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Selected Indoor Tanning Myths and Controversies

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Shedding Light on Indoor Tanning

Abstract

In the face of increasing evidence that indoor tanning is harmful, tanning enthusiasts and the tanning industry defend the practice on several grounds. The principal argument offered in defense of year-round tanning is the claimed health benefit of high levels of vitamin D, also called the sunshine vitamin, which is made in skin following UV irradiation. However, vitamin D is readily available as an oral supplement; and oral vitamin D obviates the needed exposure to UV light that also leads to photoaging and skin cancer. Further, the claimed health benefits of high vitamin D levels are unproven. A second myth, that indoor tanning is safer than sun tanning ignores the fact that tanning is a well-established DNA damage response, achieved in proportion to DNA damage, regardless of the exact wavelengths emitted by tanning bulbs or by the sun. Similarly, obtaining a “base tan” before a planned sunny vacation will not decrease cumulative UV damage. Finally, indoor tanning may be occasionally an effective, more convenient and less expensive alternative to physician-supervised phototherapy for patients with UV-responsive skin disease, but for most patients professional staff and medical light sources with specific spectral output established as optimal for their disease provide far superior safety and efficacy.

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Abbreviations

AI:

Adequate intake

FDA:

Food and Drug Administration

IARC:

International Agency for Research on Cancer

ITA:

Indoor Tanning Association

IU:

International units

PTH:

Parathyroid hormone

UV:

Ultraviolet

UVA:

Ultraviolet A

UVB:

Ultraviolet B

References

  1. Segrave K (2005) Suntanning in 20th century America. McFarland & Company, Inc., Jefferson

    Google Scholar 

  2. Albert MR, Ostheimer KG (2002) The evolution of current medical and popular attitudes toward ultraviolet light exposure: part 1. J Am Acad Dermatol 47(6):930–937

    Article  PubMed  Google Scholar 

  3. Martin JM, Ghaferi JM, Cummins DL et al (2009) Changes in skin tanning attitudes. Fashion articles and advertisements in the early 20th century. Am J Public Health 99(12):2140–2146

    Article  PubMed  Google Scholar 

  4. Randle HW (1997) Suntanning: differences in perceptions throughout history. Mayo Clin Proc 72(5):461–466

    Article  PubMed  CAS  Google Scholar 

  5. Woo DK, Eide MJ (2010) Tanning beds, skin cancer, and vitamin D: an examination of the scientific evidence and public health implications. Dermatol Ther 23(1):61–71

    Article  PubMed  Google Scholar 

  6. Levine JA, Sorace M, Spencer J et al (2005) The indoor UV tanning industry: a review of skin cancer risk, health benefit claims, and regulation. J Am Acad Dermatol 53(6):1038–1044

    Article  PubMed  Google Scholar 

  7. Indoor Tanning Association (2009a) http://www.theita.com/. Accessed 28 Nov 2009

  8. Indoor Tanning Association (2009b) Positive effects of UV light. http://www.theita.com/?page=Positive_Effects_UV&hhSearchTerms=positive±and±effects±and±of±and±UV. Accessed 2 Jan 2010

  9. Gilchrest BA (2008) Sun exposure and vitamin D sufficiency. Am J Clin Nutr 88(2):570S–577S

    PubMed  CAS  Google Scholar 

  10. Holick MF, Vitamin D (2007) deficiency. N Engl J Med 357(3):266–281

    Article  PubMed  CAS  Google Scholar 

  11. Reddy KK, Gilchrest BA (2010) What is all this commotion about vitamin D? J Invest Dermatol 130(2):321–326

    Article  PubMed  CAS  Google Scholar 

  12. Tanning Truth (2010) Vitamin D: one big reason we need sun exposure. http://www.tanningtruth.com/index.php/vitamin_d_sunshine_vitamin. Accessed 3 Jan 2010

  13. Schoenmakers I, Goldberg GR, Prentice A (2008) Abundant sunshine and vitamin D deficiency. Br J Nutr 99(6):1171–1173

    Article  PubMed  CAS  Google Scholar 

  14. Wolpowitz D, Gilchrest BA (2006) The vitamin D questions: how much do you need and how should you get it? J Am Acad Dermatol 54(2):301–317

    Article  PubMed  Google Scholar 

  15. Giovannucci E (2005) The epidemiology of vitamin D and cancer incidence and mortality: a review (United States). Cancer Causes Control 16(2):83–95

    Article  PubMed  Google Scholar 

  16. Melamed ML, Michos ED, Post W et al (2008) 25-hydroxyvitamin D levels and the risk of mortality in the general population. Arch Intern Med 168(15):1629–1637

    Article  PubMed  Google Scholar 

  17. Freedman DM, Chang SC, Falk RT et al (2008) Serum levels of vitamin D metabolites and breast cancer risk in the prostate, lung, colorectal, and ovarian cancer screening trial. Cancer Epidemiol Biomarkers Prev 17(4):889–894

    Article  PubMed  CAS  Google Scholar 

  18. Wactawski-Wende J, Kotchen JM, Anderson GL et al (2006) Calcium plus vitamin D supplementation and the risk of colorectal cancer. N Engl J Med 354(7):684–696

    Article  PubMed  CAS  Google Scholar 

  19. Ross AC, Manson JE, Abrams SA et al (2010) The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J Clin Endocrinol Metab 96(1):53–58

    Article  PubMed  Google Scholar 

  20. Bischoff-Ferrari HA, Giovannucci E, Willett WC et al (2006) Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr 84(1):18–28

    PubMed  CAS  Google Scholar 

  21. Ginde AA, Liu MC, Camargo CA Jr (2009) Demographic differences and trends of vitamin D insufficiency in the US population, 1988–2004. Arch Intern Med 169(6):626–632

    Article  PubMed  CAS  Google Scholar 

  22. American Academy of Dermatology and AAD Association (2009) Position statement on vitamin D. http://www.aad.org/Forms/Policies/Uploads/PS/PS-Vitamin%20D.pdf. Accessed 6 Jan 2010

  23. National Cancer Institute (2008) Melanoma cancer risk. http://www.cancer.gov/melanomarisktool/melanoma-cancer-risk.html. Accessed Mar 2010

  24. US Food and Drug Administration (2008) Indoor tanning: the risks of ultraviolet rays. http://www.fda.gov/downloads/ForConsumers/ConsumerUpdates/UCM190664.pdf. Accessed Mar 2010

  25. Whitmore SE, Morison WL, Potten CS et al (2001) Tanning salon exposure and molecular alterations. J Am Acad Dermatol 44(5):775–780

    Article  PubMed  CAS  Google Scholar 

  26. Karagas MR, Stannard VA, Mott LA et al (2002) Use of tanning devices and risk of basal cell and squamous cell skin cancers. J Natl Cancer Inst 94(3):224–226

    PubMed  Google Scholar 

  27. Arunabh S, Pollack S, Yeh J et al (2003) Body fat content and 25-hydroxyvitamin D levels in healthy women. J Clin Endocrinol Metab 88(1):157–161

    Article  PubMed  CAS  Google Scholar 

  28. Clemens TI, Adams JS, Henderson SL et al (1982) Increased skin pigment reduces the capacity of skin to synthesize vitamin D3. Lancet 1:74–76

    Article  PubMed  CAS  Google Scholar 

  29. Kumar J, Muntner P, Kaskel FJ et al (2009) Prevalence and associations of 25-hydroxyvitamin D deficiency in US children: NHANES 2001–2004. Pediatrics 124(3):e362–e370, Epub ahead of print

    Article  PubMed  Google Scholar 

  30. Wortsman J, Matsuoka LY, Chen TC et al (2000) Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr 72(3):690–693

    PubMed  CAS  Google Scholar 

  31. Binkley N, Novotny R, Krueger D et al (2007) Low vitamin D status despite abundant sun exposure. J Clin Endocrinol Metab 92(6):2130–2135

    Article  PubMed  CAS  Google Scholar 

  32. Jackson RD, LaCroix AZ, Gass M et al (2006) Calcium plus vitamin D supplementation and the risk of fractures. N Engl J Med 354(7):669–683

    Article  PubMed  CAS  Google Scholar 

  33. CVS (2010) CVS High potency vitamin D. http://www.cvs.com/CVSApp/catalog/shop_product_detail.jsp?filterBy=&skuId=451102&productId=451102&navAction=push&navCount=3&no_new_crumb=true. Accessed 5 Apr 2010

  34. Mouret S, Baudouin C, Charveron M et al (2006) Cyclobutane pyrimidine dimers are predominant DNA lesions in whole human skin exposed to UVA radiation. Proc Natl Acad Sci USA 103(37):13765–13770

    Article  PubMed  CAS  Google Scholar 

  35. Ren X, Li F, Jeffs G et al (2009) Guanine sulphinate is a major stable product of photochemical oxidation of DNA 6-thioguanine by UVA irradiation. Nucleic Acids Res 38(6):1832–1840

    Article  PubMed  Google Scholar 

  36. Eller MS, Ostrom K, Gilchrest BA (1996) DNA damage enhances melanogenesis. Proc Natl Acad Sci USA 93(3):1087–1092

    Article  PubMed  CAS  Google Scholar 

  37. Cui R, Widlund HR, Feige E et al (2007) Central role of p53 in the suntan response and pathologic hyperpigmentation. Cell 128(5):853–864

    Article  PubMed  CAS  Google Scholar 

  38. Parrish JA, Jaenicke KF, Anderson RR (1982) Erythema and melanogenesis action spectra of normal human skin. Photochem Photobiol 36(2):187–191

    Article  PubMed  CAS  Google Scholar 

  39. Freeman SE, Hacham H, Gange RW et al (1989) Wavelength dependence of pyrimidine dimer formation in DNA of human skin irradiated in situ with ultraviolet light. Proc Natl Acad Sci USA 86(14):5605–5609

    Article  PubMed  CAS  Google Scholar 

  40. Epstein JH, Wang SQ (2010) Understanding UVA and UVB. http://www.skincancer.org/understanding-uva-and-uvb.html. Accessed Mar 2010

  41. Lavker RM, Gerberick GF, Veres D et al (1995) Cumulative effects from repeated exposures to suberythemal doses of UVB and UVA in human skin. J Am Acad Dermatol 32(1):53–62

    Article  PubMed  CAS  Google Scholar 

  42. Kligman LH (1989) The ultraviolet-irradiated hairless mouse: a model for photoaging. J Am Acad Dermatol 21(3 Pt 2):623–631

    Article  PubMed  CAS  Google Scholar 

  43. Kang S, Fisher GJ, Voorhees JJ (2001) Photoaging: pathogenesis, prevention, and treatment. Clin Geriatr Med 17(4):643–659, v-vi

    Article  PubMed  CAS  Google Scholar 

  44. Miller SA, Hamilton SL, Wester UG et al (1998) An analysis of UVA emissions from sunlamps and the potential importance for melanoma. Photochem Photobiol 68(1):63–70

    Article  PubMed  CAS  Google Scholar 

  45. Cokkinides V, Weinstock M, Lazovich D et al (2009) Indoor tanning use among adolescents in the US, 1998 to 2004. Cancer 115(1):190–198

    Article  PubMed  Google Scholar 

  46. Indoor Tanning Association (2010) Indoor tanning FAQs. http://www.theita.com/?page=FAQs. Accessed 5 Jan 2010

  47. Coelho SG, Hearing VJ (2010) UVA tanning is involved in the increased incidence of skin cancers in fair-skinned young women. Pigment Cell Melanoma Res 23(1):57–63

    Article  PubMed  Google Scholar 

  48. Horner MJ, Ries LAG, Krapcho M, et al (2010) SEER Cancer Statistics Review, 1975–2006. http://seer.cancer.gov/csr/1975_2006/index.html. Accessed Mar 2010

  49. International Agency for Research on Cancer Working Group on Artificial Ultraviolet (UV) Light and Skin Cancer (2007) The association of use of sunbeds with cutaneous malignant melanoma and other skin cancers: a systematic review. Int J Cancer 120:1116–1122

    Google Scholar 

  50. Christenson LJ, Borrowman TA, Vachon CM et al (2005) Incidence of basal cell and squamous cell carcinomas in a population younger than 40 years. JAMA 294(6):681–690

    Article  PubMed  CAS  Google Scholar 

  51. Purdue MP, Freeman LE, Anderson WF et al (2008) Recent trends in incidence of cutaneous melanoma among US Caucasian young adults. J Invest Dermatol 128(12):2905–2908

    Article  PubMed  CAS  Google Scholar 

  52. Swerdlow AJ, Weinstock MA (1998) Do tanning lamps cause melanoma? An epidemiologic assessment. J Am Acad Dermatol 38(1):89–98

    Article  PubMed  CAS  Google Scholar 

  53. WebMD Health News (2010) FDA Panel:New tanning bed restrictions needed. http://www.webmd.com/skin-beauty/news/20100330/fda-panel-new-tanning-bed-restrictions-needed. Accessed 5 Apr 2010

  54. Yentzer BA, Feldman SR (2009) Tanning beds as an alternative for psoriasis when office-based phototherapy is not accessible. J Dermatolog Treat 20(4):238–240

    Article  PubMed  Google Scholar 

  55. Fleischer AB Jr, Feldman SR, Rapp SR et al (1996) Alternative therapies commonly used within a population of patients with psoriasis. Cutis 58(3):216–220

    PubMed  Google Scholar 

  56. Carlin CS, Callis KP, Krueger GG (2003) Efficacy of acitretin and commercial tanning bed therapy for psoriasis. Arch Dermatol 139(4):436–442

    Article  PubMed  CAS  Google Scholar 

  57. Parrish JA, Jaenicke KF (1981) Action spectrum for phototherapy of psoriasis. J Invest Dermatol 76(5):359–362

    Article  PubMed  CAS  Google Scholar 

  58. Habib F, Stoebner PE, Picot E et al (2005) Narrow band UVB phototherapy in the treatment of widespread lichen planus. Ann Dermatol Venereol 132(1):17–20

    Article  PubMed  CAS  Google Scholar 

  59. Walters IB, Burack LH, Coven TR et al (1999) Suberythemogenic narrow-band UVB is markedly more effective than conventional UVB in treatment of psoriasis vulgaris. J Am Acad Dermatol 40(6 Pt 1):893–900

    Article  PubMed  CAS  Google Scholar 

  60. Degitz K, Messer G, Plewig G et al (1998) Narrow band UVB 311 nm versus broad band UVB. New developments in phototherapy. Hautarzt 49(10):795–806, quiz 806

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Barbara A. Gilchrest .

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Mendese, G., Gilchrest, B.A. (2012). Selected Indoor Tanning Myths and Controversies. In: Heckman, C., Manne, S. (eds) Shedding Light on Indoor Tanning. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-2048-0_8

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