Before the 20th century, light skin was a privilege of the wealthy and aristocratic. Ancient Greeks, Victorian ladies, and Southern belles went to lengths to protect their skin because dark skin was plebeian.
French fashion designer Gabrielle 'Coco' Chanel changed all that in the 1920s upon returning from a vacation with a tan. Suddenly, caramel skin symbolized luxury and leisure, and young women went to great lengths to get it.
Purdue emphasized that exposure to UV radiation from the sun or from tanning booths are the most important risk factors, along with physical characteristics such as having fair skin or many moles.
One in 80 Caucasian women will get a melanoma in their lifetime, although they are not usually fatal. Sober said the overall survival rate for melanomas is about 85-90 percent, particularly when they are caught early.
But some see a dual trend in the skin cancer story. Dr. Arthur Sober, medical director for dermatology at Massachusetts General Hospital in Boston, said awareness about skin cancer and its causes have increased in the past 20 years. Groups such as the American Academy of Dermatology mounted aggressive campaigns to disseminate information about the risks of sun exposure and tanning during the 1990s.
Data from Purdue's study corroborated this, showing that the rate of increase in melanomas slowed and leveled late 1980s and early 1990s.
"In the '90s we were making progress," Sober said. "Some people were taking that message to heart and are protecting themselves and their kids."
But, Sober recalled, as newer, tanner idols such as Britney Spears and Christina Aguilera emerged in the early 2000s, the tanning trend began to reverse itself.
"All of a sudden, 15 years worth of work went 'whoof,'" Sober said.
Following multiple surgeries to remove cancerous moles and lymph nodes, both Lietz and Pedroia are involved in efforts to combat this backslide in skin care and melanoma awareness.
Lietz's platform as Miss Maryland 2006 and a Miss America contestant was melanoma awareness and Pedroia is a spokesperson for the Melanoma Foundation of New England.
Lietz has since stopped tanning and said she has learned to love her naturally pale skin, showing it off in another white gown when she competed in the 2007 Miss America pageant.
"If anything, I get more compliments now than I ever did when I was tan," Lietz said.