Are fashion trends causing an increase in melanoma rates?

Trends may come and go, and cultural attitudes shift over the years. Sometimes these changes are simple and cosmetic, and, at other times, impactful.

But now, a new study has found that the tendency in fashion to display more and more skin, and society’s emphasis on tanning as a mark of beauty or sexiness have contributed to increased ultraviolet (UV) exposure and an exponential rise in the incidence of melanoma.

The American Cancer Society reports the rates of melanoma have been increasing for at least 30 years, and while the disease accounts for less than 2 percent of skin cancer cases, melanoma causes a majority of skin-related deaths.

Researchers from New York University’s Langone Medical Center examined the effect of a number of socioeconomic factors on rates of melanoma. The study analyzed clothing styles, social norms and travel patterns dating to the early 1900s and closely examined the increasing percentage of exposed skin over the years. The cultural factors that have contributed to an increase in melanoma cases have exacerbated already well-established personal and environmental risk factors, study authors said.

“Too much sun is the main reason people get skin cancer. Genetic factors like fair skin, freckles and moles can also increase the chances of developing melanoma,” says Dr. Adam Riker, medical director of the melanoma program at Advocate Christ Medical Center in Oak Lawn, Ill. and director of the medical center’s Cancer Institute.

To conduct the study, researchers studied artwork, consumer advertisements and department store catalogs and used a standardized system to gauge the percentage of skin that was exposed to the sun. They then compared that percentage with the rate of melanoma. The study, which was published in the American Journal of Public Health, identified the following four cultural trends contributing to an increase in exposed skin:

• More revealing fashions: Evolving changes in clothing and swimsuits have exposed more skin. The bikini, which was widely adopted in the 1960s, increased women’s skin exposure to the sun from 47 percent to 80 percent. Crop tops, strapless tops and low-rise bottoms have also increased the amount of exposed skin, especially in comparison to the early 20^th century when most women and men wore concealing outfits.

• Changing social norms about tanned skin: In the early 1900s, tanned skin was denigrated as being the mark of a lower-class worker who spent long hours outdoors. By the mid 1920’s, however, a person with tanned skin was considered wealthy and well-traveled.

• Medical advice promoting benefits of UV radiation: Prior to evidence that UV exposure is dangerous, sunlight was considered a treatment for many diseases. “In the early 20th century, sunshine became widely accepted as treatment for rickets and tuberculosis and was considered to be good for overall general health,” said lead study author, Dr. David Polsky, in statement.

• Outdoor activities: With the reduced cost of plane tickets and an increase in construction of outdoor athletic fields among other factors after World War II, people began spending more time outdoors in the sun and traveling to warmer destinations.

Despite more education on the dangers of tanning during the past few decades, the rate of melanoma continues to climb. Dr. Riker explains that melanoma is the most rapidly increasing cancer in women between 20 and 40 years of age in the United States.

“The disease is highly curable if detected in the early stages. I encourage everyone to perform a full skin exam at home once a month to stay alert for any changes in their skin,” Dr. Riker says. “People should look for new freckles or moles that might appear and examine existing moles or freckles for changes in size, shape or color.”