Who tans indoors?

• On an average day in the United States, more than 1 million people tan in tanning salons.¹
• Nearly 70 percent of tanning salon patrons are Caucasian girls and women, primarily aged 16 to 29 years.²
• Nearly 28 million people tan indoors in the United States annually. Of these, 2.3 million are teens.^3,4
• In 2010, the indoor tanning industry’s revenue is estimated to be $2.6 billion.⁵

Risks of indoor tanning

• The United States Department of Health and Human Services and the World Health Organization's (WHO) International Agency of Research on Cancer panel has declared ultraviolet (UV) radiation from the sun and artificial sources, such as tanning beds and sun lamps, as a known carcinogens (cancer-causing substances).⁶
• Indoor tanning equipment, which includes all artificial light sources, including beds, lamps, bulbs, booths, etc., emits UVA and UVB radiation. The amount of the radiation produced during indoor tanning is similar to the sun, and in some cases might be stronger.^7,8
• Studies have found a 75 percent increase in the risk of melanoma in those who have been exposed to UV radiation from indoor tanning, and the risk increases with each use.^9,10,11
• The risk of melanoma is increased by 87 percent for individuals who started using tanning beds before the age of 35.¹¹
• Evidence from several studies has shown that exposure to UV radiation from indoor tanning devices is associated with an increased risk of melanoma and non-melanoma skin cancer, such as squamous cell carcinoma and basal cell carcinoma.^1,2,10,12
• Studies have demonstrated that exposure to UV radiation during indoor tanning damages the DNA in the skin cells. Excessive exposure to UV radiation during indoor tanning can lead to premature skin aging, immune suppression, and eye damage, including cataracts and ocular melanoma. ^1,13-16
• In addition to the above mentioned risks, frequent, intentional exposure to UV light may lead to an addiction to tanning.¹⁷
• Indoor tanning beds/lamps should be avoided and should not be used to obtain vitamin D because UV radiation from indoor tanning is a risk factor for skin cancer. Vitamin D can be obtained by a eating a healthy diet and by taking oral supplements.
• In a recent survey of adolescent tanning bed users, it was found that about 58 percent had burns due to frequent exposure to indoor tanning beds/lamps.¹⁸
• The FDA estimates that there are about 3,000 hospital emergency room cases a year due to indoor tanning bed and lamp exposure.¹⁹

Legislation 

• On May 2, 2012, Vermont became the second state to ban indoor tanning for those 18 years and younger.
• Only 36 states restrict indoor tanning use by minors, despite the call from the WHO to prohibit minors from indoor tanning because of the danger of skin cancer. On Oct. 9, 2011, California became the first state in the nation to prohibit the use of indoor tanning devices for all children and adolescents under the age of 18.
• The FDA is considering modifying the classification of indoor tanning beds based on a hearing in March 2010.

Academy position statement about indoor tanning

• The American Academy of Dermatology Association (AADA) opposes indoor tanning and supports a ban on the production and sale of indoor tanning equipment for non-medical purposes.
• The American Academy of Dermatology supports the WHO recommendation that minors should not use indoor tanning equipment because indoor tanning devices emit UVA and UVB radiation, and because overexposure to UV radiation can lead to the development of skin cancer.
• Unless and until the FDA bans the sale and use of indoor tanning equipment for non-medical purposes, the Academy supports restrictions for indoor tanning facilities, including:
  • No person or facility should advertise the use of any UVA or UVB tanning device using wording such as “safe,” “safe tanning,” “no harmful rays,” “no adverse effect,” or similar wording or concepts.

Learn more about the dangers of indoor tanning:

• AAD indoor tanning public service advertisements
• Dermatology A to Z: Melanoma
• Dermatology A to Z: Skin cancer

¹ Whitmore SE, Morison, WL, Potten CS, Chadwick C. Tanning salon exposure and molecular alterations. J Am Acad Dermatol 2001;44:775-80.
² Swerdlow AJ, Weinstock MA. Do tanning lamps cause melanoma? An epidemiologic assessment. J Am Acad Dermatol 1998;38:89-98.
³ Kwon HT, Mayer JA, Walker KK, Yu H, Lewis EC, Belch GE. Promotion of frequent tanning sessions by indoor tanning facilities: two studies. J Am Acad Dermatol 2002;46:700-5.
⁴ Dellavalle RP, Parker ER, Ceronsky N, Hester EJ, Hemme B, Burkhardt DL, et al. Youth access laws: in the dark at the tanning parlor? Arch Dermatol 2003;139:443-8.
⁵ ”Tanning Salons in the US: 81219c.” IBISWorld Industry Report. 2009 August 7.
⁶ U.S. Department of Health and Human Services, Public Health Service, National Toxicology Program. Report on carcinogens, 11th ed: Exposure to sunlamps or sunbeds.
⁷ Hornung RL, Magee KH, Lee WJ, Hansen LA, Hsieh YC. Tanning facility use: are we exceeding the Food and Drug Administration limits? J AM Acad Dermatol. 2003 Oct;49(4):655-61.
⁸ Miller, SA, Hamilton, SL, Wester, UG, Cyr, WH. An analysis of UVA emissions from sunlamps and the potential importance for melanoma. Photochem Photobiol 68(1998), 63-70.
⁹ Lazovich, D, et al. "Indoor Tanning and Risk of Melanoma: A Case-Control Study in a Highly Exposed Population." Cancer Epidemiol Biomarkers Prev. 2010 June;19(6):1557-1568.
¹⁰ The International Agency for Research on Cancer Working Group on artificial ultraviolet (UV) light and skin cancer "The association of use of sunbeds with cutaneous malignant melanoma and other skin cancers: A systematic review.” International Journal of Cancer. 2007 March 1;120:111-1122.
¹¹Cutaneous melanoma attributable to sunbed use: systematic review and meta-analysis. British Medical Journal 2012;345:e4757.
¹² Karagas M, et al. "Use of tanning devices and risk of basal cell and squamous cell skin cancers.” Journal of the National Cancer Institute. 2002 February 6;94(3):224-6.
¹³ Piepkorn M. Melanoma genetics: an update with focus on the CDKN2A(p16)/ARF tumor suppressors. J Am Acad Dermatol. 2000 May;42(5 Pt 1):705-22; quiz 723-6.
¹⁴ Vajdic CM, Kricker A, Giblin M, McKenzie J, Aitken JF, Giles GG, Armstrong BK. Artificial ultraviolet radiation and ocular melanoma in Australia. Int J Cancer. 2004 Dec 10;112(5):896-900.
¹⁵ Walters BL, Kelly TM. Commercial tanning facilities:a new source of eye injury. Am J Emerg Med 1987;120:767-77.
¹⁶ Clingen PH, Berneburg M, Petit-Frere C, Woollons A, Lowe JE, Arlett CF, Green MH. Contrasting effects of an ultraviolet B and an ultraviolet A tanning lamp on interleukin-6, tumour necrosis factor-alpha and intercellular adhesion molecule-1 expression. Br J Dermatol. 2001 Jul;145(1):54-62.
¹⁷Fisher DE , James WD. Indoor tanning--science, behavior, and policy. N Engl J Med 2010;363:901-3.
¹⁸Cokkinides V, Weinstock M, Lazovich D, Ward E, Thun M. Indoor tanning use among adolescents in the US, 1998-2004. Cancer 2009; 115: 190-198. 
¹⁹The FDA - accessed September 2009. http://www.fda.gov/Radiation-EmittingProducts/RadiationEmittingProductsandProcedures/Home
BusinessandEntertainment/ucm116447.htm