treatment of Mild to Moderate Atopic Dermatitis. Clinical Therapeutics. 2006; 28(12):1972-1982.

8Eichenfield LF, Tom WL, Chamlin SL, Feldman SR, Hanifin JM, Simpson EL, et al. Guidelines of care for the management of atopic dermatitis: section 1. Diagnosis and assessment of atopic dermatitis. J Am Acad Dermatol. 2014 Feb;70(2):338-51.

9Beltrani VS, Boguneiwicz M. Atopic dermatitis. Dermatol Online J 2003;9(2):1.

10Rossi A, Anzalone A, Fortuna MC, Caro G, Garelli V, Pranteda G et al. Multi-therapies in androgenetic alopecia: review and clinical experiences. Dermatologic therapy 2016;29:424-32.

11Genetics Home Reference. National Institutes of Health U.S. Library of Medicine. https://ghr.nlm.nih.gov/condition/androgenetic-alopecia#statistics. Accessed March 30, 2018.

12Dainichi T , Kabashima K. Alopecia areata: What’s new in epidemiology, pathogenesis, diagnosis, and therapeutic options? Journal of dermatological science 2017;86:3-12.

13Menter A, Gottlieb A, Feldman SR, Van Voorhees AS et al. Guidelines of care for the management of psoriasis and psoriatic arthritis: Section 1. Overview of psoriasis and guidelines of care for the treatment of psoriasis with biologics. J Am Acad Dermatol 2008 May;58(5):826-50.

14National Institutes of Health /NIAMS http://www.niams.nih.gov/Health_ Info/Psoriasis/default.asp (last accessed June 1, 2013).

15National Psoriasis Foundation – http://www.psoriasis.org/about/ (last accessed June 1, 2013).

16Gottlieb A, Korman NJ, Gordon KB, Feldman SR et al. Guidelines of care for the management of psoriasis and psoriatic arthritis: Section 2. Psoriatic arthritis: overview and guidelines of care for treatment with an emphasis on the biologics. J Am Acad Dermatol 2008 May;58(5):851-64

17Steinhoff, M., Schauber, J., and Leyden, J.J. New insights into rosacea pathophysiology: a review of recent findings. J Am Acad Dermatol. 2013; 69: S15–S26

18Elewski, B.E., Draelos, Z., Dréno, B., Jansen, T., Layton, A., and Picardo, M. Rosacea – global diversity and optimized outcome: proposed international consensus from the Rosacea International Expert Group. J Eur Acad Dermatol Venereol. 2011; 25: 188–200

19Okhovat, J.-P. and Armstrong, A.W. Updates in rosacea: epidemiology, risk factors, and management strategies. Curr Dermatol Rep. 2014; 3: 23–28

20Rosacea. National Institute of Arthritis and Musculoskeletal and Skin Diseases. https://www.niams.nih.gov/health-topics/rosacea#tab-risk.

21Abram K, Silm H, Maaroos H-I and Oona M. Risk factors associated with rosacea. Journal of the European Academy of Dermatology and Venereology. 2010; 24 (5): 565-571

22Guy GP, Machlin SR, Ekwueme DU, Yabroff KR. Prevalence and costs of skin cancer treatment in the US, 2002-2006 and 2007-2011. Am J Prev Med. 2015;48:183–7.

23Guy GP, Thomas CC, Thompson T, Watson M, Massetti GM, Richardson LC. Vital signs: Melanoma incidence and mortality trends and projections—United States, 1982–2030. MMWR Morb Mortal Wkly Rep. 2015;64(21):591-596.

24Rogers HW, Weinstock MA, Feldman SR, Coldiron BM. Incidence estimate of nonmelanoma skin cancer (keratinocyte carcinomas) in the US population. JAMA Dermatol. Published online April 30, 2015.

25American Cancer Society. Cancer Facts and Figures 2018. Atlanta: American Cancer Society; 2018

26Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin. 2018; doi: 10.3322/caac.21442.

27Muzic, JG et al. Incidence and Trends of Basal Cell Carcinoma and Cutaneous Squamous Cell Carcinoma: A Population-Based Study in Olmstead County, Minnnesota, 2000-2010. Mayo Clin Proc. Published Online May 15, 2017. http://dx.doi.org/10.1016/j.mayocp.2017.02.015

28SEER Cancer Stat Facts: Melanoma of the Skin. National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/statfacts/html/melan.html

29NAACCR Fast Stats: An interactive quick tool for quick access to key NAACCR cancer statistics. North American Association of Central Cancer Registries. http://www.naaccr.org/. (Accessed on 3-10-2016).

30Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, et al (eds). SEER Cancer Statistics Review, 1975-2012, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2012/, based on November 2014 SEER data submission, posted to the SEER website April 2015.

31Agbai ON, Buster K, Sanchez M, Hernandez C, Kundu RV, Chiu M, Roberts WE, Draelos ZD, Bhushan R, Taylor SC, Lim HW. Skin cancer and photoprotection in people of color: a review and recommendations for physicians and the public. J Am Acad Dermatol. 2014;70(4):748-62.

32Dawes SM et al. Racial disparities in melanoma survival. J Am Acad Dermatol. 2016 Nov; 75(5):983-991.

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Skin care: 5 tips for healthy skin

 

Good skin care — including sun protection and gentle cleansing — can keep your skin healthy and glowing.

By Mayo Clinic Staff

Don’t have time for intensive skin care? You can still pamper yourself by acing the basics. Good skin care and healthy lifestyle choices can help delay natural aging and prevent various skin problems. Get started with these five no-nonsense tips.

One of the most important ways to take care of your skin is to protect it from the sun. A lifetime of sun exposure can cause wrinkles, age spots and other skin problems — as well as increase the risk of skin cancer.

For the most complete sun protection:

  • Use sunscreen. Use a broad-spectrum sunscreen with an SPF of at least 15. Apply sunscreen generously, and reapply every two hours — or more often if you’re swimming or perspiring.
  • Seek shade. Avoid the sun between 10 a.m. and 4 p.m., when the sun’s rays are strongest.
  • Wear protective clothing. Cover your skin with tightly woven long-sleeved shirts, long pants and wide-brimmed hats. Also consider laundry additives, which give clothing an additional layer of ultraviolet protection for a certain number of washings, or special sun-protective clothing — which is specifically designed to block ultraviolet rays.

Smoking makes your skin look older and contributes to wrinkles. Smoking narrows the tiny blood vessels in the outermost layers of skin, which decreases blood flow and makes skin paler. This also depletes the skin of oxygen and nutrients that are important to skin health.

Smoking also damages collagen and elastin — the fibers that give your skin strength and elasticity. In addition, the repetitive facial expressions you make when smoking — such as pursing your lips when inhaling and squinting your eyes to keep out smoke — can contribute to wrinkles.

In addition, smoking increases your risk of squamous cell skin cancer. If you smoke, the best way to protect your skin is to quit. Ask your doctor for tips or treatments to help you stop smoking.

Daily cleansing and shaving can take a toll on your skin. To keep it gentle:

  • Limit bath time. Hot water and long showers or baths remove oils from your skin. Limit your bath or shower time, and use warm — rather than hot — water.
  • Avoid strong soaps. Strong soaps and detergents can strip oil from your skin. Instead, choose mild cleansers.
  • Shave carefully. To protect and lubricate your skin, apply shaving cream, lotion or gel before shaving. For the closest shave, use a clean, sharp razor. Shave in the direction the hair grows, not against it.
  • Pat dry. After washing or bathing, gently pat or blot your skin dry with a towel so that some moisture remains on your skin.
  • Moisturize dry skin. If your skin is dry, use a moisturizer that fits your skin type. For daily use, consider a moisturizer that contains SPF.

A healthy diet can help you look and feel your best. Eat plenty of fruits, vegetables, whole grains and lean proteins. The association between diet and acne isn’t clear — but some research suggests that a diet rich in fish oil or fish oil supplements and low in unhealthy fats and processed or refined carbohydrates might promote younger looking skin. Drinking plenty of water helps keep your skin hydrated.

Uncontrolled stress can make your skin more sensitive and trigger acne breakouts and other skin problems. To encourage healthy skin — and a healthy state of mind — take steps to manage your stress. Get enough sleep, set reasonable limits, scale back your to-do list and make time to do the things you enjoy. The results might be more dramatic than you expect.

Jan. 12, 2018

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Genes linked with sunburn, skin cancer risk

 

May 8, 2018

Certain genes can determine which people are more at risk of getting sunburn and possibly develop skin cancer as a result..

In a trawl of the genetics of nearly 180,000 people of European ancestry in Britain, Australia, the Netherlands and United States, researchers found 20 sunburn genes.

Eight of the genes had been associated with skin cancer in previous research, according to findings published in the journal Nature Communications.

And in at least one region of the genome, “we have found evidence to suggest that the gene involved in melanoma risk… acts through increasing susceptibility to sunburns,” co-author Mario Falchi of King’s College London told AFP.

Sun exposure is critical for the body’s production of vitamin D, which keeps bones, teeth, and muscles healthy, and which scientists say may help stave off chronic diseases, even cancer.

But too much can be painful in the short-term, and dangerous for your health.

The new study, which claims to be the largest to date into the genetics of sunburn, helps explain why people with the same skin tone can have such different reactions to exposure to sunlight—some burn red while others tan brown.

It may also begin to explain factors in skin cancer risk.
“It is necessary to explore these genes in more detail, to understand the mechanism by which they contribute to propensity to burn,” said Falchi.

In future, the research may help identify people at risk, through genetic testing.

“People tend to ‘forget’ that sunburns are quite dangerous,” said Falchi.

“Given the rise in incidence in skin cancer, we hope that knowing there is a genetic link between sunburn and skin cancer may help in encouraging people to lead a healthy lifestyle.”

More information: Genome-wide association study in 176,678 Europeans reveals genetic loci for tanning response to sun exposure, Nature Communications (2018).
nature.com/articles/doi:10.1038/s41467-018-04086-y
Journal reference: Nature Communications

Millennials aren’t getting the message about sun safety and the dangers of tanning

Many millennials lack knowledge about the importance of sunscreen and continue to tan outdoors in part because of low self-esteem and high rates of narcissism that fuel addictive tanning behavior, a new study from Oregon State University-Cascades has found.

Lead author Amy Watson and her colleagues found that those with higher levels of self-esteem were less likely to tan, while those with lower self-esteem and higher levels of narcissism were more likely to present addictive tanning behavior. The motivation for the addictive tanning behavior was the perception of improved appearance.

“This study gives us a clearer understanding of actual consumer behavior,” said Watson, an assistant professor of marketing at OSU-Cascades. “The number of people still deliberately exposing their skin to the sun for tanning purposes is alarming. We need to find new ways to entice people to protect their skin, including challenging the ideal of tan skin as a standard of beauty.”

The findings were published recently in the Journal of Consumer Affairs. Co-authors are Gail Zank and Anna M. Turri of Texas State University.

Skin cancer is the most common type of cancer worldwide, with more than 3.5 million cases diagnosed annually. Melanoma cases among women rose sharply between 1970 and 2009, with an 800 percent increase among women 18 to 39.

In an effort to improve consumer education about the role of sunscreen in the prevention of skin cancer, the Centers for Disease Control and the Food and Drug Administration developed a new “Drug Facts” panel of information now required on all sunscreen bottles. The panel includes directions for sunscreen use and advice on other sun protection measures, among other information.

The researchers’ goal with the study was to gauge whether the information on this new label is effective at curbing tanning behavior and if new information is helping to increase consumer knowledge about how and when to use sunscreen and how much to use.

The study of 250 college students, most between 18 and 23 years old, measured their sun safety knowledge and included: questions about their beliefs regarding sunscreen effectiveness and ultraviolet light exposure danger; questions about tanning motivation and behavior; an assessment of tanning addiction; and personality questions relating to self-esteem, narcissism, appearance and addictive behavior.

The study participants, 47 percent male and 53 percent female, scored an average of 54 percent on an 11-question sun safety knowledge test, which included true/false statements such as: “On a daily basis I should use at least one ounce of sunscreen on exposed skin” (true); and “When applied correctly, SPF 100 is twice as effective as SPF 50” (false).

About 70 percent of the study participants reported purposefully exposing their skin to the sun to achieve a tan. About a third of the participants reported that having a tan is important to them, while about 37 percent said they feel better with a tan, and 41 percent indicated that having a tan makes them more confident in their appearance

The participants’ levels of tanning addiction were measured through questions such as “I get annoyed when people tell me not to tan,” and “I continue to tan knowing that it is bad for me,” and “I feel unattractive or anxious to tan if I do not maintain my tan.”

The researchers found that those with lower self-esteem and higher narcissism rates were also more likely to exhibit addictive tanning behavior. They found no evidence that increased knowledge about sun safety leads to lower levels of addictive tanning.

“What we found is that this knowledge doesn’t matter to the consumers,” Watson said. “That tactic to require sunscreen manufacturers to include this information is not effective.”

Sun safety and sunscreen messaging from the CDC is all statistics-based, emphasizing the likelihood of a skin cancer occurrence or diagnosis, Watson said. But that type of message isn’t resonating with millennials. The next step for Watson and her colleagues is to begin testing other types of messages to identify ways millennials would respond more positively to sun safety measures.

“People are starting to get the message about the dangers of using tanning beds, but a large number of people are still tanning outdoors, deliberately exposing their skin to the sun, because they think it’s attractive,” she said.

“We need to move away from the narrative where tan skin is associated with health and youth. That’s the opposite of reality. Because reality is tan skin is damaged skin.”

More information: Amy Watson et al, I Know, but I Would Rather Be Beautiful: The Impact of Self-Esteem, Narcissism, and Knowledge on Addictive Tanning Behavior in Millennials, Journal of Consumer Affairs (2018). DOI: 10.1111/joca.12179
Provided by: Oregon State University

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