Indoor Tanning and the Myth of a Healthy Tan

Many people strive to achieve the "healthy glow" of tanned skin. But is getting a tan good for your health? As a pediatrician, I know the answer to this question is definitely no.

In fact, getting a tan -- whether by sitting in the sun at the beach or visiting a tanning salon -- means that you're hurting your skin. Tanning is the skin's response to damage caused by ultraviolet radiation. Skin cancers begin when this damage affects the DNA of genes controlling the growth of your skin cells. Both the sun and tanning devices emit cancer-causing UV radiation.

Despite growing public awareness of UV damage, going to tanning salons is still a common practice. Each day in the U.S., 1 million people tan indoors, and a national survey showed that an estimated 7.8 million women and 1.9 million men engaged in indoor tanning in 2013.

Pediatricians, dermatologists and other health care professionals worry because salon tanning is especially popular among teen girls and young women. A 2011 national survey of 5,600 high-school students showed that more than 13 percent of all students reported using indoor tanning devices at least once in the past year; about 21 percent of girls reported using them. Use increased with age, with about 28 percent of all 17-year-old girls reporting use. And it's not only one-time tanning before a special event like a prom -- among 17-year-old white girls who indoor tan, more than 60 percent reported doing so 10 or more times in 2011.

Unfortunately, it's easy to find tanning salons. There are more salons in the average large U.S. city than Starbucks or McDonalds! Many are located near high schools and colleges and frequently have low-cost packages offering multiple or unlimited visits. Tanning devices also can be found in apartment buildings, gyms and spas.

Some people believe that indoor tanning is harmless, but this is a myth. The truth is that tanning devices expose users to UV radiation that is much stronger than natural sunlight-- up to 15 times more intense than the sun, often resulting in burning. UV radiation from indoor tanning devices is a "Class 1 carcinogen," according to the World Health Organization -- meaning that it causes cancer in people. This adds tanning devices to the highest category of cancer-causing agents -- joining cigarettes, plutonium and others.

Skin cancer is by far the most common cancer in the U.S. It's been called an epidemic by experts. According to the American Cancer Society, in 2015 there will be about 3.5 million skin cancers in 2.2 million Americans (since some people have more than one). Most of these are basal cell and squamous cell cancers. About 5 percent are melanoma skin cancers.

Most basal and squamous cell cancers are treatable. Death from them isn't common (although there are about 2,000 deaths from squamous cell cancer each year). We're most concerned about melanoma. The ACS estimates that 73,870 new melanomas will be diagnosed in 2015. Although most are successfully treated when caught early, melanoma that has spread has no good treatments. It's the skin cancer type most likely to be deadly. About 9,940 people are expected to die from melanoma in 2015.

Melanoma is more likely to occur in men and older people, but also is found in younger people. In fact, melanoma is one of the most common cancers in those under 30 -- especially women. Melanoma rates have been rising for 30 years. Experts believe that the sharp rise in melanoma in young U.S. women over that last three decades is due, at least in part, to the fact that so many teen girls and young women indoor tan.

Starting indoor tanning at a young age increases your chance of developing skin cancer. As a result of this increased risk, the World Health Organization, the American Academy of Pediatrics, the American Academy of Dermatology and other major organizations recommend banning salon access for minors under 18 years old.

Thankfully government agencies are now taking action. In May 2014, the U.S. Food and Drug Administration, the agency that regulates tanning devices for cosmetic purposes, issued an order requiring that tanning devices in salons carry a "Black-Box Warning" stating '"Attention: This sunlamp product should not be used on persons under the age of 18 years." In July 2014, the U.S. Surgeon General issued a first-time "Call to Action to Prevent Skin Cancer" that includes the goal of reducing harms from indoor tanning.

There isn't yet a federal law requiring an outright ban prohibiting minors under 18 from using tanning salons. But in just the past three years, 13 states have moved ahead and issued these laws to protect teens. Most other states have other kinds of laws restricting minors' access to salons.

There are other factors that can increase your risk of getting melanoma and other skin cancers. People with light skin and light eyes have higher risk. You're more likely to develop melanoma if you've already had one, or if a close relative has had one. Getting older in age increases risk, as do certain genetic conditions. People can't control any of these factors.

What we can control is our exposure to UV radiation. Be safe in the sun when you're outdoors by wearing protective clothing and hats, using sunglasses, seeking shade whenever possible and generously applying sunscreen. Make sure to reapply sunscreen after swimming, sweating or exercising.

Staying away from tanning salons also is in our control. If you're an adult who indoor tans, think hard about the risks. It's not only skin cancer -- indoor tanning can result in eye damage and premature skin aging including wrinkles and leathery, sagging skin. Research also suggests some people may actually be addicted to indoor tanning -- just like with smoking cigarettes, people can get hooked when they're young, and have a hard time quitting when they want to later on.

If you're the parent of a teen, talk to your daughter or son about the hazards of tanning devices. I know of several young indoor tanners who did not realize that skin cancer could happen to them -- until it did . Some of these young people died from melanoma.

Discuss how some advertisers, movies and TV shows promote being tanned as being more attractive than having naturally light skin. Convince your kids not to buy into the myth that a tan equates with health and beauty. Fortunately, there are many non-tanned celebrities who serve as role models for good skin health.

The bottom line for everyone: Indoor tanning causes skin cancer -- so stay away. Embrace your natural skin color, and take care of the skin you're in!