Tanning beds: safe alternative to sun?

By Heidi Mallis, B.A and Diana Zuckerman, PhD
Updated 2015

For many years, tanning beds were advertised as a safe alternative to a natural suntan, but in fact, there was no evidence that was true.  No U.S. government agency evaluated sun lamps, tanning beds, or tanning booths to make sure they were safe.  As a result, nearly 30 million people in the U.S. were using tanning beds each year1, 2.3 million of whom were adolescents.2

Research evidence was growing about the risks of tanning beds.  According to the American Academy of Dermatology and the World Health Organization, indoor tanning increases a person’s chances of developing melanoma by 59 percent, and the risk goes up with each use.3

Finally, in 2014 the U.S. Food and Drug Administration (FDA) announced that all sun lamps and UV lamps intended for use in sun lamp products must come with warnings include the following:

  • This product is contraindicated for persons under the age of 18 years;
  • This product must not be used if skin lesions or open wounds are present;
  • This product should not be used on people who have had skin cancer or a family history of skin cancer
  • People repeatedly exposed to UV radiation should be regularly evaluated for skin cancer3

As evidence grew of the link between tanning beds and skin cancer, especially for men and women in their 20s, more than 60% of states passed some kind of legislation restricting the use of tanning salons by children under 18 and two states, California and Vermont, have passed complete bans of indoor tanning for minors.4

What does this mean for you?

Tanning beds expose the user to a lot of artificial UV radiation in a short period of time. Just one 8-20 minute session exposes a person to more UV radiation than an entire afternoon spent in natural sunlight. In fact, doses of UV radiation emitted by high pressure sunlamp products may be up to 10 to 15 times higher than that of the midday sun, which is more intense than UV radiation found in nature.

A study conducted by Dr. S. Elizabeth Whitmore and Dr. Warwick Morison of Johns Hopkins University School of Medicine found that ten tanning sessions in two weeks produced evidence of a suppressed immune system among participants. This means that the body is less capable of fighting off infectious agents.5 Tanning bed use is also associated with faster skin aging because the UV radiation destroys skin fibers and damages elasticity. Characteristics of skin aging include wrinkles, dark spots, and a leathery texture.6

The International Agency for Research on Cancer lists tanning beds in its highest cancer risk category, “carcinogenic to humans.” This means that there is enough evidence to conclude that tanning beds can cause cancer in humans. Prior to 2009, the agency, which is part of the World Health Organization (WHO), previously classified tanning beds as “probably carcinogenic.” The change came after an analysis of more than 20 epidemiological studies indicating that people who begin using tanning devices before age 30 are 75% more likely to develop cutaneous melanoma, the most serious type of skin cancer7

Skin cancer is the most common form of cancer, with more than one million cases diagnosed each year in the U.S. There are three types of skin cancer: squamous cell, basal cell, and melanoma. Squamous cell carcinomas typically occur on surfaces exposed to the most sunlight, such as the ears or face. This type of skin cancer can spread quickly to other organs in the body. Basal cell carcinomas account for 8 out of 10 skin cancers. They grow very slowly and rarely spread to other parts of the body (as a result, they are highly treatable). Melanomas are the third and most dangerous type of skin cancer. They are less common than basal and squamous cell carcinomas but much more serious.8 Melanomas usually present as a change to an existing mole or an entirely new mole that is black or has a blue-black area. Their diameter is typically larger than that of a pencil eraser. If caught early, melanomas are often completely curable. However, they are much more likely to spread to other parts of the body if not found early.9

Risk factors for all three types of skin cancer include:

  • Lifetime exposure to UV radiation (from natural or artificial sources)
  • Family history of skin cancer
  • Geographic location (people who live close to the equator as well as in the mountains are exposed to higher levels of UV radiation)
  • Fair skin that freckles or burns easily
  • Severe sunburns as a child
  • Radiation therapy

Here are a few ways to lower your risk and avoid wrinkles and other skin damage:

  • Avoid direct sun exposure during midday hours (from 10 am-4 pm),
  • Use sunscreen with a sun protection factor (SPF) of at least 15
  • Regularly check your skin for any new moles, sores, or scaly patches (and visit a dermatologist if you notice the lesion changing form or color), and
  • Avoid using a tanning bed or booth (especially if you are a child, teenager, or young adult).10

Keeping track of moles and other changes to your skin are an easy way to improve your skin health. However, the U.S. Preventive Services Task Force suggests that if you are not at an increased risk of developing skin cancer, there is no need for yearly skin checks by a dermatologist.11

Continue to monitor any existing or new moles and contact your doctor if you detect any significant changes in size, shape, or color.

 

  1. Indoor Tanning Association (2005). Positive effects of UV light. href=”http://www.theita.com/indoor/faq.cfm#ans5″>http://www.theita.com/indoor/faq.cfm#ans5 (Accessed August 31, 2009).  
  2. American Academy of Dermatology (2009, July 30) American Academy of Dermatology commends reclassification of tanning beds as carcinogenic.  
  3. Food and Drug Administration (2014, May). Indoor Tanning Raises Risk of Melanoma: FDA Strengthens Warnings for Sunlamp Products. href=”http://www.fda.gov/downloads/ForConsumers/ConsumerUpdates/UCM399241.pdf”>http://www.fda.gov/downloads/ForConsumers/ConsumerUpdates/UCM399241.pdf (Accessed September 2015).  
  4. Balk SJ, Fisher DE, Geller AC. Teens and Indoor Tanning: A Cancer Prevention Opportunity for Pediatricians. Pediatrics, 2013; 131(4): 772-785.  
  5. Whitmore SE, Morison WL. The effect of suntan parlor exposure on delayed and contact hypersensitivity. Photochemistry and Photobiology, 2000; 71(6): 700-705.  
  6. FDA (2009, May 5). The risks of tanning. U.S. Department of Health and Human Services. http://www.fda.gov/Radiation-EmittingProducts/RadiationEmittingProductsandProcedures/Tanning/ucm116432.htm (Accessed September 3, 2009).  
  7. WHO International Agency for Research on Cancer Monograph Working Group (2009, July 29). A Review of Human Carcinogens—Part D: Radiation. The Lancet Oncology, August 2009; 10 (8): 751-2.  
  8. American Cancer Society (2009, May 6). What are basal and squamous cell skin cancers? http://www.cancer.org/docroot/CRI/content/CRI_2_2_1x_What_Is_Nonmelanoma_Skin_Cancer_51.asp?sitearea= (Accessed September 4, 2009).  
  9. National Cancer Institute (2003, March 31). Signs and symptoms of melanoma. U.S. National Institutes of Health. http://www.cancer.gov/cancertopics/wyntk/melanoma/page8  
  10. National Cancer Institute (2009, July 30). What you need to know about skin cancer. U.S. National Institutes of Health. http://www.cancer.gov/cancertopics/wyntk/skin (Accessed September 2, 2009).  
  11. U.S. Preventive Services Task Force (2009, February 3). Screening for skin cancer: U.S. Preventive Services Task Force recommendation statement. Agency for Healthcare Research and Quality. Annals of Internal Medicine, 2009; 150(3): 188-193. (Accessed September 8, 2009).