Indoor tanning is NOT pretty

As a nurse who specializes in skin care, I have become increasingly alarmed by the rise in skin cancers, especially melanoma, among young people. I believe a major contributor to this phenomenon is the practice of indoor tanning, now a five billion dollar industry in the United States.

In 2009, the International Agency for Research on Cancer (IARC) classified Ultraviolet Radiation (UVR) as carcinogenic and placed it in its highest risk category, along with mustard gas and arsenic. This year the American Academy of Pediatrics (AAD) joined the American Medical Association (AMA), the World Health Organization (WHO), the American Cancer Society (AMC), the American Dermatology Association (ADA) and the Skin Cancer Foundation in acknowledging the perils of UV exposure by demanding a ban on indoor tanning for minors.

Ultraviolet A and B radiation damage skin cells and are the primary cause of precancerous and cancerous skin lesions. Youth in their teens and twenties who use tanning beds are at a greater risk for developing melanoma, the deadliest form of skin cancer. IARC studies have shown the use of tanning beds, even when used according to tanning industry standards, by people before the age of 35, raises their risk of melanoma by 75 percent.

Melanoma in now the most common form of skin cancer in white females ages 20-24. I believe it is no coincidence that this group represents a major component of the indoor tanning population. Skin cancer exceeds breast, colon, and lung cancer combined yet it is the most preventable. To paraphrase Dr. Leonard Lichtenfeld of the American Cancer Society, there are no safe tanning beds, regardless of claims from the tanning industry. They damage the skin, the eyes and offer no meaningful, necessary health benefit.

Tanned skin has been associated with youth and beauty since the early 1920's, but in reality, it is a sign of skin damage. As the skin reacts to what is called in medical terminology an “insult” caused by UVA rays, it triggers an increase in melanin resulting in the appearance of darker skin color. This damaging exposure, in addition to skin cancers, leads to early wrinkling caused by the loss of elasticity and collagen. The visible and unsightly results are sagging skin, uneven skin color, dilated capillaries, rough patches, a “leathery” appearance, and dark spots on the skin referred to as “age spots” These show up especially on the face, neck, chest, and arms.

In my practice, I see young women in their 20s who are frequent tanners who show the same aging effects as women twice as old. The damage caused by UV radiation from indoor tanning, as well as exposure to the sun, is cumulative and often irreversible. As stated above, the earlier the age tanning begins, the greater the risk of skin cancers and premature aging.

Recently, some alternatives to tanning through ultraviolet exposure have come on the scene. One that shines with good health involves an attitude change rather than a specific action. It is the “Go With Your Own Glow,” campaign promoted by the Skin Cancer Foundation. I am happy to say that many fashion leaders, sports stars and entertainment celebrities are climbing on this bandwagon.

Another alternative to indoor tanning that is gaining in popularity is the use of facial bronzers. These come in a variety of colors to match individual skin tones and may be applied in either powder, creams or tinted moisturizers for a more natural glow. Although not in sync in with the “go with your own glow” idea, facial bronzers are considerably less dangerous than indoor tanning.

A third alternative is the use of self-tanners. The FDA has approved the use of dihydroxyacetone (DHA) which is the color additive used in self-tanners. These self-tanners come in creams and lotions. When applied to the skin, DHA temporarily darkens the skin by reacting with amino acids on the skin's surface. The color gradually fades as dead skin cells slough off, usually within a week. Since DHA has been approved for external application only, it is not approved for use in tanning booths where it is difficult to avoid exposure to the eyes, lips, mucous membranes, or even to inhaling it internally.

From my clinical experience and studies in the field of dermatology and skin care, it is clear to me that protection from UVA and UVB exposure is key to the prevention of premature aging and skin cancers, especially melanoma. Because I believe It is imperative to inculcate children with this knowledge from an early age, I serve on the Board of the Children's Melanoma Prevention Foundation, (CMPF) whose mission is prevention through education from kindergarten through 12th grade.

CMPF offers a five-point action acronym for sun safety called SunAWARE. These action steps are as follows:

  1. Avoid unprotected exposure to sunlight, seek shade, and never indoor tan.
  2. Wear sun protective clothing, including a long-sleeved shirt, pants, a wide-brimmed hat and sunglasses year-round.
  3. Apply recommended amounts of broad-spectrum sunscreen with a sunburn protection factor (SPF) >30 to all exposed skin and reapply every two hours, or as needed.
  4. Routinely examine your whole body for changes in your skin and report suspicious changes to a parent or healthcare provider.
  5. Educate your family and community about the need to be SunAWARE.

I sincerely hope everyone who reads article this will embrace these steps, make them a part of your daily routine, and encourage your family and friends to do likewise. Remember over 90 percent of skin cancers are preventable, easily detected, and when detected early, curable.

Be safe. Be SunAWARE!

Lori Skinner, RN, BSN cares for patients of all ages at South Shore Skin Center and Spa, one of Massachusetts’ most progressive dermatology practices offering a wide range of medical, surgical and cosmetic services with offices in Cohasset and Plymouth, MA. She also serves as Director of the Children's Melanoma Prevention Foundation, non-profit educational foundation that is dedicated to teaching children and their caretakers safe and proven methods of sun protection and skin cancer prevention. For more information, visit and