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Beauty, style, and fashion

Detailed records exist, both written and evidential, from nearly 10,000 years; throughout that entire time, there has always been a fixation and motivation to change our appearance, to have fashionable styles of dress, and to conform to the ideal image of our local society. Depending on our preferences, this produces an attempt to look more desirable, more warlike, or more macho than we think we really are. The driving force is image, and this overrides concerns that relate to health or longterm survival. When life expectancy was short this was irrelevant, but now we must think further ahead.

The simplest changes have frequently been to use body and face paints that make us look darker, more colourful, or paler. Paints are effective, but we rarely consider the properties of the pigments and whether there are long-term effects. Creams that made a pale skin, to show we were not peasants working in the fields, used lead oxide (a distinctly toxic chemical), and other colourings for red and black could be similarly unfortunate and potentially toxic.

This is not just a historic pattern: it still exists, although a desire for pale skin may have been replaced by a preference for deep suntans. Certainly it is attractive to Western eyes, but in the rush to have it, many people have gone for rapid UV exposure, either from the sun or from UV lamps. Over the short term, the results are successful, but the skin damage occurs and, particularly with young people, there is a strong link to later life skin cancers. In the USA, legislation now bans children and young people from the tanning studios. With an increasingly large number of older people, there is also an increase in the use of many creams, etc. to hide liver spots and wrinkles. These introduce new chemicals into our bodies, often with unknown side effects.

Discussions of possible links between suntans and skin cancers are quite complex and, because they involve the word cancer, emotive and often ill informed. The general public may not realize that there are two types of skin cancer, one of which (melanoma) is extremely serious, whereas the other, more common type is not life-threatening. Rapid tanning, whether via a sun bed or by lying on a Mediterranean beach, can lead to melanoma. By contrast, a steadily accumulated tan is less hazardous, and although skin cancer sites may appear, they are rarely life-threatening. It was assumed that the UV from the sunlight promotes just vitamin D (which we need), but obviously it does more than this. Recent statistics point to surprising evidence that those people with steadily accumulated tans (even if they have some skin cancer) have a greater life expectancy than the non-tanned. Medical knowledge and data are increasing, but because highlights are packaged into headlines and short articles in the press or TV, the details are lost. Simplistic media statements blur the research results, and comments on safety and benefits can be confusing, or lost. Rather worse is that although medical opinions may eventually change, the original simplistic view is entrenched in the public sector.

Other manufactured skin coloration, via tattoos, is incredibly fashionable in some age groups. As ever with mass markets, the industrial standards are variable; in some countries, dyes are used that can have long-term carcinogenic properties. One obvious downside of tattoo technology is that a passionate declaration of ‘I love Mary’ is fine until she is replaced by someone else, and unfortunately tattoo removal is not easy. The good news in this case is that Mary is a fairly common name, so replacements are possible. There is also the reality that a tattoo on firm young flesh may look OK, but once ageing sets in, then it is unattractive on wrinkles. Tattoos are a statement of a specific generation, but the patterns and styles evolve, so they become a clear indicator of an age group as the designs and colours go out of fashion. The art work is then a permanent label of a former lifestyle, even if we change our types of friends.

The more drastic reshaping of our bodies with piercing or tribal scar patterns, stretched necks or earlobes, etc. have existed for thousands of years, and within a local context may be desirable. Such treatments do not always fit well in a modern world where people travel freely, over long distances, to very different cultures. Some of the earlier distortions of binding feet or heads to change their shape are also fulfilling localized concepts of beauty or social status, but are distinctly negative in maturity; for example, women with bound feet as children have difficulty walking.

Even modern bodybuilding can look impressive (if not taken to excess), but once the training stops, the appearance is liable to be worse than the original. Because the priority is the image, people tend to overlook that the diets, drugs, and medications, plus the physical efforts used to achieve the figure, are often a disaster in terms of health. Many of the body ‘enhancing’ drugs are illegal, but nevertheless still in use because initially they are effective. The longer-term effects are far less positive. For example, anabolic steroids are strongly linked to mood disorders, kidney damage, and other changes that are contrary to the original image enhancement, as they can include loss of fertility and sexual function, or even breast growth on men.

Similar aspects of damage to the body result from both excessive food intake and starvation patterns of restructuring. Modern surgery capitalizes on our weaknesses, so people will undergo major and numerous ‘reconstructions’ to achieve their ideal figure or facial shape. Having watched some of the examples on TV programmes, it is far from obvious to an outsider that the changes were worthwhile, or even an improvement. The remodelling industry is of course extremely profitable and an excellent business for surgeons. These are highly personal opinions, and many patients are very content, but my own view is that in most cases the results look so unnatural that they are a waste of time, money, and surgical skill. The failures are frequently obvious in attempts to avoid the appearance of ageing.

Historic fashions have included immense wigs, complete with poor hygiene and lice, and corsets to produce narrower waists or larger bosoms (or flatter ones). Each ideal shape has been in vogue despite the known distortions of the skeleton and internal organs, as well as the tendency to induce fainting, etc. Every one of these ‘advances’ has been driven by some new aspect of technology, whether in the use of bones or plastics for corset materials, silicon for breast implants, surgery for facial sculpting, or Botox and filler procedures. The desire to reshape will obviously continue with future generations, and only the target image is difficult to predict. There will continue to be profit for the engineers and surgeons who enable the changes, and failure from the people to think ahead and consider the long-term negative factors, either in terms of health or appearance at a later stage in life.

My comments on reshaping and image have an important message: if we are unable to recognize the downside even of technology that intimately changes our own health and appearance, then I am not surprised if we fail to see problems from technologies that are complex and outside our personal daily experience and knowledge.

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