When a group of teens, aged 12 to 17, was asked during a recent survey by the American Academy of Dermatology if they were aware that getting a suntan can be dangerous for their skin, an overwhelming majority (79 percent) said "yes." Eighty-one percent said that they know that childhood sunburns increase their risk of developing skin cancer as an adult.

Still, 60 percent of the teens surveyed admitted that they had suffered at least one sunburn during summer 2004. While 38 percent said they knew someone who has or had skin cancer, 47 percent thought that people look healthier with a tan. And 66 percent believed that people appear physically better with a tan.

"There's a big disconnect," says dermatologist Darrell S. Rigel, M.D., a clinical professor with New York University Medical Center in New York City, who led the survey. "What's ironic is that a tan is fleeting, whereas the scars and disfigurement that often occur from skin cancer are permanent."

To find about more about the risks of sun and indoor tanning exposure as well as the attitude differences among males and females when it comes to tanning, Connect for Kids interviewed Dr. Rigel:

Why did you and your team think it was important to conduct this study?

The fact is that skin cancer rates are rising at a faster rate than any other cancer in the United States. There are more skin cancers than all of the other cancers combined in the U.S. A lot of data suggests that the sun you get as a child or teenager significantly impacts your risk of developing skin cancer later in life.

We hear reports about skin cancer in adults all the time—what about in kids?

Teenagers can get skin cancer, but it's much rarer. As younger people are using tanning beds more often, we are seeing more skin cancer in teens. Still, usually you don't see the negative effects of sun exposure for years after.

What major differences between males and females did you find when it comes to sunbathing attitudes?

Overall, boys were not as smart as girls when it came to sun exposure. Girls were more likely to wear sunscreen and were more likely to spend less time outdoors. Boys were, however, more likely to wear hats—about four times more than teenage girls. Teenage girls were also much more likely to have gone to use tanning beds to get ready for a special event—like prior to the prom or a wedding—than boys.

Can you explain how wearing a hat can make a difference?

Well, a third of all skin cancers occur on the nose, so if you wear a hat with a pretty good brim, you dramatically cut your risk later in life. The best kind of hat, though, is not a cap, but a hat with a brim that goes all the way around. Roughly, for every one inch of brim you wear on your head regularly, you end up getting about a 10 percent decrease in risk of skin cancer later in life.

Are younger boys more likely to protect themselves more than older boys?

Yes. I think part of it, as you get older, men tend to not adopt health behaviors as well as women do. Also, I don't think teenage boys are wearing caps necessarily to protect them from the sun. They think it's stylish.

What are the risks for teens who go to tanning salons?

Well, there are general problems with hygiene when beds aren't cleaned out regularly. There are all kinds of bacteria in there. I wouldn't put myself in one of those just for the sanitary reasons. That aside—think about it—if you're tanning faster in a tanning bed than in natural sunlight, the only way that can be so is that you're getting ultra-violet radiation at a higher rate of exposure.

Do you support bans on young people using tanning beds?

Yes. The fact is, I see the results of bad sun smarts everyday. I support efforts by the FDA (Food and Drug Administration) to put warnings on them. Some states already ban kids 18 and under from using them, or require parental approval. There will be more and more states looking at this issue as more young people develop skin cancer. I will tell you that 20 years ago, it was virtually unheard of to hear about someone under the age of 30 with a skin cancer.

Some people might say we're trying too hard to protect kids regarding this issue. How would you respond?

Well, I think there are plenty of good reasons to be outdoors—what you have to do when you are outdoors is use common sense. I tell my patients to wear sunscreen and wear a hat. But there is absolutely no reason to use an artificial tanning bed because you're exposing yourself to dangers with none of the benefits of being outdoors.

What protection level sunscreen should teens be wearing?

SPF 15 or higher.

Is a young person at risk for not getting enough Vitamin D if he or she is too careful about avoiding sun exposure?

People get lots of incidental sun exposure, like by walking into and out of your school. You don't need very much sun to convert Vitamin D in your skin—probably five minutes, two or three times a week. You also get it through various foods and milk. If a kid has a Vitamin D deficiency, they more than likely have some other issue going on, like a genetic problem.

Does getting a sunburn increase the risk for skin cancer more than getting a tan?

Burns are bad for melanoma in general—the more sunburns you get, the greater your risk for getting melanoma. For non-melanoma skin cancer, it appears that it's the chronic sun exposure that does you in. The bottom line is that there's no such thing as a safe tan. If you think about it, in order to get tan, your body has to be injured by the ultra-violet rays that are hitting you. That causes the pigment in your skin to try to protect you.

Is it necessary for darker-skinned kids to take precautions against the sun's rays?

The fairer-skinned you are, the greater your risk for developing skin cancer. But, anyone can develop skin cancer. Whether darker-skinned or not, you're still better off protecting yourself.

Are kids from different regions more likely to be at risk for skin cancer?

The closer to the equator, the stronger the sun's rays. Interestingly, two studies have shown that people in the upper Midwest have the worst attitudes toward the sun, probably because it's so cold in the winter that they try to grab as much sun as they can in the spring and summer.

What's your opinion on why many kids in our society have such a fascination with being tan, despite the risks that we know about?

If you look back before the 1920s, the pale look was in. If you were darker-skinned, it was like you had been working in the fields as opposed to living a life of leisure. Some things turned it around: Coco Chanel helped the tan look come in in the late 1920s, early 1930s. And color movies helped people see the stars in Hollywood looking very tan from sitting out by their pools. In black and white, you couldn't see that...

The pendulum kind of swung back about ten years ago. The public icons, like Nicole Kidman, were more fair-skinned people. Now, some of the stars that young people look up to, like J.Lo, have a darker look. It's not like light-skinned or dark-skinned is good or bad. My message is, 'Love the skin you're in.'

Resources:

• CDC Sun Exposure Campaign
• The Sun Safety for Kids organization provides resources to help school administrators develop comprehensive sun safety programs for their schools.

Rob Capriccioso is a staff writer for Connect for Kids.