Despite strong evidence that sun exposure causes skin cancer and premature aging, many people continue to tan in the sun or go to tanning facilities. Why?  Because people believe that a tanned complexion makes them more attractive.

I wanted to see if this really is the case, because if it is, then I'm fighting a significant battle when I tell my patients to avoid tanning.  To put this to the test, I joined forces with dermatology colleagues at Emory.  We used the social website www.hotornot.com, where people post pictures of themselves and ask others to rate how "hot" they are.  Academic researchers generally do not rely on social websites, but this site gave us objective data on people's attractiveness.  We had the public rate photos of 45 women at their baseline skin color and after the images were altered to make the skin appear tanned.

I began the study with the strong hope that tanning had no impact on attractiveness, but that was not the case.  Sixty-seven percent of the subjects received a higher rating once their tanned photo was uploaded to the site, and 27 percent of those subjects received a significantly higher rating. In other words, a tanned subject had a 2:1 chance of being considered more attractive.

As a dermatologist, I now realize it is not enough just to give advice on UV protection.  The desire to look attractive is a significant short-term incentive for people to tan.  We need to realize, however, there are real trade off’s long term.  These include accelerated aging, wrinkles, age spots, and risk of potentially disfiguring skin cancer.  I see countless patients each week who are now dealing with those side effects of cummulative UV exposure and who regret not protecting their skin.  My focus is now discussing these trade off's, as well as helping my patients find alternatives to tanning.

The Hot or Not study was featured on the cover of the Journal for Dermatologic Surgery, ABC News, and KKTV.