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Dr. Rachel Ness, Fargo, Published April 14 2012

An indoor tan is not a ‘safe tan’

In response to the April 6 opinion article written to try to discredit the original article in the March 25 Forum that was intended to educate consumers on the dangers of tanning beds and ultimately save lives:

I feel an obligation to educate consumers on the implications of using tanning beds because I think the opinion article on April 6 confuses them. As a board-certified dermatologist, I have no financial interest in the indoor tanning industry. Unfortunately, the tanning industry generates many of my skin cancer patients.

A carcinogen

The U. S. Department of Health and Human Services and the World Health Organization’s International Agency for Research on Cancer panel have declared ultraviolet radiation from tanning beds is a carcinogen. Tanning beds have been linked to an increased risk of melanoma and non-melanoma skin cancers such as squamous cell and basal cell cancers. Tanning beds have also been linked to premature skin aging, immunosuppression and eye damage such as cataracts and ocular melanoma.

One difference between outdoor and indoor UV exposure is radiation variants. Indoor tanning uses primarily UVA; outdoor exposure has both UVA and UVB. UVB is what gives you red sunburn, but UVA penetrates much deeper in the skin and is linked to many detrimental side effects. So when you go into a tanning bed with very high levels of UVA, the consumer is able to get a delayed tan (what they want) from the UVA and avoid a lot of red UVB sunburn (what they don’t want). But they unknowingly take on a significant amount of radiation from the UVA spectrum. So avoiding red sunburn in a tanning bed is not an indicator of a “safe tan.”

Excellent studies

Both UVA and UVB are likely to contribute to melanoma. The significance of UVA is gaining attention as a cause of skin cancers and has led to UVA protection in sunscreens. A study abstract that was presented March 16 at the American Academy of Dermatology annual meeting found indoor tanning might be a more reliable predictor of invasive cutaneous melanoma than outdoor sunburns. This echoes the Minnesota Skin Health Study, which found an increased risk for melanoma from having any history of tanning bed use. (Cancer Epidemiol Biomarkers Prev. 2010;19:1558-1568).

The referenced “Smart Tan Survey” (sponsored by the tanning industry) has no reputable scientific background or even relevance; it is simply asking consumers about self-perceived sunburns (that is only a reference to their perceived UVB exposure and not UVA exposure).

An indoor tan is another way to get a jump-start on DNA damage. The Indoor Tanning Association was recently legally prohibited from making false health and safety claims about indoor tanning in a settlement with the Federal Trade Commission, but, unfortunately, being illegal has not stopped the practice. Two months ago, the congressional Democratic minority of the House Energy and Commerce Committee found 90 percent of the tanning salons, when contacted, were still telling consumers that “indoor tanning had no health risks.” This is illegal but is still occurring.

Spray option

The tanning industry makes $5 billion a year. Tanning is big business. I am not trying to create a hardship for small businesses. I promote our local businesses on a daily basis in my practice by recommending spray-on tans if patients wish to pursue a safe radiation-free tan. (I do not provide this service and have no financial interest in it). The article of March 25 was going to include information on spray tans and promote local business, but The Forum writer decided radiation-free spray tanning was such an important issue, she wanted to give “spray tans” a whole article of its own in the future.

I stand behind the article The Forum wrote on the negative effects of indoor tanning beds. And I stand behind protecting the public (your families and mine). For further information on this important issue, visit www.skincancer.org or www.aad.org.


Ness, MD, is a board-certified dermatologist.


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