By Gery P. Guy Jr., PhD, MPH
If you read no further, know this: there is no such thing as a safe tan. Indoor tanning is just as dangerous, if not more, than tanning outside in the sun. In fact, indoor tanning injures thousands of people each year badly enough to go to the emergency department. Indoor tanning can cause sunburn and damage to your eyes that could lead to vision loss. Indoor tanning can also cause premature skin aging, including loss of elasticity, wrinkling, age spots, and changes in skin texture.
Most dangerous of all, indoor tanning is a recognized cause of skin cancer, including deadly melanoma. Skin cancer is the most common form of cancer in the United States. Approximately 3.5 million cases of non-melanoma skin cancers are treated each year, and more than 70,000 melanomas are diagnosed yearly. While many cancers have been on the decline in recent years, rates of melanoma, which causes the most skin cancer-related deaths, have been on the rise. Increased exposure to ultraviolet radiation (UV) through indoor tanning may be partially responsible for the continued increase in melanoma, especially among young women. Indoor tanning is particularly dangerous for younger and more frequent users.
There are a lot of misconceptions about indoor tanning, so it's important to know the following:
- Tanned skin is not healthy skin. That "healthy glow" from the tanning bed indicates damage to your skin. Whether tanning or burning, you are exposing yourself to harmful UV rays. In fact, every time you engage in indoor tanning, you increase your risk of melanoma. The truly healthy glow is your natural skin color.
- A base tan is not a safe tan. A tan is the body's response to injury from UV rays. Skin cells respond to damage from UV rays by producing more pigment, which shows that damage has been done. A base tan only provides a sun protection factor (SPF) of about 3 or less, which does little to protect you from future UV exposure. The best way to protect your skin from the sun is by using these widely recommended tips for skin cancer prevention.
- Tanning indoors is not safer than tanning outside in the sun. Indoor tanning and tanning outside are both dangerous. Artificial UV rays from indoor tanning are typically much more intense than UV rays from the sun. The intensity of UV rays can vary depending of the age and type of light bulbs.
- Indoor tanning is not a safe way to get vitamin D. While vitamin D is important for bone health, studies showing links between vitamin D and other health conditions are inconsistent. Although it is important to get vitamin D, vitamin D, if needed, can be obtained safely through diet or supplements. (Vitamin D is found naturally in fatty fish, and is added to foods such as milk and some cereals. Read the labels to find out which foods have vitamin D added.) Tanning harms your skin, and the amount of UV you need to get enough vitamin D is difficult to measure, as it is different for every person.
Who does indoor tanning?
Despite the clear dangers associated with indoor tanning, nearly 1 in 3 young white women ages 16-25 engage in indoor tanning each year. Among those who use indoor tanning, approximately half report 10 or more sessions per year. This is particularly concerning given the increased risk of skin cancer among younger and frequent users.
Tanning often begins during the adolescent years. Studies show kids are more likely to indoor tan if their parents allow it or if the parents indoor tan themselves. Research suggests that girls who start tanning with their mothers tend to begin tanning at an earlier age and are more likely to become regular, habitual tanners than girls who initially tanned alone or with a friend. Studies also suggest that parents aren't very aware of the risks associated with indoor tanning. Given the potential for these behaviors to continue into adulthood, we have to reach likely tanners early to keep them from starting or help them to stop indoor tanning.
What works to keep youth from tanning?
Because of the dangers imposed by indoor tanning, a number of states are restricting its use among minors. Several states have passed laws that require parents to give permission for their children to tan indoors, or even accompany them to the facility. Seven states (Oregon, California, Illinois, Nevada, Texas, Vermont, and Washington) have prohibited the use of indoor tanning by those younger than 18 years altogether.
Research shows that age restrictions do have an impact on indoor tanning rates, while parental permission laws alone do not. This may be because tanning facilities are more likely to comply with age restrictions. These laws could have a lasting effect if they keep some adolescents from ever starting to indoor tan. Preventing indoor tanning among minors could substantially decrease the health and economic burden of skin cancer.
Additionally, encouraging conversations about indoor tanning between parents and teens and making sure parents are monitoring their teens' indoor tanning may be promising approaches to reduce indoor tanning among young people. We also know that peer groups can strongly influence tanning behaviors. The desire to look attractive and healthy and to conform to what society at large deems beautiful often drives behaviors that raise skin cancer risk. As long as students and their friends think tanned skin is more beautiful and healthy-looking, they'll continue tanning. Any efforts to reduce indoor tanning and prevent skin cancer will need to consider these underlying motives.
The evidence linking indoor tanning to an increased skin cancer risk is clear. Indoor tanning is an unnecessary and easily avoidable source of UV exposure. Reducing indoor tanning is an important strategy for reducing the burden of skin cancer. It is clear that children need to be protected from the harms of indoor tanning. Comprehensive efforts are needed to prevent skin cancers and increase understanding about the hazards of tanned skin.
Although indoor tanning remains widespread among certain subgroups of the population, it is important to keep in mind that the majority of young Americans (i.e., 87% of high school students) are not engaging in indoor tanning. You have a better chance at keeping your skin healthy and beautiful for life by avoiding tanning both outside in the sun and indoors in tanning beds.
Read more about indoor tanning and how to protect your skin in the sun.
Dr. Guy is a health economist in the Division of Cancer Prevention and Control's Epidemiology and Applied Research Branch.