Answer to Question #676 Submitted to "Ask the Experts"

Q

Are tanning beds very dangerous if you only go ten times throughout the whole year?

A

The use of tanning beds is a complex question that pits the desire of people to look and feel young and healthy against the demonstrated hazards to health from exposure to ultraviolet radiation from the sun and/or tanning beds or sunlamps. On one side is the strong, but relatively subdued, opposition of medical groups and public health organizations and on the other the advertisements of a growing industry that enthusiastically encourages artificial tanning and tends to downplay the existence or significance of health risks. The use of tanning devices continues to grow despite warnings from the medical community that discourage their use. It is estimated that one million Americans visit tanning parlors every day, and the tanning industry earns over one billion dollars per year. Tanning devices are also available for home use. The tanning industry is largely unregulated and, for that reason, it is important for those who wish to use tanning devices to be aware of the risks. Exposure to excessive sunlight has been associated with cancer since 1894. Since then, many studies have associated skin cancer with the ultraviolet component in the sunlight. Solar radiation and exposure to sunlamps or sunbeds (tanning beds) are each listed in the Report on Carcinogens, Ninth Edition by the National Toxicology Program as "known to be a human carcinogen." See the NTP Advisory Group Makes Recommendations for 9th Report on Carcinogens Web page for details. According to this report, sunlamp or sunbed exposure is associated with increased likelihood of developing cutaneous malignant melanoma with the risk increasing with duration of exposure. Effects are especially pronounced in individuals under 30 and in those who experienced sunburn. Malignant melanoma of the eye is also associated with the use of sunlamps. Other effects of excessive exposure to ultraviolet radiation from the sun or tanning booths are sunburn, eye damage, premature aging of the skin, and phototoxic reactions. The damage to the skin caused by ultraviolet radiation causes the skin to produce a dark pigment called melanin. It is the production of melanin that causes the skin to darken and produce the tan. A tan will protect against further ultraviolet radiation damage to the skin, but this protection is not perfect and some damage will occur even with a good tan. Sunscreens are partially effective, depending on the UV wave length and proper and liberal use of the sunscreen. Tanning booths are designed to produce much greater amounts of ultraviolet radiation in a given time than the sun. This allows a person to get a tan with much less exposure time than is necessary with sunlight. It also means that you must keep accurate track of your time in the tanning booth, because a few extra minutes can result in a "sunburn." The eye is especially prone to damage in tanning booths. The eyes are normally protected from direct sunlight by the eyebrows. Research indicates that the ultraviolet radiation levels to the eye could be over 100 times greater in a tanning booth than outside in the sun. Corneal burns, cataracts, and, in rare instances, retinal damage can occur. It is important to wear eye protection when using a tanning booth. Wearing sunglasses or keeping your eyes closed is not sufficient. The U.S. Food and Drug Administration (FDA) Center for Devices and Radiological Health (CDRH) has promulgated regulations concerning sunlamp products and UV lamps intended for use in sunlamp products under the Regulations for the Administration and Enforcement of the Radiation Control for Health and Safety Act of 1968 (21 CFR 1040.20). These include performance requirements, timers, protective eyeware to be worn during product use, compatibility of lamps, and labeling. The American Medical Association (AMA) passed a resolution in 1994 calling for a ban of the use of suntan parlor equipment for nonmedical purposes. Dermatologists have urged the FDA to take action to discourage use of suntan parlors and suntan beds. According to the Report on Carcinogens, Ninth Edition the FDA Center for Devices and Radiological Health and the Centers for Disease Control and Prevention (CDC) encourage avoidance of sunlamps and sunbeds. If you are taking prescription drugs, check with your pharmacist or doctor before using a tanning booth. Some drugs can increase your reaction to ultraviolet radiation. These drugs may not make you noticeably sensitive to sunlight, but they may make you very sensitive to the intense ultraviolet radiation in a tanning booth. FDA has published a list of medications that increased sensitivity to light (HHS Publication FDA 91-8280). These drugs include, but are not limited to:

• Some antibiotics
• Some high blood pressure medications
• Some tranquilizers
• Diuretics
• Some birth control pills
• Some oral diabetes medications

After considering the risks, if you still decide to use a tanning booth, be sure to follow these suggestions.

• Don't overdo it. Start with short time intervals and slowly build up your exposure times.
   
• Wear eye protection. Just closing your eyes, wearing sunglasses, or using cotton balls is not enough. Wear the goggles made for tanning booths.
   
• Avoid direct contact with the bulbs.
   
• Insure that an attendant is nearby to help you in an emergency.

Your skin type is very important. Some people tan easily while others can only achieve a very light tan. Some cannot tan at all. Your tanning ability is genetically controlled and cannot be altered. Before using a tanning booth, this should be discussed with the operator. William P. Kirk, Ph.D., CHP