Exposure to UV radiation is the most common environmental risk factor for the development of melanoma and nonmelanoma skin cancer. It has also been established that cutaneous melanoma is correlated with number of lifetime sunburns.1 While adults and adolescents have become more aware of this link, tanning remains prevalent, and use of effective sun protection remains low in the United States, particularly among young women.2,3 Previous studies of magazine images have come to contradictory conclusions regarding younger models and portrayal of tanned skin and use of sun protection.4,5
The purpose of this study is to determine whether fashion magazine images differentially promote tanning and sun-protection practices to young women compared with older women. We examined white models in 2 popular United States fashion magazines targeting audiences of adolescent girls (Seventeen) and mature women (In Style) during the months of May through July 2009 (n = 346 images). All photographs of one-half page or larger showing 4 models or fewer were independently coded by 2 of us, and differences were resolved by consensus. Tan level was assessed relative to 4 reference photographs of a model with graded tans used in previous studies.6 For models portrayed outdoors, sun-protection practices including staying in the shade, wearing sun-protective hats, and the amount of clothing cover were also assessed.
Most models in Seventeen appeared to fall into the age range of 12 to 24 years (81%), while most models in In Style appeared older than 24 years (70%). The degree of tan portrayed by the models in each of the magazines was not statistically different ( χ2P = .49) (Table 1), nor was the percentage of models portrayed outdoors in unshaded settings (65% of Seventeen models vs 72% of In Style models) (Fisher exact P = .15). Most of the models in both magazines had no tan or a light tan. Only 15% of models in Seventeen and 13% of models in In Style had a medium tan, and no Seventeen models and 1% of In Style models had a dark tan. Significantly more In Style models (4%) than Seventeen models (none) wore sun-protective hats (defined as any hat with a brim) (Fisher exact P = .03), and there was a trend toward decreased clothing cover among models in Seventeen (Table 2).
While models in Seventeen were not portrayed more frequently in the sun or with more tanned skin, they were portrayed with significantly fewer sun-protective hats and less clothing cover. Previous US survey studies have shown a significant increase in sunscreen use among adolescents from 1998 to 2004.2,3 However, there was little change in other sun-protection practices such as sun-protective hats, clothing cover, and staying in the shade. In an Australian study,4 the most commonly reported means of photoprotection before experience of self-described “worst sunburns ” was the use of sunscreen, while other sun-protective practices were used less than 2% of the time. A study of parents of adolescents3 reported increased use of sunscreen as well as sun-protective hats and clothing cover from 1998 to 2004. The use of sun-protective hats and clothing cover was more prevalent with increasing age.
The infrequent portrayal of effective sun-protection practices in adolescent magazines may contribute to infrequent use of these practices in real life. While it appears that there is a trend toward lighter tans in models, the portrayal of effective sun-protective practices remains low. This is of particular concern because this presents a formula for more unintentional and extreme sunburns.
The generalizability of our results is limited by our sample size of only 6 issues of 2 magazines over 1 summer. Further research characterizing other magazines, online media, television, and movies is needed to determine whether the content of these formats promotes tanning and/or sun-protection practices. While it is likely that social norms, appearance anxiety, and tanning bed advertisements aimed at teens contribute to tanning behavior and sun-protection practices in young women,2,7 our study demonstrates a differential portrayal of teens with decreased clothing cover in fashion magazines. Therefore, fashion magazines may be an important target for sun-protection interventions.
Correspondence: Dr Dellavalle, Dermatology Service, Department of Veteran Affairs Medical Center, 1055 Clermont St, Box 165, Denver, CO 80220 (email@example.com).
Accepted for Publication: December 16, 2010.
Author Contributions: Mr Gamble, Mss Fuller and Duke and Dr Dellavalle had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: Gamble, Walkosz, and Dellavalle. Acquisition of data: Gamble, Dymek, Walkosz, and Jensen. Analysis and interpretation of data: Gamble, Fuller, Duke, and Dellavalle. Drafting of the manuscript: Gamble, Fuller, and Duke. Critical revision of the manuscript for important intellectual content: Gamble, Fuller, Dymek, Walkosz, Jensen, and Dellavalle. Statistical analysis: Duke. Administrative, technical, and material support: Walkosz. Study supervision: Walkosz and Dellavalle.
Financial Disclosure: None reported.
Previous Presentation: Part of this work was presented as a poster at the 2010 Society for Investigative Dermatology Annual Meeting; May 5-8, 2010; Atlanta, Georgia.
Additional Contributions: Nancy Boyd, BSN, provided administrative support, and Jacob Thomas, BA, contributed to analysis of the data.
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