Purpose: To inform readers of all the possible negative and positive effects of indoor tanning

Audience: Ones who are considering indoor tanning bed use

NY Times Health Section
Effects of Indoor Tanning Bed Use
22 September 2016
Indoor tanning came onto the market in the 1970s. Immediately health concerns arose
regarding the risks of practicing indoor tanning use such as malignant melanoma and nonmelanoma cancers. Throughout the years, the FDA has been encouraged to classify indoor
tanning beds as a class III device, which would permit greater restrictions on indoor tanning bed
use. In 2010, a 10% tax was introduced to indoor tanning use in regard to the growing concern of
indoor tanning dangers. Skin cancer risk is increased up to 75% for people under 30 who practice
indoor tanning. According to the Clinics in Dermatology Journal, 35% of adults tan while 59%
college aged adults and 17% of adolescents use tanning beds indoors. The International Agency
for Research on Cancer provided that ultraviolet radiation-emitting beds are listed in its highest
category for risk of cancer as they are carcinogenic to humans. With the risks of indoor tanning
at an all time high, why are one million Americans still tanning indoors everyday? Why hasnt
the FDA shut down the indoor tanning business completely?
Common motives for indoor tanning according to Carolyn Heckman are to be more
attractive as well as a way to relax and reduce stress. However, there are more reasons that go
deeper as to why so many people are still using tanning beds. The elderly will use indoor
tanning beds to gain healthier levels of Vitamin D. Low vitamin D levels leads to increased risks
of numerous diseases. When vitamin D levels are restored, the muscular system is influenced as
well as the prevention of fractures and falls. UVB tanning exposure from tanning beds supply
vitamin D that increases the levels in the body.
UVA exposure from tanning beds has been proven to be more effective than bright light
therapy to aid with mood disorders such as season affective disorder (SAD) and seasonal
depression (SD). These disorders usually occur in the winter months when there is not a lot of
sunlight for an extended period of time. These global environmental factors affect human
biological organisms. Adolescents with mild depressive disorder may be inclined to receive light
exposure from indoor tanning beds. Anti-depressants have greater side affects on adolescents so
light therapy as been an alternative. Activity rhythms and sleep were more advance with
increased light exposure.
Medical professionals have made it known that indoor tanning use can be an alternative
for treating psoriasis. In a study done with 113 patients with psoriasis, 68% saw improvement
from indoor tanning bed use. Doctors advise to only tan for the amount they recommend to the
patient. Doctors do not favor this option because the tanning time cannot be monitored by them
to prevent exposure. Single high UV doses from indoor tanning produce a deep inflammatory
state categorized by the production of pro-inflammatory cytokines and chemokine. However,
repetitive low UV doses show no sign of inflammation. This is why it is crucial to follow the
recommended time prescribed by a medical professional when tanning indoors for psoriasis.

The most common affects from UV exposure from indoor tanning beds are cancer risks
and photoaging. Melanoma is the third most common form of skin cancer. Melanoma is feared
the most because the cells are potentially spread through metastasis. Data from the National
Cancer Institute Surveillance Epidemiology and End Results specified that 68,131 people would
develop melanoma and only 10% of these cases involves a genetic component. This means that
90% of melanoma patients have had biological, environmental, and behavior factors contribute
to this cancer. Further research from a study done by the International Agency for Cancer
Research stated that individuals who have used a tanning bed indoors have an increased 1.15
(15%) chance of melanoma developing. If an individual has tanned indoors before the age of 35,
the risk of melanoma is increased to 1.75.
Photoaging refers to the visible effects of ultraviolet radiation on the skin. The skin
changes through photoaging include wrinkling, dryness, hyperpigmentation, visible blood
vessels, elastosis, and loss of firmness. Skin that is aged chronologically is atrophic. When skin
is photoaged, the skin is thickened through hyperplasticity. This can be seen as a protective
agent against UV damage because the outer layer of the skin acts as a shield. However, solar
elastosis is formed when the collagen of the skin becomes disorganized. Solar elastosis is found
in the inner layer of skin that has been chronically exposed to UV. The end result of this process
is the formation of wrinkles.
Other effects of indoor tanning bed use that have been brought to attention are eye
irradiation and psychological dependence. UV exposure for long periods of time can cause
damage to the eye lens. As stated above, common motives for tanning indoors include relaxation
and reduced stress. Diagnostic and Statistical Manual of Mental Disorders ran a study of 229
college students who tanned indoors and found that 39.3% of these tanners experienced greater
anxiety which could be a leading reason as to why this is a motive to tan indoors.
It is hard to say if the pros outweigh the cons of indoor tanning effects. Research has
provided that tanning indoors can both help and/or harm an individual physically and mentally.
Tanning salon revenue reached $3 billion in 2014; however, restrictions have continued to be put
against this industry in what seems to be a force to end it all together.

Works Cited
Azzam, Naiel, and Ahuva Dovrat. "Long-term Lens Organ Culture System to Determine Age
related Effects of UV Irradiation on the Eye Lens." Experimental Eye Research 79.6
(2004): 903-11. Web.
Barysch, Marjam Jeanette, Gnther F. Hofbauer, and Reinhard Dummer. "Vitamin D, Ultraviolet
Exposure, and Skin Cancer in the Elderly." Gerontology56.4 (2010): 410-13. Web.
Cela, Eliana M., Adrian Friedrich, Mariela L. Paz, Silvia I. Vanzulli, Juliana Leoni, and Daniel
H. Gonzlez Maglio. "Time-course Study of Different Innate Immune Mediators
Produced by UV-irradiated Skin: Comparative Effects of Short and Daily versus a Single
Harmful UV Exposure." Immunology 145.1 (2015): 82-93. Web.
Heckman, Carolyn J., and Sharon L. Manne. Shedding Light on Indoor Tanning. Dordrecht:
Springer, 2012. Print.
Madigan, Lauren M., and Henry W. Lim. "Tanning Beds: Impact on Health, and Recent
Regulations." Clinics in Dermatology 34.5 (2016): 640-48. Web.
Niederhofer, Helmut, and Kai Von Klitzing. "Bright Light Treatment as Mono-therapy of Non
seasonal Depression for 28 Adolescents." International Journal of Psychiatry in Clinical
Practice 16.3 (2012): 233-37. Web.
Owen, Allison Leah, Sarah Grogan, David Clark-Carpenter, and Emily Bucklety. "Effects of an
Appearance-Focussed Versus a Health-Focussed Intervention on Mens Attitudes
Towards UV Exposure." International Journal of Men's Health 15.1 (2016): 34-51. Web.
19 Sept. 2016.
Pudikov, I. V., and V. B. Dorokhov. "The Special Physiological Importance of the UV-A
Spectrum for Successful Phototherapy." Human Physiology Hum Physio l38.6 (2012):
634-39. Web.
Su, Johanna, Daniel J. Pearce, and Steven R. Feldman. "The Role of Commercial Tanning Beds
and Ultraviolet A Light in the Treatment of Psoriasis." Journal of Dermatological
Treatment 16.5-6 (2005): 324-26. Web.
Szabo, Liz. "Tanning Beds Face New Taxes and Restrictions." USA Today. N.p., 29 Mar. 2010.
Web. 19 Sept. 2016.

The Effects of Indoor Tanning

Keywords: Indoor tanning, tanning bed, tanning bed use, tanning bed use indoor, skin cancer
Summary Statement: The FDA is placing stricter laws on tanning beds due to negative health
affects and cancer risks. Tanning beds can cause damage to the skin but research shows that
possible effects of tanning can be positive dependent upon the usage.
20 Facts from 10 sources:
1. As the use of indoor tanning beds gained popularity in the decades after their
appearance in the market in the early 1970s, concerns arose regarding their use.
Clinical research has revealed an association between indoor tanning and several
health risks, including the subsequent occurrence of melanoma and non- melanoma
skin cancers, the development of psychologic dependence, and a tendency toward
other high-risk health behaviors

In an average day in the United States, it has been estimated that more
than one million people will use an indoor tanning device
This gives background information on tanning beds as well as a short
summary of the common risks associated with tanning beds.

Madigan, Lauren M., and Henry W. Lim. "Tanning Beds: Impact on Health, and Recent
Regulations." Clinics in Dermatology 34.5 (2016): 640-48. Web.
2. Vitamin D is essential for enteral and renal calcium and phosphate uptake as well as
their integration into bones. Vitamin D, at adequate levels, allows for adequate calcium
absorption in the kidneys and prevents induction of secondary hyperparathyroidism.
Further- more, it influences the muscular system. One further ad- vantage of vitamin D,
particularly in the elderly population, is the prevention of falls and fractures.

Several authors even promote the use of UV B lamps or tanning beds in

order to increase vitamin D production
This gives the reasons that people need vitamin D and how tanning can
provide it for people.

Barysch, Marjam Jeanette, Gnther F. Hofbauer, and Reinhard Dummer. "Vitamin D, Ultraviolet
Exposure, and Skin Cancer in the Elderly." Gerontology 56.4 (2010): 410-13. Web.
3. Synchronization of the rhythms of physiological processes with one another and with
environmental factors is determined by the regular alternation of night and day. This
correction is performed with sunlight.

A special subtype of depression has been distinguished: the so called

seasonal affective disorder (SAD)
This gives evidence that sunlight can help improve people who experience
seasonal depression. The hours of sunlight are shorter in the winter so
people turn to tanning beds.

Pudikov, I. V., and V. B. Dorokhov. "The Special Physiological Importance of the UV-A
Spectrum for Successful Phototherapy." Human Physiology Hum Physiol 38.6 (2012):
634-39. Web.
4. The most common reason cited for indoor tanning is the belief that tans make one
more attractive. Relaxation/stress relief aspects of the indoor tanning experience are the
second most cited motive for indoor tanning, with other commonly studied predictors
including parental attitudes toward indoor tanning, the idea that a tan is healthy-looking,
and perceived advantages of indoor tanning over tanning in the sun.

Individuals who have used a tanning bed in their life area at relative risk of
developing melanoma compared to the general population.
This sources gives motives that people have for indoor tanning bed use as
well as share statistics of those who are at risk for skin cancers related to
UV exposure.

Heckman, Carolyn J., and Sharon L. Manne. Shedding Light on Indoor Tanning. Dordrecht:
Springer, 2012. Print.
5. Antidepressants are effective treating psychiatric disorders in adolescents, but
nevertheless depression often is inadequately treated. In adolescents, there is a greater
risk of medication side effects.

Increased light exposure is generally associated with more advanced

rhythms (as was observed comparing the bright light and placebo period in
this study), the results are consistent with the possibility that these
depressed patients were subsensitive to circadian effects of light.
This source gives insight on how light exposure can help improve
symptoms of depression in adolescents as an alternative to prescription
drugs.

Niederhofer, Helmut, and Kai Von Klitzing. "Bright Light Treatment as Mono-therapy of
Non-seasonal Depression for 28 Adolescents." International Journal of Psychiatry in
Clinical Practice 16.3 (2012): 233-37. Web.
6. Factors that contribute to damage eye lens are age related and caused by UV radiation
exposure.

The potency of the eye lens to recover from damage is greater when the
intervals between UV-A exposures are longer

This article explains how repetitive UV exposure to the eye lens can cause
serious damage.
Azzam, Naiel, and Ahuva Dovrat. "Long-term Lens Organ Culture System to Determine Age
related Effects of UV Irradiation on the Eye Lens." Experimental Eye Research 79.6
(2004): 903-11. Web.
7. A Food and Drug Administration advisory panel recommended Thursday that the
agency consider actions such as requiring that teenagers get parental consent before using
a tanning bed or even banning the use of tanning beds among teens. The advisers also
recommended reclassifying tanning lamps from Class I medical devices -- a category that
includes tongue depressors and elastic bandages -- to a Class II or Class III device, which
would permit the agency to impose greater restrictions.

About 35% of 17-year-old girls use tanning machines, an FDA report says.
People under 30 who use tanning machines increase their risk of skin
cancer by 75%, according to the International Agency for Research on
Cancer, which is affiliated with the World Health Organization. That
agency last July listed ultraviolet radiation-emitting beds as "carcinogenic
to humans," its highest category of cancer risk.
This source gives good facts about the tanning bed restrictions that have
been put in place over the last few years.

Madigan, Lauren M., and Henry W. Lim. "Tanning Beds: Impact on Health, and Recent
Regulations." Clinics in Dermatology 34.5 (2016): 640-48. Web.
8. As we age, the condition of our skin deteriorates due to a variety of intrinsic
and extrinsic factors, determined not only by genetics and physiological health but also
by behavior and lifestyle choice. Every part of the body ages as a result of the passage of
time: this process is called chronologic or intrinsic ageing

Cumulative, repeated exposure to solar ultraviolet radiation (UVR) is

linked to the induction of specific types of skin cancer and the expression
of cutaneous damage markers responsible for the majority of the visible
signs of skin ageing
This source gives information about how the skin can age without UV
exposure as well as how repeated exposure still causes more harm.

Owen, Allison Leah, Sarah Grogan, David Clark-Carpenter, and Emily Bucklety. "Effects of an
Appearance-Focussed Versus a Health-Focussed Intervention on Mens Attitudes
Towards UV Exposure." International Journal of Men's Health 15.1 (2016): 34-51. Web.
19 Sept. 2016.
9. A single high UV dose produces a deep inflammatory state characterized by the
production of pro-inflammatory cytokines and chemokines that, in turn, induces the
recruitment of neutrophils and macrophages into the irradiated area.

Repetitive low UV doses drive the skin to a photo-induced alert state in

which there is no sign of inflammation

This source gives a look at how UV can cause a inflammatory and how it
doesnt, it depends on the amount of UV exposed to the skin.
Cela, Eliana M., Adrian Friedrich, Mariela L. Paz, Silvia I. Vanzulli, Juliana Leoni, and Daniel
H. Gonzlez Maglio. "Time-course Study of Different Innate Immune Mediators
Produced by UV-irradiated Skin: Comparative Effects of Short and Daily versus a Single
Harmful UV Exposure." Immunology 145.1 (2015): 82-93. Web.
10. It is the opinion of the authors that the physician recommending commercial tanning
treatment bears a majority of the responsibility for safe and appropriate usage. This can
easily be done with monitoring through phone contacts to assess problems and remind
patients of the potential risk of excessive tanning and recommended office follow-up.

In a study of 578 psoriasis patients, 113 patients (36%) had used nonprescription tanning equipment; 68% of those found tanning efficacious.
This source proves that tanning bed use can help patients with psoriasis if
done correctly by doctors recommendation.

Su, Johanna, Daniel J. Pearce, and Steven R. Feldman. "The Role of Commercial Tanning Beds
and Ultraviolet A Light in the Treatment of Psoriasis." Journal of Dermatological
Treatment 16.5-6 (2005): 324-26. Web.