That straightforward statement, backed up by reams of research data, is surprisingly controversial -- controversial to the $5 billion indoor tanning industry, at least. The Indoor Tanning Association, for example, claims that tanning salons are not harmful if used "responsibly" and that there are even health benefits of UV rays, such as the production of vitamin D. However, primary care physicians, dermatologists, and skin cancer organizations around the world disagree. Here's why.
Who Uses Tanning Salons?
According to the American Academy of Dermatology (AAD), more than 1 million people use one of the 25,000 tanning salons in the U.S. on an average day. Of these, most are Caucasian females ages 16 to 29. More than 25% of teenage girls have used tanning salons three or more times in their lives. Research also indicates that tanning can actually be habit-forming, with sufferers displaying similar symptoms as drug- and alcohol-addicted individuals. The tanning industry is growing rapidly, with revenues increasing five-fold since 1992.
The Evidence that Tanning Salons are Harmful
Indoor tanning equipment, which includes all artificial light sources, including beds, lamps, bulbs, and booths, emits mostly high-output UVA but also UVB radiation. (UVB causes sunburn while UVA is a deeper penetrating radiation linked to melanoma.) The amount of the radiation produced during indoor tanning is similar to the sun and in some cases may be stronger.
According to the AAD, indoor tanning is associated with an increased risk of premature aging (age spots and wrinkles), immune system suppression, eye damage (cataracts), and skin cancer (especially squamous cell carcinoma and melanoma). Evidence for the dangers of indoor tanning is overwhelming. For example, a 2007 review of 19 studies by the International Agency for Research on Cancer found that the use of tanning salons increased the risk for melanoma and squamous cell carcinoma, but not basal cell carcinoma, in people under aged 35. In addition, the review found no evidence to support the claim that indoor tanning protects the skin from subsequent sun damage. In September 2008, three more reviews were published in the medical journal Pigment Cell and Melanoma Research that highlighted the huge amount of evidence linking tanning salons and melanoma.
Refuting the Vitamin D Argument
Vitamin D, which the body makes through a chemical reaction to UVB light, helps maintain the body's calcium levels and so is crucial for healthy bones and preventing many diseases. It can be ingested from dietary supplements or foods like eggs, fish, mushrooms, and fortified beverages. Of course, it can also be obtained from the sun. However, experts caution that obtaining it from a carcinogen like ultraviolet radiation is the least safe source. Only a relatively short exposure to UV light is needed to produce vitamin D; a 20-minute tanning session provides about 5 to 7 times more ultraviolet radiation than is needed to produce vitamin D. The AAD states unequivocally that "vitamin D from food and dietary supplements offers the same benefits -- without the danger of skin cancer -- as vitamin D obtained from UV light."
Tanning Salon Legislation
A federal law enacted in 2007 will likely soon lead to more explicit warning labels on tanning equipment; specifically, the phrase "Ultraviolet radiation can cause skin cancer" is being considered. Individual states have gone much further: as of late 2008, about 27 states have implemented restrictions on tanning salons. Most of the laws require underage teens to get parental permission to lie under the tanning-bed lamps. A handful of states completely ban access to artificial UV light in salons for those younger than 13, 14 or 16. Others require teens to bring along a parent or a doctor's prescription. Advocates compare the use of tanning beds to cigarette smoking and the drinking of alcohol -- unhealthy practices that states already put off limits to minors.
Medical organizations worldwide advocate a ban or severe restrictions on indoor tanning for non-medical purposes, including the World Health Organization, International Agency for Research on Cancer, United States Department of Health & Human Services, American Academy of Dermatology, National Cancer Institute, American Cancer Society, and many more.
These experts agree that there is no such things as a safe tan. Everybody, especially young adults and children, should put a priority on their health over vanity and avoid tanning salons.
"Indoor Tanning Fact Sheet." American Academy of Dermatology. 18 September 2008.
"Vitamin D Fact Sheet." American Academy of Dermatology. 21 September 2008.
Bennett DC. "Ultraviolet wavebands and melanoma initiation." Pigment Cell and Melanoma Research 2008 21(5):520-524. 18 September 2008.
Berwick M. "Are tanning beds 'safe'? Human studies of melanoma." Pigment Cell and Melanoma Research 2008 21(5):517-519. 18 September 2008.
International Agency for Research on Cancer Working Group on artificial ultraviolet (UV) light and skin cancer. "The association of use of sunbeds with cutaneous malignant melanoma and other skin cancers: A systematic review." Int J Cancer 2007 120(5):1116-22. 19 September 2008.
"States Say No to Teen Tanning." Pew Research Center. 27 March 2007. 18 September 2008.
Tran TT, Schulman J, Fisher DE. "UV and pigmentation: molecular mechanisms and social controversies." Pigment Cell and Melanoma Research 2008 21(5):509-516. 18 September 2008.