Jenna Hoffman thinks that people, herself included, generally look better with a tan - "better than bright white," she says.
So most weekends, she's lying outside with her eyes closed, listening to music while the sun darkens her skin. If she knows she'll be outside all day, she wears sunscreen. Otherwise, "I don't wear it every time because I'm trying to get a tan," says Hoffman, 29, who lives in Dallas.
Because skin cancer runs in her family, and because she's had a few pre-cancerous spots removed, she goes to the dermatologist every six months.
Sunbathing "is always taking a risk," says Hoffman, who is blond and fair-skinned. "If anything pops up, I'll get it removed," she says.
Despite well-publicized research about risks of sunbathing, despite skin cancer being the most common malignancy in the United States and despite a rise in melanoma rates - the American Cancer Society predicts 77,000 new cases and 9,000 deaths in 2013 - Hoffman's attitude isn't all that uncommon.
One reason is that tanning is like other unhealthful habits, says Richardson, Texas, dermatologist Dr. Cameron Coury.
"We know smoking is bad for us, but people still smoke," says Coury, a physician with Dermatology Specialists and on staff at Methodist Richardson Medical Center. "There's some sort of satisfaction."
Additionally, "there's a social component to being tan," she says.
"They're out at the lake and the pool and think it's fun. It's definitely a challenge trying to educate someone, especially living in Texas. We have 300-plus days of sun every year."
Dr. Jerald L. Sklar sighs when asked why, when sun exposure is responsible for so many types and cases of skin cancer, people continue to suntan.
"That's a good question," says Sklar, a physician on staff at Baylor University Medical Center. He offers three possibilities:
A tanning addiction: "They get a brain high that makes them happy," he says.
A vitamin D issue: Yes, some sun is needed to help strengthen bones, he says, "but not enough to risk skin cancer."
An invincible feeling: "The younger crowd - teenagers, young adults - think they're invincible," says Sklar, who is with Dallas Associated Dermatologists. "They think you have to have that 'healthy' tan.
They're not realizing later in life the damage this causes."
Says Coury: "My younger patients don't see brown spots or wrinkles or changing moles. That doesn't mean when you're 50 and something pops up, you won't wish you'd lived your younger lives differently."
She's heartened by parents who won't let their children go outside without sunscreen and stores like J. Crew that sell sun-protective clothing.
"But you have to encourage that to continue when they hit the teen years and want to rebel," Coury says.
Many people - including Hoffman, who says she looks slimmer when she's tan - associate being bronze with being healthy. That wasn't always the case, Coury says. At some points in history, having pale skin showed you didn't have to earn a living working outdoors.
Now though, "We live in a time when everyone is aware of physical appearance and wants to look good and young and healthy and all those things," she says.
Often, in what she calls a "weird contradiction," people are obsessed about exercise, weight loss and quitting smoking but not about caring for their skin.
"People take their skin for granted a lot of times unless there's a problem," she says.
Or, in many cases, someone else has a problem.
"I can't tell you how many people come in and say someone they know has been diagnosed or died from melanoma," Sklar says.
When a close friend ended up with the disease, Rebecca Thompson changed her tanning habits. Thompson, 39, remembers coating her skin with baby oil in her teen years and climbing onto the roof of her house to sunbathe. During summer camp, she never wore sunscreen. In high school and college, she'd sometimes go to a tanning booth, especially if she had an important event coming up.
Although she likes feeling the sun on her skin as she reads a book by the pool, Thompson has cut way back on her sunbathing. She might go out about 10 times during the summer, and "I slather on the sunscreen."
"When my friend was diagnosed, it was a wake-up call," says Thompson, who teaches fourth grade. "I still like to tan; I still like to lay out. But my skin doesn't get as much sun because I use so much sunblock."
Another reason she "lathers up," she says, is to avoid getting wrinkles.
Sklar uses that potential outcome when he can't seem to reach young women about the skin cancer aspect, he says.
"I try to hit on both to get their attention," he says. "They're immortal at that age, so maybe the skin damage-wrinkle aspect is better."
Hoffman, who says she gets a sunburn about once a month, does make sure she wears sunglasses.
"It looks goofy having raccoon eyes," she says, "but I don't want wrinkles."
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