By Naveen Athrappully
Contributing Writer
Using tanning beds is linked to a nearly threefold jump in the risk of melanoma, the deadliest type of skin cancer, according to a Dec. 12 peer-reviewed study published in the “Science Advances” journal.
“Melanoma is responsible for an estimated 11,000 deaths annually in the United States. The main cause is exposure to ultraviolet radiation, which generates mutations in melanocytes, driving their transformation to melanoma,” the study said. Melanocytes are skin cells that produce melanin, the natural pigment that gives skin its color.
In the study, researchers analyzed medical records of 32,315 patients seen by Northwestern University’s Dermatology service. From this, the researchers identified 2,932 patients with a history of tanning bed use and compared them with 2,925 people who did not use them.
Researchers found that among people who used tanning beds, melanoma was diagnosed in 5.1% of them, which is far higher than the 2.1% incidence rate among the group that never used tanning beds, the study said.
“After adjusting for age, sex, sunburn history, and family history, tanning bed use remained associated with a 2.85-fold increase in melanoma risk,” according to a Dec. 12 statement from Northwestern University, whose researchers were part of the study.
Among tanning bed users, melanoma was found to be more common in body regions with low cumulative sun damage than in those who did not use the beds.
The researchers hypothesized that indoor tanning increases the risk of melanoma by increasing the mutation burden on melanocytes, the study said. Furthermore, indoor tanning mutagenizes a larger field of melanocytes beyond the body regions typically not exposed to natural sunlight, such as the buttocks and lower back.
Researchers collected skin samples from three groups: 11 tanning bed users and two control groups. The control groups consisted of nine individuals who did not use tanning beds but had higher risk factors for melanoma than the general population, and six samples from deceased individuals to represent the general population.
They measured mutations in 182 melanocytes derived from these groups. “The mutation burden of melanocytes in tanning bed users was nearly twofold that of melanocytes from control donors,” the study said.
After assessing the high levels of mutational damage to skin cells from users of tanning beds, “it is difficult to justify marketing claims that the spectra of UV radiation in tanning beds are safer than natural sunlight,” researchers wrote.
Dr. Pedram Gerami, first author of the study and professor of skin cancer research at Northwestern University Feinberg School of Medicine, said that during outdoor exposure, 20% of an individual’s skin may suffer the most damage.
However, among tanning bed users, “we saw those same dangerous mutations across almost the entire skin surface,” he said, adding that there needs to be a policy change, with indoor tanning made illegal “at the very least” for minors.
According to Gerami, most of his patients began tanning when they were young and now regret it. He suggested that tanning beds carry warnings like those on cigarettes.
“When you buy a pack of cigarettes, it says this may result in lung cancer,” Gerami said. “We should have a similar campaign with tanning bed usage.”
“The World Health Organization has deemed tanning beds to be the same level of carcinogen as smoking and asbestos. It’s a class one carcinogen,” he said.
Back in 2009, the WHO’s International Agency for Research on Cancer classified UV-emitting tanning devices as “carcinogenic to humans.”
The study was funded by multiple organizations, including the National Institutes of Health, the Department of Defense Melanoma Research Program, and the Greg and Anna Brown Family Foundation Award. The authors declared no competing interests.
Warning Labels and Parental Consent
According to the American Suntanning Association, a network of indoor tanning service providers, moderation is key when tanning indoors.
Professional indoor tanning salons promote a “balanced message” about indoor tanning, educating customers about the potential risks of UV overexposure, ASA said.
“Tanning customers are required to read and sign consent forms that include warnings about potential risks associated with indoor tanning. Warning labels are found on every tanning device and almost always in other general areas. Professional tanning facilities care about your teens and require parental consent for teenagers who tan,” it said.
The association also warns that exposure to ultraviolet radiation could increase the risk of skin cancer, skin damage, and serious eye injuries.
According to ASA, tanning a body will depend on which of the six skin types an individual has.
“The fairest skin type — known as Skin Type I — cannot suntan without burning and should not use UV tanning equipment,” the association said.
“But darker skin types can develop suntans. For those who can develop suntans, our system gradually acclimates you to UV exposure based on your skin type.”
In a May 2023 post, the Food and Drug Administration warned people about the risks involved in tanning.
While alerting about the risk of developing skin cancer, the agency highlighted that getting a tan won’t protect skin from sunburn or other type of skin damage, as is popularly believed.
The extra melanin in tanned skin only provides a Sun Protection Factor of about 2 to 4, which is far below the recommended SPF of 15, the FDA said.
Moreover, a long-term side effect of UV exposure is premature aging, wrinkles, dark spots, and leathery skin.
