COMMENTARY

Staying Sun Safe: Confessions of a Former Tanner

Sandra A. Fryhofer, MD

Disclosures

May 03, 2011

In This Article

Tanning As an Addiction

In my former tanning days, my favorite activity was to read while lying face down on a raft floating in a pool. I loved the way sitting in the sun made me feel. Now, science has validated my early "sunny attachment." Sun exposure affects biorhythms and can make one feel good.[1] My tanning vice only took place outdoors. I have never ever used a tanning bed or sunlamp, and after reading the report "Addiction to Indoor Tanning" in the Archives of Dermatology, I'm glad.[12] It suggests that tanning beds may be addicting. This study of more than 400 college students found that nearly one third of indoor tanning bed users met the criteria for full blown addiction.

Teens and Tanning Beds

Many teens like to tan. Survey data from the AAP indicate that almost one quarter of non-Hispanic white teens age 13 to 19 have used a tanning facility.[1] The AAP joined ranks with the World Health Organization, the American Medical Association (AMA), and the AAD in supporting legislation banning the use of artificial tanning devices in teens under age 18.

The World Health Organization's International Agency for Research on Cancer has labeled tanning devices as carcinogenic to humans.[13] Further work by Lazovich and colleagues[11] found a more than twofold increased melanoma risk in UVB-emitting device users and a more than fourfold increased melanoma risk in UVA-emitting device users. This study was criticized by the tanning industry, which cited "statistical irregularities."[14]

In March 2010, an FDA advisory panel recommended stricter FDA regulation of tanning beds. Currently, tanning beds are class I devices, the same category as tongue depressors. The panel was unanimous in ruling that tanning beds and sun lamps should not be in the class I device category. The advisory panel was split on whether they should be placed in class II (with x-ray machines) or in class III (with implanted pacemakers and silicone breast implants). The advisory panel also recommended more risk disclosure about the dangers of tanning, along with patient brochures and prominent posting of warnings.[15] The FDA has not yet taken final action on the panel's recommendations.[2]

Mother-Daughter Tanning Rituals

A letter published in the Archives of Dermatology suggests that for some families, tanning together is a mother-daughter ritual. A survey of female college students at East Tennessee State University revealed that about 40% of the tanners made their first trip to the tanning salon with their mother. The study also found that girls who initially went tanning with their moms not only started tanning at a younger age, but also carried a more than 4 times greater risk of becoming "heavy tanners." Heavy tanning meant making more than 25 tanning salons visits in a year.[16]

"Fake" Tans: The Safer Alternative

A 10% tan tax for indoor tanning services went into effect on July 1, 2010. This tan tax does not apply to "spray tans."[17] Sunless tanning products contain dihydroxyacetone, a colorless vegetable-based sugar[18] that "darkens" the skin when it combines with amino acids in the skin. A recent survey[19] found that more than 10% of adolescents used sunless tanning products in the past year. Unfortunately, the study also found that kids using sunless tanning products still had risky radiation exposure behaviors: more indoor tanning and more sunburns, but not more sunscreen use. On the other hand, another sunless tanning study of women recruited on the beaches of Massachusetts used skin cancer education and UV imaging as part of the intervention. This study did have positive short-term (2 months) and long-term (1 year) effects: less sunbathing, more sunless tanning, and greater use of protective clothing.[18]

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