Teja Munshi

Measurement of tanning dependence

Indoor tanning has been found to be addictive. However, the most commonly used tanning dependence measures have not been well validated.

Minimal Erythema Dose (MED) testing.

Ultraviolet radiation (UV) therapy is sometimes used as a treatment for various common skin conditions, including psoriasis, acne, and eczema. The dosage of UV light is prescribed according to an individuals skin sensitivity. Thus, to establish the proper dosage of UV light to administer to a patient, the patient is sometimes screened to determine a minimal erythema dose (MED), which is the amount of UV radiation that will produce minimal erythema (sunburn or redness caused by engorgement of capillaries) of an individuals skin within a few hours following exposure. This article describes how to conduct minimal erythema dose (MED) testing. There is currently no easy way to determine an appropriate UV dose for clinical or research purposes without conducting formal MED testing, requiring observation hours after testing, or informal trial and error testing with the risks of under- or over-dosing. However, some alternative methods are discussed.

Psychiatric and Addictive Symptoms of Young Adult Female Indoor Tanners

Purpose. Indoor tanning (IT) increases risk for melanoma and is particularly common among young adult women. IT has also been linked with some psychiatric symptoms, and frequent tanning may indicate tanning dependence (addiction) associated with endorphin release during ultraviolet radiation exposure. The objective of the current study was to investigate associations between IT, tanning dependence, and psychiatric and substance use symptoms in young adult women. Design. Cross-sectional survey and psychiatric interview. Setting. Online, except for the Mini International Neuropsychiatric Interview (MINI), which was completed over the telephone. Subjects. Participants were 306 female university students aged 18 to 25 years. Measures. MINI, Seasonal Scale Index, tanning dependence scales, reporting ever having used a tanning bed or booth with tanning lamps (single item), reporting smoking a cigarette in the last 30 days (single item). Analysis. Descriptive statistics, χ2 analysis, multivariate logistic regression. Results. Forty-six percent of the sample reported a history of IT, and 25% were classified as tanning dependent. Multivariate logistic regression analyses showed that IT was significantly associated with symptoms of alcohol use disorders, generalized anxiety, and not having social anxiety. Tanning dependence was associated with symptoms of alcohol use disorders. Conclusion. Tanning is of concern not only for its association with skin cancer but for its association with psychiatric and substance use symptoms. Young women with certain psychological problems may seek relief from their symptoms by IT. These findings suggest that indoor tanners may benefit from health behavior and other psychosocial interventions.

Association between tobacco waterpipe smoking and head and neck conditions: A systematic review

BACKGROUND With the growing popularity of waterpipe smoking (WPS), it is important to understand how WPS may impact health. The aim of this study was to systematically review the literature to identify potential health effects of WPS, specifically on the head and neck region. TYPES OF STUDIES REVIEWED The authors systematically reviewed published articles that focused on WPS and head and neck conditions identified from the following databases: PubMed and MEDLINE, PsycInfo, and Google Scholar. RESULTS The authors included 20 articles in the review. Ten of the articles pertained to oral tissue outcomes, 7 to head and neck cancer, and 3 to the voice and middle ear. The authors found that WPS was associated with greater inflammation, Candida, periodontitis, dry socket, blood chromium and nickel levels, premalignant lesions, oral cancer, esophageal squamous cell carcinoma, attic retraction, edema in the vocal cords, and lower habitual vocal pitch and voice turbulence index. CONCLUSIONS AND PRACTICAL IMPLICATIONS WPS is associated with various head and neck conditions. Educational and policy approaches may be required to limit the spread of WPS and its potentially deleterious effects.

Original ContributionsSystematic ReviewAssociation between tobacco waterpipe smoking and head and neck conditions: A systematic review

BACKGROUND With the growing popularity of waterpipe smoking (WPS), it is important to understand how WPS may impact health. The aim of this study was to systematically review the literature to identify potential health effects of WPS, specifically on the head and neck region. TYPES OF STUDIES REVIEWED The authors systematically reviewed published articles that focused on WPS and head and neck conditions identified from the following databases: PubMed and MEDLINE, PsycInfo, and Google Scholar. RESULTS The authors included 20 articles in the review. Ten of the articles pertained to oral tissue outcomes, 7 to head and neck cancer, and 3 to the voice and middle ear. The authors found that WPS was associated with greater inflammation, Candida, periodontitis, dry socket, blood chromium and nickel levels, premalignant lesions, oral cancer, esophageal squamous cell carcinoma, attic retraction, edema in the vocal cords, and lower habitual vocal pitch and voice turbulence index. CONCLUSIONS AND PRACTICAL IMPLICATIONS WPS is associated with various head and neck conditions. Educational and policy approaches may be required to limit the spread of WPS and its potentially deleterious effects.

Psychosocial Correlates of Sunburn among Young Adult Women

Skin cancer is an increasingly common disease, particularly among young adult women. Sunburn early in life is a risk factor for skin cancer. Few studies have reported on psychosocial correlates of sunburn. The current study consisted of an online survey of undergraduate women from a university in the northeastern part of the USA. A logistic regression demonstrated that young women who reported a history of four or more sunburns were significantly more likely to report fair skin, higher perceived susceptibility to skin cancer, greater perceived benefits of tanning (e.g., appearance enhancement), lower perceived control over skin protection, and more frequent sunscreen use. Sunbathing was not associated with a greater number of sunburns. These results suggest that young women who sunburn more often possess other skin cancer risk factors, are aware of their susceptibility to skin cancer, and try to use sunscreen, but feel limited control over their skin protection behavior and are not less likely to sunbathe than others. Therefore, interventions are needed to assist high risk young women in asserting more control over their sun protection behavior and perhaps improve the effectiveness of the sunscreen or other skin protection methods they do employ.

Contextual factors, indoor tanning, and tanning dependence in young women.

OBJECTIVES To investigate the association of contextual factors such as cost, tanning accessibility, regulations, or marketing and indoor tanning or tanning dependence. METHODS One hundred thirty-nine college-aged female indoor tanners completed a questionnaire between 2009 and 2011. RESULTS Higher scores on tanning dependence and assessment in the spring/summer (versus the fall/winter) were associated with more frequent indoor tanning in the last 30 days (ps < .05). More frequent indoor tanning, greater session length, and more trouble paying for tanning were associated with higher scores on tanning dependence (ps < .05). CONCLUSIONS Public health research and practice could benefit from attention to such contextual factors as tanning cost and regulations regarding session length.

Correspondence and Correlates of Couples’ Skin Cancer Screening

IMPORTANCE Skin cancer is common among older adults. Some national organizations recommend total cutaneous examination (TCE) and skin self-examination (SSE) for skin cancer detection. Although the spousal relationship is a known influence on health behavior, little is known about the level of correspondence in skin screening among couples. OBJECTIVE To investigate correspondence of TCE and SSE among older couples, demographic correlates of correspondence, and correspondence among barriers to skin examinations. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional online survey of cohabitating partners 50 years or older performed from June 1, 2010, through July 31, 2010, via the nationally representative GfK (Gesellschaft für Konsumforschung or Society for Consumer Research) Internet panel. MAIN OUTCOMES AND MEASURES Both TCE in the past 3 years and SSE in the past year. RESULTS Correspondence among partners was high. For TCE, both partners had completed TCE in 23.9%, and both partners had not completed TCE in 47.3%. With regard to SSE, both partners had completed SSE in 39.8%, and both partners had not completed SSE in 38.9%. Correlates of both partners not completing TCE include lower household income, larger household size, nonmetropolitan residence, living in the Midwest, and being in a same-sex relationship. Correlates of both members not completing SSE included larger household size and being in a same-sex relationship. Barriers to screening that members of couples reported were similar to one another. CONCLUSIONS AND RELEVANCE Couples were mostly concordant with regard to engagement in skin examinations. Therefore, dyadic interventions to increase screening rates could be useful. Certain sociodemographic groups should especially be targeted.

The association of tanning behavior with psycho-tropic medication use among young adult women

Despite its known association with skin cancer, tanning remains popular among young adult women. Indoor tanning behavior has been found to be associated with affective and addictive disorders. To better understand potential psychological and biological mechanisms of tanning behavior, we investigated associations between tanning and medication (psychotropic and other) use among young women. Two hundred and fifty-three women age 18–29 years old were recruited from two northeastern university campus communities. Women self-reported tanning frequency and chronic medication use. In both univariate and multivariate analyses, indoor tanning ≥12 times last year was significantly associated with use of psychotropic medication and anti-depressants in particular. Sunbathing was not associated with medication use. Potential reasons for associations between tanning and psychotropic medication use are discussed. Indoor tanners should be warned that some psychotropic medications are photosensitizing, thus increasing risk for burns and other skin damage from indoor tanning.

Skin Cancer Screening

Skin cancer is the most common cancer in the US, with almost three million individuals being diagnosed annually [1]. Both melanoma and non-melanoma (or keratinocyte) skin cancer (NMSC) incidence rates have been increasing in recent decades [2]-[4]. In 2012, melanoma is predicted to be the fifth most common cancer among US men and the sixth most common cancer among women [2]. Risk factors for melanoma and NMSC include male sex, age over 50 years, personal or family history of melanoma or NMSC, red hair, blue or green eyes, Fitzpatrick skin type I (very fair skin sensitive to ultraviolet radiation [UV]) with freckles, actinic keratosis on the head, familial atypical mole-melanoma syndrome, or numerous (i.e., > 100) moles [2], [5]-[15]. Additionally, many melanomas and NMSCs can be attributed to UV exposure such as via outdoor occupations, one blistering sunburn prior to age 18, multiple sunburns at any age, or indoor tanning [15]-[21].