NOTE: This story ran in the Aug. 24, 2011, edition of the Chicago Tribune.
Tanning was as much a part of Lindsay Walsh's teenage social life as talking on the phone.
Two or three times a week — more for special occasions — she and her friends would hit the salons, beckoned by their posters of bronzed, beautiful women. This went on for years, starting when she was 15.
In reality, Walsh, a strawberry blonde of Irish descent with lots of freckles and moles, didn't tan much. Mostly, she burned. But she said she always felt invigorated, more confident, when she walked out with more color.
"For me, I thought it was a great investment," Walsh said. "If I was tan, I was prettier. … I continued to go for the small glow it gave me."
Now, Walsh, a 24-year-old Orland Park resident, never leaves home without wearing an 85 SPF sunblock and hat, and she's always on the lookout for shade. It was a lesson she learned the hard way, in 2009.
That August, Walsh's mother noticed a mole on Walsh's thigh that was peeling and bleeding. A hasty trip to the dermatologist revealed she had melanoma. Further surgeries indicated that the cancer had spread to some lymph nodes. Walsh spent 10 days in the hospital, was on bed rest for about three months and had to undergo chemotherapy for a year.
Walsh's doctors told her that several things likely contributed to her diagnosis: her heritage; her sun-tanning, often without sunscreen, which resulted in several burns over the years; and her use of tanning beds.
She is one of a growing number of young women who are diagnosed with melanoma. Incidents of the potentially deadly form of skin cancer have increased for at least 30 years, according to the American Academy of Dermatology, and the rate among white women aged 15 to 39 has grown by an average of 3 percent a year for the last 20 years.
Dr. Ross Levy, a dermatological surgeon at NorthShore University HealthSystem medical group who specializes in skin cancer, said that recent studies suggest that individuals who start tanning before age 35 increase their risk of melanoma 75 percent.
It's the most common form of cancer for women aged 25 to 29, according to the academy, and the second most common for females 15 to 30 — together the prime age range of tanning salon customers. Illinois law bans the use of tanning beds for those under 14 and requires parental consent for those under 18. Two bills pending in Springfield would ban any use by children.
And while the indoor tanning industry continues to rebut them, numerous studies have documented a relationship between ultraviolet radiation emitted by sun lamps and cancer. The World Health Organization and the U.S. Department of Health and Human Services have warned that the use of tanning beds can increase the risk of skin cancer. WHO also labeled children under 18 as one of several high-risk groups.
"The data is clearly there," Levy said.
But despite the warnings and growing body of scientific evidence, young women continue to go to tanning salons, in part, some experts say, because the tanning salons play down the scientific evidence and play up the benefits of vitamin D from ultraviolet rays. And the notion that tanned skin is beautiful persists.
John Overstreet, executive director of the Indoor Tanning Association, which represents the industry, asserts that the "science isn't there" to show a link between tanning beds and skin cancer, and the group's website touts medical benefits of UV exposure.
Such mixed messages can make it difficult for people to assess their risks.
Carmela Gil, of Chicago, has heard some of the warnings about sunless tanning, and they've prompted her to cut back her visits, but not give them up completely.
"As I was getting older, I read how bad it is for you," said Gil, 38. "I am concerned, but there are concerns about everything. I use lots of sunscreen and am more cautious with my face."
But she, too, is still swayed by the notion that she looks better — "more awake" — with a tan.
As evidence that bronzed skin remains a beauty benchmark despite its risks, many women are turning to sunless tanning.
Renata Bregstone, of Glencoe, "did tanning beds in college for a year or two" but stopped when she learned of their link to skin cancer. Now she gets spray tans for special occasions.
Ashley Rizzo, manager of Palm Beach Tan in Highland Park, said spray-tanning used to account for 20 percent of her business; now it's about 65 percent.
Both Rizzo and John Szymski, who owns Toucan Tan in Glenview, as well as other Chicago-area tanning salon proprietors, tout the benefits of vitamin D that is gained with ultraviolet exposure in tanning beds. And both said there's a way to tan responsibly.
"The actual sun in the sky can cause the same (damage) as a tanning bed," Rizzo said. "You should do it the right way, the healthy way — not more than twice a week — for not more than seven minutes each time — to get your vitamin D."
Rizzo, though, acknowledged that some of her clients come daily for 15-minute sessions.
Experts scoff at the notion of responsible tanning.
"There is absolutely no such thing as safe tanning," Levy said. "A tan is a response to injury caused by ultraviolet radiation and causes DNA damage to the cells in your skin."
The vitamin D claims are similarly suspect, he said. Although there is a body of literature suggesting a link between vitamin D and lower incidence of cancer, "you can get more than enough D from food and ambient sun exposure," Levy said.
Overstreet contends that the industry has already been hurt by the recession and by a 10 percent federal tax that was imposed on indoor tanning last year to help fund the health care overhaul.
Dermatologists, who are fighting efforts to repeal the so-called tanning tax, say it sends an important message about the dangers of sunless tanning.
"The fact that this touches so many young people has so many of us concerned," said Dr. Leonard Lichtenfeld, deputy chief medical officer of the American Cancer Society.
Among them is Erin Clement, who frequented the salons from ages 18 to 24. A routine visit to a dermatologist revealed that what appeared to be a tiny freckle on her arm was melanoma.
"I heard of the warnings, but thought it could never happen to me," said the now-26-year-old Chicagoan. "I am healthy and active and don't look like the girls on the 'Jersey Shore' (show) who go tanning seven days a week. If I hadn't have gone to a dermatologist — and I went on a whim — I likely wouldn't have found this."
Walsh, another melanoma survivor, wishes she had gotten the message sooner.
Now she gets checked by a dermatologist every three months and regularly goes for CT, PET and MRI scans. In January, a mole on her back proved to be melanoma, but it was removed and had not spread. Her ordeal has prompted her friends to stop tanning, too, and go for regular skin checks.
Walsh said she has struggled with depression since her diagnosis but also said the experience has changed her in positive ways. Instead of pursuing a teaching career, she plans to attend nursing school this fall. Walsh said she doesn't take things for granted anymore. But she wishes for another change.
"I wish tanning beds would go away," she said.