On an average day in America, more than 1 million people visit an indoor tanning salon. That’s why dermatologists nationwide have declared war on the practice, which research overwhelmingly has shown causes cancer.

 

“I personally believe that indoor tanning is as much a risk to our population as cigarette smoking and working with asbestos. We know that those two things cause cancer, and so does indoor tanning,” said Mary E. Maloney, MD, chief of the Division of Dermatology at the University of Massachusetts Medical School.

 

Maloney said that, in one study, researchers plotted the increase in the number of tanning parlors in the United States and then plotted the rising incidents of melanoma in young women. “The curves looked the same over time. It really seems that we are going to be fostering an epidemic of skin cancer,” she said.

 

Melanoma, the most deadly type of skin cancer, is the most common form of cancer for young adults ages 25 to 29 and is the second most common form of cancer for adolescents and young adults ages 15 to 29. In that last category, melanoma rates are increasing faster in females than males. “I’ve seen families just decimated by melanoma,” Maloney said. “I’ve seen young women who have started tanning early in their lives, and they now have melanoma. These are not people in their 80s. These are people in their 20s and 30s. We know that the earlier you start going in the tanning beds, the greater your chances are of developing melanoma.”

 

The American Academy of Dermatology Association supports a federal ban on the production and sale of indoor tanning equipment for nonmedical purposes. Until that happens, the AADA recommends a list of restrictions. At the top of the list is a prohibition against indoor tanning by anyone under 18 years old. The AADA also urges:

Other countries already have taken significant actions against indoor tanning. Last November, the National Health Surveillance Agency, the Brazilian equivalent of the FDA, prohibited the sale and use of tanning devices for aesthetic purposes. In June 2009, the German parliament overwhelmingly passed a law to prohibit the use of tanning beds by minors. Public petitions in Australia support a prohibition of indoor tanning by minors, and legislation is under consideration by the British parliament to do the same.

 

AADA President William D. James, MD, is vice chairman of the Dermatology Department at the University of Pennsylvania Health System. He and Maloney both testified in March before an FDA panel considering changes to the classification of indoor-tanning devices. Today, they are Class 1 devices – the same as adhesive bandages and tongue depressors. “There were people there telling their own stories,” James recalled. “There were not only dermatologists talking about their patients and what they’re seeing in everyday practice, but also actual patients or family members of patients who had died. Some of the testimony was very moving.”

 

In his testimony, James cited research that concludes that exposure to UV-A and UV-B radiation causes DNA damage, which produces genetic mutations that lead to skin damage and ultimately to skin cancer. “If tanning has occurred, DNA damage has preceded it,” James told the panel.

 

Later in his testimony, James said, “Despite industry claims to the contrary, artificial UV radiation from indoor tanning is NOT a safer alternative to outdoor UV exposure from the sun. High-pressure tanning lamps used in tanning facilities emit doses of UV-A as much as 12 times that of the sun. No comparably powerful source of UV-A radiation exists in nature, and the UV-A doses per unit of time received by the skin during a typical tanning-bed session are far higher than what is experienced during daily outdoor activities or sunbathing.”

 

James said the FDA’s reconsideration of the classification of indoor-tanning devices was more than likely prompted by last year’s pronouncement from the World Health Organization that ultraviolet radiation is a human carcinogen. In June 2009, 20 scientists from nine countries met at the International Agency for Research on Cancer, a WHO working group, to reassess the classification of different types of radiation as carcinogens. UV radiation from tanning beds was elevated to Group 1, meaning it causes cancer in humans.

 

“The evidence is out there, and it’s just growing,” James said. “Every month, it seems, I’m reading something new about the dangers of indoor tanning.” He noted that studies also are indicating that tanning is addictive, that it activates the same parts of the brain triggered by drug dependence. In fact, research results released in April in the Archives of Dermatology revealed 39 percent of study participants exhibited one of two measurements of addiction, while 30 percent of participants met the other criteria.

 

The Federal Trade Commission has clamped down on indoor-tanning advertisements and the claims made in them. Here’s one example: In March 2008, the Indoor Tanning Association launched an ad campaign designed to portray indoor tanning as safe and beneficial. The campaign denied skin-cancer risks and said indoor tanning was approved by the government and boosts healthy vitamin D levels in the body. The ads also misrepresented a National Academy of Sciences study by claiming that the research concluded that “the risks of not getting enough ultraviolet light far outweigh the hypothetical risk of skin cancer.” In January 2010, the FTC charged the association with making false claims and agreed to a settlement that bars the association from any further deception. In fact, the settlement contains the exact wording of notices that must accompany any claims. For a claim that indoor tanning ups vitamin D levels, this wording must be included:“NOTICE: You do not need to become tan for your skin to make vitamin D. Exposure to ultraviolet radiation may increase the likelihood of developing skin cancer and can cause serious eye injury.”

 

A body blow to the indoor-tanning industry will be dealt July 1, when a 10 percent federal excise tax on tanning bed and booth services takes effect. The new levy is part of the healthcare-reform legislation. “I certainly think it’s a very fair and appropriate tax, and I’m thrilled with it,” Maloney said. “It sends a message.”