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Needless to say, Holick has become something of a patron saint for the Indoor Tanning Association. Levy posits that the doctor will be regarded five years from now the way that diet guru Dr. Atkins is today -- as a pioneering thinker whose insights were wrongly mocked during his day. Holick's main premise is simple: Brief and unfettered exposure to the sun allows your body to obtain the calcium it needs for bone strength and general health. He suggests unblocked sunshine on the face, hands, and feet for five to fifteen minutes per day. Currently, Holick estimates at least 42 percent of Americans are deficient in vitamin D, thanks to a bogus anti-sun campaign that has only heated up in the last decade. He acknowledges that we can get plenty of vitamin D by drinking fortified milk or eating oily fish, but says absorbing the sun's rays is the most holistic and efficient course.
Holick takes his sun worship even further, prescribing what he calls "sunshine therapy" to ward off ailments as varied as depression, hypertension, multiple sclerosis, and even some cancers. For instance, he argues that obesity can be treated with a steady dose of UV radiation that helps to strengthen weak bones and reinvigorate flabby muscle tissue.
Yet even Holick stops short of endorsing "tanning per se," aware that radiation overdose is too risky to chance. But for anyone who remains determined to get a tan, he recommends starting with a base tan. "Increasing the melanin content in your skin by going to an indoor tanning facility will provide you with a certain amount of natural protection against a burn," he writes. "Start increasing melanin content in your skin by visiting an indoor tanning facility at least one month before you leave, and have three sessions a week."
Seventeen-year-old Micaela Williams has been visiting indoor tanning salons for two years -- frequently enough that, in some circles, her use of the beds might earn her the nickname "tanorexic," a pejorative used by high school kids who view indoor tanners as foolish to the point of self-harm. Williams has worked in salons, and says she tans about three times a week during the summer to maintain her bronze. Like most of her friends, the San Ramon resident is aware of the suggested link between tanning beds and melanoma. Yet what she truly fears is a sunburn.
"In a tanning salon, you're in a controlled environment," she says. "You know exactly what you're getting."
On each tanning bed, warning stickers tell the user that the government believes prolonged use of the machines can lead to skin damage. Tanning beds emit two kinds of ultraviolet radiation: UVA, which is most common, and UVB, which packs a greater dose of energy. According to the cigarette-pack-like warnings on the beds, "Tanning devices in salons, tanning parlors, spas, and similar settings that emit mostly UVA light are in no way less harmful alternatives to the sun's rays, insofar as UVA rays penetrate deeper than UVB rays, causing damage to the underlying connective tissue as well as to the skin's surface."
Williams says that when she started using the beds at the age of fifteen, she took in dermatologists' arguments and research provided by the tanning industry. She believes that other high-school-age patrons are just as aware, and shouldn't be prevented from using the salons. "Once you're that age, you can think for yourself," she says. "You can read the paper and make your choices."
To maintain her even tan, Williams alternates between less and more powerful tanning beds. At larger salons such as Tropical Solutions, a variety of wattages are available to the user. "Low beds" emit mostly UVA rays and are believed to penetrate further into the skin, while the more powerful "high beds" are heavier on the UVB rays and work on the surface. Tropical Solutions advertises the "Big Kahuna," which it says should not be used for more than fifteen minutes per session because of the intensity of its "100 percent UVB rays."
"The high beds bring out the color real fast, and the low beds keep it," Williams explains. After tanning sessions, she lotions herself with a mineral-based cream to replenish the minerals her skin loses from sweating.
Recently, tanning lotions that color the skin have gained popularity with those who prefer not to use a tanning bed. The gels are gaining fame even in Hollywood, but the coloring agents haven't persuaded Williams. "The lotion makes your skin turn orange," she says, "and it's gone in five days."
Williams can't say if she feels a boost in vitamin D after one of her visits. But for the teenager, the process of lying down and absorbing UV radiation for a quarter hour is a meditative one. "It's relaxing," she says, "like a nap in the middle of the day."
Inside the East Bay Laser & Skin Care Center in Walnut Creek, the tattered victims of a silent war gather in the waiting room. Underneath their clothing, they're marked and scarred. In some cases they have escaped death. They arrive to have their cancerous skin repaired or excised. Simply put, they've absorbed too much radiation.
Christine Min-Wei Lee, a dermatologic surgeon and the center's director, knows the stats off the top of her head: In the United States, melanoma rates are steadily increasing by 3 percent every year, along with nonmelanoma skin cancers. Currently, one in 68 Americans risks developing invasive melanoma, which constitutes a 2000 percent increase since 1930. And not only will 7,500 people die from the well-known skin cancer this year, the profile of those who contract it is changing rapidly.
Once seen as an old man's disease that afflicted fishermen or farmers, melanoma is now striking teenagers -- and even preteens. "The youngest melanoma patient I have seen was twelve years old," Lee says, "but I know of two cases of melanoma in the East Bay in children aged four and six years old."
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