How to Talk to Patients About Sunless Tanning

June 12, 2020

Tanning remains a very popular trend in the beauty world. But there’s been a shift in the way people get those tans as the general public becomes more aware of the dangers of outdoor tanning and tanning beds. Though available for many years, sunless tanning has increasingly become a more desirable option, both because of the dangers of its alternatives and because of more sophisticated formulas.

This provides dermatologists with a better opportunity to talk to their patients about safe tanning alternatives. But what does that conversation look like? To find out, we spoke with three board-certified dermatologists, Drs. Jill Fichtel, Jeannette Graf, and Joel Schlessinger. Dr. Fichtel operates Transformative Dermatology in Franklin, Tennessee. Dr. Graf has her own private practice in Great Neck, New York and is also the founder and owner of the Dr. Jeannette Graf skin care line. Dr. Schlessinger has a private practice in Omaha, Nebraska and is also CEO of Together, they gave their thoughts on recent tanning trends, as well as their tips for how to discuss tanning with patients.

With all of the advocacy and education around skin cancer awareness and the dangers of tanning beds, do you find that the conversation with your patients about sunless tanning has changed? If so, in what ways?

Drs. Fichtel and Graf believe that the conversation has shifted dramatically in recent years. According to Dr. Jeanette Graf, “The advocacy and education regarding the dangers of tanning beds and their high risk of skin cancer has been quite effective in diminishing their use.” Dr. Fichtel agrees and believes that some of the change has come from artificial tanning’s dramatic rise in popularity on social media and with celebrities. She’s found that it’s less common for her to have to explain the dangers of tanning beds and outdoor tanning. More often, patients approach her for advice on artificial tanning.

On the other hand, Dr. Schlessinger still often has patients who have trouble giving up traditional tanning methods. He says “We are still in an uphill battle it seems. That’s a sad thing to say, but it is just the way it is, with ingrained habits among teenagers and even adults.” In his view, these ingrained habits form the biggest roadblock to helping people tan in safe ways.

What misunderstandings or questions do you hear about self-tanning?

              A common question that Dr. Graf hears is this: “Is spray tanning safe?” Thankfully, the answer is fairly straightforward. As Dr. Graf puts it,

“Yes it is, and certainly much safer than tanning in the sun and UV tanning beds which cause skin cancer, especially the latter. Spray tans do not cause skin cancer and have been used safely for over 30 years since they consist primarily of Dihydroxyacetone (DHT) which stains the outer surface of skin simulating a tan color.”

In terms of safety, the only concern that patients should have is with proper preparation. Dr. Graf warns that patients going in for a spray tan should be careful of aerosolization. She encourages them to wear protective equipment such as small swimming goggles, nose filter plugs and protective lip balm. Any mucous membranes should be treated with care. Another tip she offers, although more for aesthetic results than safety, is for patients to wear a coat of nail polish to prevent discoloration.

For Dr. Fichtel, a common question is if sunless tanners work as well as spray tans.

“For big events,” says Dr. Fichtel, “a professional spray tan is your best bet compared to home sunless tanners. Applying sunless tanners at home is an art that takes time to perfect. If you are looking for a quick tan, at home sunless tanners are a good option. However, if you are looking for a more professional, well done tan, a professional spray tan may be best.”

What questions do you ask your patients before recommending a particular tanning product?

              The most important questions revolve around allergies and sensitivities. According to Dr. Fichtel, “Most contain fragrance so if you are sensitive or allergic to fragrance, find one that is fragrance-free (as opposed to unscented) if possible.” She also recommends that patients perform a skin test over a small area to make sure that they won’t have a reaction to the product before applying it all over their bodies. Dr. Schlessinger agrees, adding that some patients are allergic to DHT itself. He likes to ask patients about their history with self-tanning to find out if they’ve had reactions to certain products in the past.

Beyond these more clinical questions, Dr. Fichtel reminds us that patients will have a preference for a particular shade of tan, and so it’s often prudent to ask about that preference before offering a particular recommendation. At the same time, she encourages patients using sunless tanners for the first time to use a product that builds gradually. That way they can avoid any unwanted effects from using too much of a strong formula all at once.

What advice do you give to patients who are using self-tanners for the first time?

Both Dr. Fichtel and Dr. Graf stress the importance of carefully reading and following the directions as they’re laid out for the given product. That includes directions for both prep and post-application maintenance. Watching any related videos online can also be helpful. Different at-home tanners have can have fairly different directions, so even if a patient has used a self-tanner in the past, they should be careful to note any differences in usage.

Dr. Schlessinger encourages his patients to take things slowly their first time. He says “There are no benefits to overdoing and over applying. It will take a little time to get the perfect look, but it is worth it to be careful and approach it slowly at first!”

Dr. Graf shares this sentiment, and advises first-time self-tanners to build up their tan gradually one day at a time. That way, patients can avoid being stuck with a deeper tan than they would have liked.  She also encourages patients to wait for 24 hours after hair removal before applying their tanning lotion. That includes both regular shaving and hair removal treatments such as waxing.

Dr. Fichtel likes to prepare first-timers for the potential staining that can happen. “If you are going to use an at-home tanner, make sure to lay a dark blanket over your sheets and wear old pajamas that you don’t mind getting a bit discolored.” Finding tanning products that wash out of clothing and bedsheets is also wise. Reading customer reviews can be very helpful in this search. Another recommendation that she gives is for patients to apply a Vaseline-like product to bony areas before applying the self-tanner. That way it’ll go on more evenly and reduce streaking.

But perhaps her most important piece of advice is to talk to patients about the continued importance of sunscreen. Many people feel as if they have more protection against the sun when they have a tan, so it’s important to explain that a spray tan or lotion isn’t a replacement for regular sunscreen usage.

All three doctors recommend that patients exfoliate before applying a self-tanning product. Exfoliating does two things. First, it helps to smooth uneven areas of skin, allowing the lotion to go on with the most even coating possible. It also helps the tan last longer, since it will have been applied to a fresh layer of cells.

What self-tanning products do you recommend and why?

Recommendations from Dr. Jeannette Graf:

St. Tropez Self  Tan Classic Bronzing Mousse: Made for use at home, this tanning mouse dries quickly and is streak free. There’s also little to no scent, and the tan adjusts based on the users own skin tone.

Infinity Sun Glow on the Go Rapid Bronze Mousse: Enhanced with vitamins, hyaluronic acid and antioxidants, this self-tanner goes beyond just tanning to help improve skin health. It’s also customizable since users can choose their level of tan depending on how long they wait to rinse the cream off.

Infinity Tan Me BB Cream: Formulated with a replenishing complex, Dr. Jeanette recommends this BB cream since it helps to tone and smooth skin while promoting a tan glow.

Jergens Natural Glow Daily Moisturizer: Designed for building a tan gradually, this moisturizer is easy to incorporate into a regimen since it can replace a daily lotion. It also doesn’t have the typical odor of self-tanners, and contains a blend of antioxidants including vitamin E.

Recommendations from Dr. Jill Fichtel:

St. Tropez face mist: Like the St. Tropez tanning mouse, this tanning mist goes on streak free and dries quickly. Dr. Fichtell recommends this for her patients to use at home since it washes out of sheets easily and doesn’t leave a sticky feeling when used.

Norvell Venetian: Used at Dr. Fichtel’s own clinic, this tanning spray for pros uses anti-orange bronzer pigments to counteract undesirable orange tones. Skin is left with a more natural-looking bronze. The level of tan can be adjusted based on how long the patient waits to shower afterwards.

Recommendations from Dr. Joel Schlessinger:

Jane Iredale Tantasia Self Tanner & Bronzer: Dr. Schlessinger describes himself as “a huge fan” of this self-tanner. It’s made with hydrating glycerin to help moisturize skin when applied, helping to smooth out rough areas for a more even finish.

Dr. Dennis Gross Skincare Alpha Beta® Glow Pad Self-Tanner for Face: This tanner is easy for patients to use, since each pad is made with the right amount of tanner for the face, neck and décolleté. The pads also contain exfoliators to encourage a smooth application.

Vita Liberata pHenomenal 2-3 Week Tan Mousse: Formulated to be odorless, this tanner is a great choice for patients who have concerns about a fake tan smell. It also dries quickly, and last up to four times longer than regular tans.

In the campaign against skin cancer, encouraging patients to practice safe tanning is a key strategy. Being ready for the potential questions and conversations surrounding artificial tanning can not only improve your patients’ satisfaction, it can help support the health of your patients’ skin.

What kind of trends have you seen in tanning among your own patients? Let us know in the comments below!

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