Question of the Week

April 30, 2007


For some high school students, the past few weeks have involved getting ready for prom. Still others have been getting ready for summer.

Whatever the reason, students around the country have been "working on their tans" (whether or not there has been any sun).

"A recent study of more than 10,000 teens across the US found that tanning bed use was increasing, especially among adolescent girls.  This does not bode well for the health of the nation.  In 1994, a Swedish study found that women 18-30 years old who visited tanning parlors 10 times or more a year had seven times greater incidence of melanoma than women who did not use tanning salons. ... And in 2002, a study from Dartmouth Medical School found that tanning device users had 2.5 times the risk of squamous cell carcinoma and 1.5 times the risk of basal cell carcinoma .  And yet, even with all this evidence, the tanning salons remain unrepentant."

Those who are tempted to try a tanning salon because they live in a place that doesn't get that much sun form much of the year, think they look better with a tan, or think that tanning salons are safer might want to consider the long term effects of tanning bed use.

"Tempted to try a tanning salon? Maybe you've heard that sunbeds only use 'safe' UVA light, avoiding the UVB light that causes burning. But unfortunately it's not that simple. UVA rays can cause just as much -- if not more -- damage than UVB rays because they penetrate the skin more deeply. In fact, doctors say that the use of tanning salons is one reason they're treating more young patients for skin cancer. ... The sun's rays contain two types of ultraviolet radiation that affect your skin: UVA and UVB. UVB radiation burns the upper layers of skin (the epidermis), causing sunburns. UVA radiation penetrates to the lower layers of the epidermis, where it triggers cells called melanocytes (pronounced: mel-eh-no-sites) to produce melanin. Melanin is the brown pigment that causes tanning. Both UVA and UVB rays contribute to skin aging. Both types also can cause potentially cancerous changes in your cells' DNA. And, according to a recent study, radiation from just 10 indoor-tanning sessions in 2 weeks can suppress a person's cancer-fighting immune system. Although tanning beds use UVA light, the concentration of UVA rays from a tanning bed is greater than that from the sun. And, despite manufacturer claims, some tanning lamps do also emit UVB light. So if you try indoor tanning, you'll absorb far more rays in the long run, significantly age your skin, and put yourself at even greater risk for skin cancer."

What about all the claims from tanning salons stating that they are safe?

"The Food and Drug Administration (FDA) and the Federal Trade Commission (FTC) share responsibilities in the regulation of sunlamps and tanning devices. The FDA enforces regulations that deal with labels on the devices; the FTC investigates false, misleading, and deceptive advertising claims about the devices."

The Federal Trade Commission found several "false, misleading, and deceptive advertising claims" that caused them to issue a Consumer Alert. A few highlights of that Alert follow:

"FTC Consumer Alert
....Ads that claim indoor tanning devices are a safe alternative to outdoor tanning may be false. ... Here are some claims commonly made about indoor tanning --- and the facts.

'You can achieve a deep year-round tan with gentle, comfortable, and safe UVA light.' "Ultraviolet light is divided into two wavelength bands. Shortwave ultraviolet rays called UVB can burn the outer layer of skin. Longwave ultraviolet rays called UVA penetrate more deeply and can weaken the skin’s inner connective tissue. Long-term exposure to the sun and to artificial sources of ultraviolet light contributes to the risk of developing skin cancer. Two types of skin cancer, basal cell and squamous cell, are treatable if detected early. Melanoma, another type of skin cancer, can be fatal.

'No harsh glare, so no goggles or eye shades are necessary.'
"Studies show that too much exposure to ultraviolet rays, including UVA rays, can damage the retina. Overexposure can burn the cornea, and repeated exposure over many years can change the structure of the lens so that it begins to cloud, forming a cataract. Left untreated, cataracts can cause blindness....

'Tan year round without the harmful side effects often associated with natural sunlight.'
"Exposure to tanning salon rays increases the damage caused by sunlight. This occurs because ultraviolet light actually thins the skin, making it less able to heal. Unprotected exposure to utltraviolet rays also results in premature skin aging. A tan is damaged skin that is more likely to wrinkle and sag than skin that hasn’t been tanned. ... According to some skin specialists, skin that has a dry, wrinkled, leathery appearance early in middle age is a result of UV exposure that occurred in youth.

'No danger in exposure or burning.'
"Whether you tan indoors or out, studies show the combination of ultraviolet rays and some medicines, birth control pills, cosmetics, and soaps may accelerate skin burns or produce painful adverse skin reactions, such as rashes. In addition, tanning devices may induce common light-sensitive skin ailments like cold sores."

While they may have heard about skin reactions, many teens consider them minor and think that they will have many years before they see any damaging effects from their indoor tanning.

" ‘Indoor tanning is simply not safe,’ said dermatologist James M. Spencer, M.D., one of the authors of the article. ‘A recent report from the Centers for Disease Control (CDC) showed that there were 700 emergency room visits because of injuries like sunburns, infections, and eye damage from tanning bed use. In addition to these immediate injuries, tanning bed users have an increased risk of developing skin cancer, including the most deadly form, melanoma, in the long term.’ ... [T]he new high-pressure UVA sunlamps can emit doses of UVA that can be as much as 15 times that of the sun, significantly increasing a tanning bed user’s skin cancer risk. ‘If you really want to look tan, consider using a sunless self-tanning product,’ Dr. Spencer said."

Even the "long term effects" may show up sooner than expected.

"When Charlie was diagnosed with 4th stage melanoma, she was 25 years old and life couldn’t have been better. She had graduated three-and-a-half years before from Brown University, planning on going to medical school. ... She died on Nov. 24, 2003, eight months after her initial diagnosis."

Charlie didn't spend more time than others her age out in the sun, yet "Charlie was diagnosed with 4th stage melanoma..."

"Although scientists have known for some time that too much UV radiation can be harmful, new information makes these warnings even more important. Some scientists have suggested recently that there may be an association between UVA radiation and malignant melanoma, the most serious type of skin cancer. ... 'Overexposure to ultraviolet radiation is the most preventable cause of skin cancer."

With teens and young adults showing up in emergency rooms and skin cancer rates on the rise, many states have legislation to limit teen usage of tanning salons.

Still other states are still working to get legislation passed.

"State Sen. James Timilty, D-Walpole, has refiled legislation to keep teens younger than 16 out of tanning salons. Teens who are 17 or 18 would need written parental consent to use tanning beds. Timilty said he refiled the legislation, similar to a bill he filed last spring, because he said Massachusetts has a high rate of skin cancer and melanoma deaths, compared with the rest of the country. ... According to the National Cancer Institute, Massachusetts has a skin cancer mortality rate 18 percent above the national average. Additionally, the state has a 4 percent higher rate of melanoma diagnosis. ... Dr. Kathryn Bowers, president of the Massachusetts Academy of Dermatologists, said teens who want a tanned look have healthier options, such as bottle and spray tans. The products have improved in quality over the years, and she often cannot tell the difference between fake and real tans."

Questions of the Week:
What do you know about the possible health risks associated with indoor tanning? What do you think your friends, family members, and peers know about this topic? What should they know? What would be the best way to reach them with this information? Whose responsibility is it to make sure that people (teens and adults) have accurate information before deciding to use a tanning salon?

If you are in a state that currently has laws restricting the use of tanning salons for teens, what effect do you think the legislation has had? If you are in a state that does not currently have laws regarding teen tanning salon use (or in a state that is considering it), what effects would such legislation have on the behaviors of your friends, family members, and peers?

Please email me with any ideas or suggestions.
Note: Due to increasing amounts of SPAM sent to this account, please include "QOW" in the subject line when sending me email.

I look forward to reading what you have to say.

[email protected]
Health Community Coordinator
Access Excellence @ the National Health Museum

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