Z. D. Draelos, MD
Department of Dermatology, Bowman Gray School of Medicine, Winston-Salem, North Carolina, USA
Over the past century, tanned skin shifted from being unpopular to becoming the height of fashion. However, the past decade has again seen white skin become fashionable as more and more people become aware of the dangers of spending too much time in the sun. Even so, having tanned skin is still popular and probably will be for some time to come. This article will focus on cosmetic products that are designed to simulate tanning of the skin by coloring or staining the skin without sun exposure.
self-tanning creams, sunscreens
Despite extensive evidence that sun exposure induces premature cutaneous aging and skin cancer, patients continue to find tanned skin cosmetically desirable. Tanning booths are frequented by people of all ages from adolescent to mature patients and the industry is presently thriving in all regions of the United States. However, brown skin was not always fashionable. Wealthy females of the mid-to-late 1800s shunned sun exposure to the point of carrying parasols and spending extensive time indoors to distinguish themselves from farm labor who displaued deeply tanned skin from hours of working outdoors. As machinery replaced farm workers and indoor work behind a desk or in a factory became the norm, white skin became a sign that an individual did not have the luxury of spending time in the sun or vacationing in a sunny location. Therefore, as the work activities shifted indoors, a tan became fashionable.
Perhaps some of the education provided by dermatologists regarding sun avoidance is reaching fashion circles, as a review of the chic look for fall 1990 was white skin. Currently, the trendy makeup fashion is a powdered, matte, white face with vivid red lips and dark hair, but it is hard to imagine that “the tan” will loose its fashion desirability quickly.
Cosmetic products that imitate a summer tan fall into several categories: self-tanning creams, bronzing gels, bronzing powders and tinted moisturizers.
Self-tanning creams, sold at both mass merchandisers and cosmetic counters, have become extremely popular because they produce a golden skin color overnight without sun exposure. These products are not new, but have seen a resurgence of popularity. This is because the new formulations produce a more natural golden color while the older products dyed the skin a somewhat unusual orange color. The golden color is quite acceptable on persons with blonde or light brown or light brown hair who tend to have golden hues to their skin, but it is not attractive on Mediterranean individuals with an olive complexion, or extremely fair persons with pink skin tones.
The active ingredient is 3-5% dihydroxyacetone incorporated into a glycerin and mineral oil base to form a white cream that turns the stratum corneum golden. A chemical reaction actually occurs between the keratin protein of the skin and the sugar component of the self-tanning cream. The resulting byproduct is a brown color that stains the skin. Formulations are available for the face and body, but most do not incorporate a sunscreen, nor is the golden skin color protective against actinic damage. Allergic contact dermatitis from use of the product is infrequent, but may be due to the incorporated fragrance or preservative.
The color is not permanent and is lost as the stratum corneum desquamates. Thus continues use is necessary. The major disadvantage of the product is that it stains all contacted skin surfaces including the palms of the hands, if it is not removed, and will produce deeper staining of the follicular ostia, seborrheic keratosis, actinic keratosis, porokeratosis and icthotic skin. Many patients are not aware that they have these skin conditions until the self-tanning cream highlights the irregularity.
Self-tanning creams cost from $15-$40 (US) for a 4-6oz tube and provide approximately 10-12 complete leg applications. Products are marketed to both men and women.
Dermatologists should ask patients about the use of a self-tanning cream before making the diagnosis of carotenemia from the appearance of yellow palms, or expressing undue concern of a lesion that has changed color. This may simply represent a stained stucco keratosis. Other than this confusion, self-tanning creams are safe and an excellent alternative to a tan from hours spent in the sun.
Bronzing gels are pigmented polymers that are spread over the skin to simulate the appearance of a tan. They provide transparent color. Some products actually stain the skin, while others are removed with one washing, and still others incorporate a sunscreening agent in the formulation. Products are marketed through both male and female cosmetic lines and have become surprisingly popular with men.
Bronzing powders are identical in formulation to face powders except for the addition of different pigments. The powder is stroked from a compact with a powder sponge or puff and applied to the body. The product is usually dusted down the central face, neck and shoulders to simulate a tan. The powder is easily removed by rubbing and provides slight physical sun protection due to the titanium dioxide in most formulations.
Some moisturizers contain pigment that provides a sheer tanned appearance in addition to possessing emollient qualities.
Technically, it is impossible to separate a tinted moisturizer from a sheer, moisturizing facial foundation. Usually a facial foundation contains titanium dioxide to provide coverage to underlying cutaneous pigment defects whereas a tinted moisturizer does not, but the distinction is slight. Tinted moisturizers may or may not possess a chemical sunscreen.
Dermatologists may wish to familiarize themselves with cosmetics designed to simulate a tan for those patients who insist on displaying bronze skin. The cosmetics may or may not contain a sunscreening agent, but the color produced is not protective. Certainly, a cosmetic tan is safe alternative for patients who use a tanning booth or worship the sun.
- Draelos ZK, Cosmetic in Dermatology. Edinburgh, Churchill Livingstone, 1990. Pp 25-30.