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By Carol Rados
Parents of teen-agers are strongly encouraged by public health experts and medical professionals to discuss with their kids the dangers of indoor tanning equipment, and even to discourage its use. In fact, legislators in some states are proposing to make it illegal for a teen to tan in a commercial salon without parental consent.
According to the American Cancer Society (ACS), exposure to the sun's ultraviolet (UV) rays appears to be the most important environmental factor in developing skin cancer. Consequently, the dangers from exposure to UV rays from artificial sources of light, such as tanning beds and sunlamps, are similar to the dangers of exposure to sunlight. Moreover, some experts strongly believe that the sharp rise in the rates of the most serious type of skin cancer--malignant melanoma--may be due to increased exposure to UV radiation, whether from natural sunlight or artificial sources of light.
When exposed to UV radiation, the skin begins to produce a pigment called melanin to protect itself from burning. It is the production of melanin that causes the skin to darken and produce the tan. The production of new melanin takes three to five days.
Joshua L. Fox, M.D., a dermatologist in Fresh Meadows, N.Y., says, "Continued use of a tanning bed or sunlamp can be quite dangerous, particularly during the teen-age years." Teens are at greater risk, he says, because they are still experiencing tremendous growth at the cellular level, and, like other cells in the body, the skin cells are dividing more rapidly than they do during adulthood.
W. Howard Cyr, Ph.D., and Sharon A. Miller, both laboratory leaders in the Food and Drug Administration's Center for Devices and Radiological Health, say that the agency has regulated the manufacture of sunlamp products--sunlamps, tanning beds, tanning booths, and other related equipment--since 1979. Initially, there was a widespread acute risk from sunlamp products, as indicated by a large number of skin and eye injuries treated annually in hospital emergency rooms. Federal performance standards for sunlamp products were established to protect people from acute burns and exposure to hazardous shortwave UV radiation that was unnecessary for tanning.
In 1985, the agency decided to amend the standards to make the requirements more compatible with then-current products. When sunlamp technology changed and sunlamps emitting primarily UVA radiation--longer-wave, less efficient at producing a sunburn--became prevalent, longer exposure times were allowed, Miller says.
In 1986, the FDA published a policy letter that described how the maximum timer limit should be determined and provided guidance on recommended exposure schedules. The manufacturers of sunlamp products are required to include a recommended exposure schedule in their labeling. This schedule should be clearly visible to users before they begin their exposure session.
"FDA does not recommend the use of indoor tanning equipment," Miller says. Fox agrees. "There is no such thing as a safe tan," he says. "Just one sunburn increases your risk for skin cancer."
However, Miller says that if people insist on using tanning devices, there are things they can do to reduce the potential dangers.
"Start slowly, with short exposure times, and build up to a tan. If you get the maximum exposure the first time, you will probably get burned," Miller says. And, she adds, often people don't even know they are burned until it's too late. "Remember that a sunburn doesn't usually show up until several hours after the exposure," she says. In addition, the recommended exposure schedules do not allow for tanning more frequently than every other day. After a tan is developed, tanning frequency should be reduced to no more than twice a week.
Cyr and Miller warn that, in practice, tanning salon operators control the exposure time and that they may allow the customer to exceed exposure times written on the label. This is especially true for the beginning of the tanning course when users are advised to start off with very short exposures, usually five minutes or less. Fox says that people who use these products should always ask to see the information contained in the label. Be wary, he adds, if tanning salon operators can't produce it.
Miller says that the use of FDA-compliant eyewear that blocks UV rays is absolutely essential for tanning bed users to protect their eyes from corneal burns and cataracts from long-term exposure.
A study done by researchers at Wake Forest University, published in the July 2004 issue of the Journal of the American Academy of Dermatology, found that participants thought UV exposure was not only desirable for improving appearances, but also was somewhat addictive. The study concluded that "The relaxing and reinforcing effects of UV exposure contribute to tanning behavior in frequent tanners and should be explored in greater detail."
Fox advises parents to explore safer, alternative means for their children to acquire a tan. "Teens should know about the options," he says, which include self-tanners in the form of creams and gels. "Get the look you like without the damage that can occur with tanning equipment."