Indoor Tanning Remains Appealing, and Deadly, for Millions

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Long Island Pathologist discusses why Americans continue to use tanning salons.

We are supposed to know better and to be concerned with more important things than getting a fabulous tan. But plenty of us are regularly subjecting our skin to dangerous ultraviolet (UV) rays through indoor tanning. And the experts are seeing the results, as the rates of melanoma, the deadliest form of skin cancer, continue to rise. According to the American Academy of Dermatology (AAD), more than a million Americans head to a tanning salon every day, and there are nearly 30 million tanners, roughly twice as many as a decade ago, among us.

And despite the fact that indoor tanners are most often young women, recent research shows that one in ten people (of both genders) over the age of 50 visit tanning salons, says George Hollenberg. MD, a board-certified dermatologist and pathologist and medical director of Acupath Laboratories, Inc., a national specialty medical laboratory. "The new data shows that there are plenty of parents, and grandparents, using tanning salons, too." The rates of indoor tanning are on the rise, as is the perception that having a tan looks better than having pale skin.

Meanwhile, the AAD reports that the incidence of melanoma has risen steadily in the United States, at a rate of more than 1 percent a year. "This is very different from what we're seeing with other types of cancer," Dr. Hollenberg says. Overall cancer rates have gone down by about 0.6 percent a year, he notes. Melanoma accounts for more than 75 percent of all skin cancer deaths, and one American dies from melanoma every 62 minutes.

Despite the best efforts of dermatologists and other health experts, there seems to be a decreasing public understanding of the dangers of tanning: Many people believe (incorrecty) that an indoor tan is safer than the old-fashioned beach variety, and a recent study found that fewer people today are aware of the link between limiting tanning and the risk of developing melanoma (and other types of skin cancer) than were 15 years ago. "Unfortunately," says Dr. Hollenberg, "millions of Americans just aren't getting the message, or they're choosing to ignore it."

Why? Dr. Hollenberg offers these surprising reasons:
Tanning is addictive. It's true: Research has confirmed that there's more to a tanning habit than vanity (or the feel-good effects of the warm sun or cozy tanning bed). "Studies show that tanning produces an effect similar to alcohol and other addictive substances, and people get hooked on the relaxing sensation of soaking up rays," Dr. Hollenberg says. What's more, controlled, blinded tests that put habitual tanners into regular UV-emitting beds and dummy beds (without the UV emissions) have shown that people can distinguish between the two, and get the reinforcing effects from the UV-emitting beds only, which means that the UV rays themselves can be addictive. "This might explain why many people continue tanning even if they know the dangers," he says. Just as an alcoholic will return to drinking despite its negative effects, a habitual tanner will continue to hit the beach, or the tanning salon, regardless of his or her understanding of the risks.

People think it's healthy. Another problem is the popular misconception that indoor tanning can help produce vitamin D, an essential nutrient that was tied to a reduced incidence of breast cancer in a recent, and controversial, study, which was conducted by researchers at the University of California San Diego using epidemiological and other statistical data. "The study found that women with higher levels of vitamin D in their blood and living closer to the equator had a lower incidence of breast cancer, so some people interpreted that as a prescription for tanning," Dr. Hollenbeg says. "But there are many factors that vary among the countries close to and far away from the equator, and the link between vitamin D and breast cancer is certainly not clear." He notes that another study found that women with higher blood vitamin D levels do not have significantly lower risk of breast cancer. "Even if vitamin D were the antidote for breast cancer, tanning is not the way to get it," he says. "Anyone who's short in D can easily get enough through supplements -- they don't have to resort to tanning."

What we do know, he says, is that indoor tanning can lead to melanoma, and more time you spend in a tanning salon, the greater your risk of developing the disease. According to the AAD, other research has found that regular tanning bed has been associated with a 55 percent increase in the risk of melanoma. UV radiation is a known carcingoen, and it's involved in about half of all human malignancies.

"The bottom line is that indoor tanning is as bad or worse for you than lying in the sun, and it's been definitively tied to skin cancer and premature aging," Dr. Hollenberg contends. The radiation produced during indoor tanning is similar to that produced by the sun (and in some cases even stronger) and it's been proven to damage the DNA in skin cells. "There's no such thing as a safe suntan," he says.

About Dr. George Hollenberg
Dr. George Hollenberg, M.D. is an authority in the fields of pathology, clinical pathology and dermatopathology with expertise in the areas of dysplastic nevi, melanoma, prostate and gastrointestinal cancer. Board-certified in Pathology and Dermatopathology, Dr. Hollenberg is a Fellow of the College of American Pathologists, The American Society of Dermatopathology and the AMA. He has published articles on skin, prostate and gastrointestinal cancer, and is the Consultant in Dermatopathology to The North Shore University Hospital Center. As the founding director of Acupath Laboratories, Inc., Dr. Hollenberg supervises the analysis of tens of thousands of biopsies per year, using the latest cutting-edge technology in histology and immunocytochemistry, as well as the latest advances in computerized report preparation.


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