![Tanning bed, May 2009 (brightened)](https://upload.wikimedia.org/wikipedia/commons/e/eb/Tanning_bed%2C_May_2009_%28brightened%29.jpg)
Indoor tanning involves using a device that emits
ultraviolet radiation
Ultraviolet (UV) is a form of electromagnetic radiation with wavelength from 10 nm (with a corresponding frequency around 30 PHz) to 400 nm (750 THz), shorter than that of visible light, but longer than X-rays. UV radiation i ...
to produce a cosmetic
tan
Tan or TAN may refer to:
Businesses and organisations
* Black and Tans, a nickname for British special constables during the Irish War of Independence. By extension "Tans" can now also colloquially refer to English or British people in general, es ...
. Typically found in tanning salons, gyms, spas, hotels, and sporting facilities, and less often in private residences, the most common device is a horizontal tanning bed, also known as a sunbed or solarium. Vertical devices are known as tanning booths or stand-up sunbeds.
First introduced in the 1960s, indoor tanning became popular with people in the
Western world
The Western world, also known as the West, primarily refers to the various nations and states in the regions of Europe, North America, and Oceania. , particularly in
Scandinavia
Scandinavia; Sámi languages: /. ( ) is a subregion in Northern Europe, with strong historical, cultural, and linguistic ties between its constituent peoples. In English usage, ''Scandinavia'' most commonly refers to Denmark, Norway, and S ...
, in the late 1970s. The practice finds a cultural parallel in
skin whitening
Skin whitening, also known as skin lightening and skin bleaching, is the practice of using chemical substances in an attempt to lighten the skin or provide an even skin color by reducing the melanin concentration in the skin. Several chemicals ha ...
in Asian countries, and both support multibillion-dollar industries. Most indoor tanners are women, 16–25 years old, who want to improve their appearance or mood, acquire a pre-holiday tan, or treat a skin condition.
[Hay and Lipsky (2012), 181–184.]
Across Australia, Canada,
Northern Europe
The northern region of Europe has several definitions. A restrictive definition may describe Northern Europe as being roughly north of the southern coast of the Baltic Sea, which is about 54°N, or may be based on other geographical factors ...
and the United States, 18.2% of adults, 45.2% of university students, and 22% of adolescents had tanned indoors in the previous year, according to studies in 2007–2012. As of 2010 the indoor-tanning industry employed 160,000 in the United States, where 10–30 million tanners visit 25,000 indoor facilities annually.
[Tanning lamps and beds]
Medical Devices Advisory Committee, Food and Drug Administration, 2010, 1. In the United Kingdom, 5,350 tanning salons were in operation in 2009.
[ From 1997 several countries and US states banned under-18s from indoor tanning.] The commercial use of tanning beds was banned entirely in Brazil in 2009 and Australia in 2015.[ , thirteen U.S. states and one territory have banned under-18s from using them, and at least 42 states and the ]District of Columbia
)
, image_skyline =
, image_caption = Clockwise from top left: the Washington Monument and Lincoln Memorial on the National Mall, United States Capitol, Logan Circle (Washington, D.C.), Logan Circle, Jefferson Memoria ...
have imposed regulations, such as requiring parental consent.
Indoor tanning is a source of UV radiation, which is known to cause skin cancer
Skin cancers are cancers that arise from the skin. They are due to the development of abnormal cells that have the ability to invade or spread to other parts of the body. There are three main types of skin cancers: basal-cell skin cancer (BCC) ...
, including melanoma
Melanoma, also redundantly known as malignant melanoma, is a type of skin cancer that develops from the pigment-producing cells known as melanocytes. Melanomas typically occur in the skin, but may rarely occur in the mouth, intestines, or eye ( ...
and skin aging
The human skin is the outer covering of the body and is the largest organ of the integumentary system. The skin has up to seven layers of ectodermal tissue guarding muscles, bones, ligaments and internal organs. Human skin is similar to ...
, and is associated with sunburn
Sunburn is a form of radiation burn that affects living tissue, such as skin, that results from an overexposure to ultraviolet (UV) radiation, usually from the Sun. Common symptoms in humans and animals include: red or reddish skin that is h ...
, photodrug reactions, infection
An infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable di ...
s, weakening of the immune system
The immune system is a network of biological processes that protects an organism from diseases. It detects and responds to a wide variety of pathogens, from viruses to parasitic worms, as well as cancer cells and objects such as wood splinte ...
, and damage to the eyes, including cataract
A cataract is a cloudy area in the lens of the eye that leads to a decrease in vision. Cataracts often develop slowly and can affect one or both eyes. Symptoms may include faded colors, blurry or double vision, halos around light, trouble ...
s, photokeratitis
Photokeratitis or ultraviolet keratitis is a painful eye condition caused by exposure of insufficiently protected eyes to the ultraviolet (UV) rays from either natural (e.g. intense sunlight) or artificial (e.g. the electric arc during welding) ...
(snow blindness) and eye cancer
Eye neoplasms can affect all parts of the eye, and can be a benign tumor or a malignant tumor (cancer). Eye cancers can be primary (starts within the eye) or metastatic cancer (spread to the eye from another organ). The two most common cancers th ...
. Injuries caused by tanning devices lead to over 3,000 emergency-room cases a year in the United States alone. Physicians may use or recommend tanning devices to treat skin conditions such as psoriasis
Psoriasis is a long-lasting, noncontagious autoimmune disease characterized by raised areas of abnormal skin. These areas are red, pink, or purple, dry, itchy, and scaly. Psoriasis varies in severity from small, localized patches to comple ...
, but the World Health Organization
The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level o ...
does not recommend their use for cosmetic purposes.[ The WHO's ]International Agency for Research on Cancer
The International Agency for Research on Cancer (IARC; french: Centre International de Recherche sur le Cancer, CIRC) is an intergovernmental agency forming part of the World Health Organization of the United Nations.
Its role is to conduct and ...
includes tanning devices, along with ultraviolet radiation from the sun, in its list of group 1 carcinogens. Researchers at the Yale School of Public Health found evidence of addiction to tanning in a 2017 paper.
Background
Ultraviolet radiation
Ultraviolet radiation (UVR) is part of the electromagnetic spectrum
The electromagnetic spectrum is the range of frequencies (the spectrum) of electromagnetic radiation and their respective wavelengths and photon energies.
The electromagnetic spectrum covers electromagnetic waves with frequencies ranging from ...
, just beyond visible light
Light or visible light is electromagnetic radiation that can be perceived by the human eye. Visible light is usually defined as having wavelengths in the range of 400–700 nanometres (nm), corresponding to frequencies of 750–420 te ...
. Ultraviolet wavelength
In physics, the wavelength is the spatial period of a periodic wave—the distance over which the wave's shape repeats.
It is the distance between consecutive corresponding points of the same phase on the wave, such as two adjacent crests, tro ...
s are 100 to 400 nanometres
330px, Different lengths as in respect to the molecular scale.
The nanometre (international spelling as used by the International Bureau of Weights and Measures; SI symbol: nm) or nanometer (American and British English spelling differences#-re ...
(nm, billionths of a metre) and are divided into three bands: A, B and C. UVA wavelengths are the longest, 315 to 400 nm; UVB are 280 to 315 nm, and UVC wavelengths are the shortest, 100 to 280 nm.
About 95% of the UVR that reaches the earth from the sun is UVA and 5% UVB; no appreciable UVC reaches the earth. While tanning systems before the 1970s produced some UVC, modern tanning devices produce no UVC, a small amount of UVB and mostly UVA. Classified by the WHO as a group 1 carcinogen, UVR has "complex and mixed effects on human health". While it causes skin cancer
Skin cancers are cancers that arise from the skin. They are due to the development of abnormal cells that have the ability to invade or spread to other parts of the body. There are three main types of skin cancers: basal-cell skin cancer (BCC) ...
and other damage, including wrinkle
A wrinkle, also known as a rhytid, is a fold, ridge or crease in an otherwise smooth surface, such as on skin or fabric. Skin wrinkles typically appear as a result of ageing processes such as glycation, habitual sleeping positions, loss of ...
s, it also triggers the synthesis of vitamin D
Vitamin D is a group of fat-soluble secosteroids responsible for increasing intestinal absorption of calcium, magnesium, and phosphate, and many other biological effects. In humans, the most important compounds in this group are vitamin D3 (c ...
and endorphin
Endorphins (contracted from endogenous morphine) are chemical signals in the brain that block the perception of pain and increase feelings of wellbeing. They are produced and stored in an area of the brain known as the pituitary gland.
Hist ...
s in the skin.
History
In 1890 the Danish physician Niels Ryberg Finsen
Niels Ryberg Finsen (15 December 1860 – 24 September 1904) was a Faroese- Icelandic physician and scientist. In 1903, he was awarded the Nobel Prize in Medicine and Physiology "in recognition of his contribution to the treatment of diseases, e ...
developed a carbon arc lamp
An arc lamp or arc light is a lamp that produces light by an electric arc (also called a voltaic arc).
The carbon arc light, which consists of an arc between carbon electrodes in air, invented by Humphry Davy in the first decade of the 1800s, ...
("Finsen's light" or a "Finsen lamp") that produced ultraviolet radiation for use in skin therapy, including to treat lupus vulgaris
Lupus vulgaris (also known as tuberculosis luposa) are painful cutaneous tuberculosis skin lesions with nodular appearance, most often on the face around the nose, eyelids, lips, cheeks, ears and neck. It is the most common ''Mycobacterium tuberc ...
. He won the 1903 Nobel Prize in Physiology or Medicine
The Nobel Prize in Physiology or Medicine is awarded yearly by the Nobel Assembly at the Karolinska Institute for outstanding discoveries in physiology or medicine. The Nobel Prize is not a single prize, but five separate prizes that, accord ...
for his work.
Until the late 19th century in Europe and the United States, pale skin was a symbol of high social class among white people. Victorian women would carry parasol
An umbrella or parasol is a folding canopy (building), canopy supported by wooden or metal ribs that is usually mounted on a wooden, metal, or plastic pole. It is designed to protect a person against rain or sunburn, sunlight. The term ''umbr ...
s and wear wide-brimmed hats and gloves; their homes featured heavy curtains that kept out the sun. But as the working class
The working class (or labouring class) comprises those engaged in manual-labour occupations or industrial work, who are remunerated via waged or salaried contracts. Working-class occupations (see also " Designation of workers by collar colou ...
es moved from country work to city factories, and to crowded, dark, unsanitary homes, pale skin became increasingly associated with poverty and ill health. In 1923 Coco Chanel
Gabrielle Bonheur "Coco" Chanel ( , ; 19 August 1883 – 10 January 1971) was a French fashion designer and businesswoman. The founder and namesake of the Chanel brand, she was credited in the post-World War I era with popularizing a sporty, c ...
returned from a holiday in Cannes
Cannes ( , , ; oc, Canas) is a city located on the French Riviera. It is a communes of France, commune located in the Alpes-Maritimes departments of France, department, and host city of the annual Cannes Film Festival, Midem, and Cannes Lions I ...
with a tan, later telling ''Vogue'' magazine: "A golden tan is the index of chic!" Tanned skin had become a fashion accessory.
In parallel physicians began advising their patients on the benefits of the "sun cure", citing its antiseptic
An antiseptic (from Greek ἀντί ''anti'', "against" and σηπτικός ''sēptikos'', "putrefactive") is an antimicrobial substance or compound that is applied to living tissue/skin to reduce the possibility of infection, sepsis, or putre ...
properties. Sunshine was promoted as a treatment for depression, diabetes, constipation, pneumonia, high and low blood pressure, and many other ailments. Home-tanning equipment was introduced in the 1920s in the form of "sunlamps" or "health lamps", UV lamps that emitted a large percentage of UVB, leading to burns. Friedrich Wolff, a German scientist, began using UV light on athletes, and developed beds that emitted 95% UVA and 5% UVB, which reduced the likelihood of burning. The world's first tanning salon opened in 1977 in Berlin, followed by tanning salons in Europe and North America in the late 1970s.[ In 1978 Wolff's devices began selling in the United States, and the indoor tanning industry was born.]
Devices
Lamps
Tanning lamps, also known as tanning bulbs or tanning tubes, produce the ultraviolet light in tanning devices. The performance (or output) varies widely between brands and styles. Most are low-pressure fluorescent tubes, but high-pressure bulbs also exist. The electronics systems and number of lamps affect performance, but to a lesser degree than the lamp itself. Tanning lamps are regulated separately from tanning beds in most countries, as they are the consumable portion of the system.
Beds
Most tanning beds are horizontal enclosures with a bench and canopy (lid) that house long, low-pressure fluorescent bulb
A fluorescent lamp, or fluorescent tube, is a low-pressure mercury-vapor gas-discharge lamp that uses fluorescence to produce visible light. An electric current in the gas excites mercury vapor, which produces short-wave ultraviolet lig ...
s (100–200 watt) under an acrylic
Acrylic may refer to:
Chemicals and materials
* Acrylic acid, the simplest acrylic compound
* Acrylate polymer, a group of polymers (plastics) noted for transparency and elasticity
* Acrylic resin, a group of related thermoplastic or thermosett ...
surface. The tanner is surrounded by bulbs when the canopy is closed. Modern tanning beds emit mostly UVA (the sun emits around 95% UVA and 5% UVB). One review of studies found that the UVB irradiance In radiometry, irradiance is the radiant flux ''received'' by a ''surface'' per unit area. The SI unit of irradiance is the watt per square metre (W⋅m−2). The CGS unit erg per square centimetre per second (erg⋅cm−2⋅s−1) is often used ...
of beds was on average lower than the summer sun at latitudes 37°S to 35°N, but that UVA irradiance was on average much higher.
The user sets a timer (or it is set remotely by the salon operator), lies on the bed and pulls down the canopy. The maximum exposure time for most low-pressure beds is 15–20 minutes. Maximum times are set by the manufacturer according to how long it takes to produce four "minimal erythema doses" (MEDs), an upper limit laid down by the FDA. An MED is the amount of UV radiation that will produce erythema
Erythema (from the Greek , meaning red) is redness of the skin or mucous membranes, caused by hyperemia (increased blood flow) in superficial capillaries. It occurs with any skin injury, infection, or inflammation. Examples of erythema not asso ...
(redness of the skin) within a few hours of exposure.
High-pressure beds use smaller, higher-wattage quartz bulbs and emit a higher percentage of UVA.[Lessin et al. (2012), 92.] They may emit 10–15 times more UVA than the midday sun,[ and have a shorter maximum exposure time (typically 10–12 minutes). UVA gives an immediate, short-term tan by bronzing melanin in the skin, but no new melanin is formed. UVB has no immediate bronzing effect, but with a delay of 72 hours makes the skin produce new melanin, leading to tans of longer duration. UVA is less likely to cause burning or dry skin than UVB, but is associated with wrinkling and loss of elasticity because it penetrates deeper.][
Commercial tanning beds cost $6,000 to $30,000 as of 2006, with high-pressure beds at the high end. One Manhattan chain was charging $10 to $35 per session in 2016, depending on the number, strength, and type of bulbs. This is known as level 1–6 tanning; level 1 involves a basic low-pressure bed with 36 x 100-watt bulbs. Depending on the quality of the bed, it may contain a separate facial tanner, shoulder tanners, a choice of tanning levels and UVA/UVB combinations, sound system, ]MP3
MP3 (formally MPEG-1 Audio Layer III or MPEG-2 Audio Layer III) is a coding format for digital audio developed largely by the Fraunhofer Society in Germany, with support from other digital scientists in the United States and elsewhere. Origin ...
connection, aromatherapy
Aromatherapy is based on the usage of aromatic materials including essential oils and other aroma compounds, with claims for improving psychological and physical well-being. It is offered as a complementary therapy or as a form of alternative ...
, air conditioning, a misting option and voice guide. There are also open-air beds, in which the tanner is not entirely enclosed.
Booths
Tanning booths (also known as stand-up sunbeds) are vertical enclosures; the tanner stands during exposure, hanging onto straps or handrails, and is surrounded by tanning bulbs. In most models, the tanner closes a door, but there are open designs too. Some booths use the same electronics and lamps as tanning beds, but most have more lamps and are likely to use 100–160 watt lamps. They often have a maximum session of 7–15 minutes. There are other technical differences, or degrees of intensity, but for all practical intents, their function and safety are the same as a horizontal bed. Booths have a smaller footprint, which some commercial operators find useful. Some tanners prefer booths out of concern for hygiene, since the only shared surface is the floor.
Lotions and goggles
Before entering a tanning unit, the tanner usually applies indoor tanning lotion
Indoor tanning lotions accelerate the tanning process, by promoting the production of melanin. Increasing blood flow to the skin is a proposed mechanism, which may in turn stimulate production of melanin by melanocytes. Indoor tanning lotions u ...
to the whole body and may use a separate facial-tanning lotion. These lotions are considerably more expensive than drugstore lotions. They contain no sunscreen
Sunscreen, also known as sunblock or sun cream, is a photoprotective topical product for the skin that mainly absorbs, or to a much lesser extent reflects, some of the sun's ultraviolet (UV) radiation and thus helps protect against sunburn and ...
, but instead moisturize the skin with ingredients such as aloe vera, hempseed oil
Hemp oil (hemp seed oil) is oil obtained by pressing hemp seeds. Cold pressed, unrefined hemp oil is dark to clear light green in color, with a nutty flavor. The darker the color, the grassier the flavour. It should not be confused with hash oi ...
and sunflower seed oil
Sunflower oil is the volatile organic compound, non-volatile oil pressed from the Sunflower seeds, seeds of the sunflower (''Helianthus annuus''). Sunflower oil is commonly used in food as a cooking oil, frying oil, and in cosmetics, cosmetic fo ...
. They may also contain dihydroxyacetone
Dihydroxyacetone (; DHA), also known as glycerone, is a simple saccharide (a triose) with formula .
DHA is primarily used as an ingredient in sunless tanning products. It is often derived from plant sources such as sugar beets and sugar cane, an ...
, a sunless tanner. So-called "tingle" tanning lotions cause vasodilation
Vasodilation is the widening of blood vessels. It results from relaxation of smooth muscle cells within the vessel walls, in particular in the large veins, large arteries, and smaller arterioles. The process is the opposite of vasoconstriction, ...
, increasing blood circulation.
Goggles
Goggles, or safety glasses, are forms of protective eyewear that usually enclose or protect the area surrounding the eye in order to prevent particulates, water or chemicals from striking the eyes. They are used in chemistry laboratories and ...
(eye protection) should be worn to avoid eye damage. In one 2004 study, tanners said they avoided goggles to prevent leaving pale skin around the eyes. In the US, CFR Title 21 requires that new tanning equipment come with eye protection and most states require that commercial tanning operators provide eye protection for their clients. Laws in other countries are similar.
Prevalence
Tanning-device use
Indoor tanning is most popular with white females, 16–25 years old, with low-to-moderate skin sensitivity, who know other tanners. Studies seeking to link indoor tanning to education level and income have returned inconsistent results. Prevalence was highest in one German study among those with a moderate level of education (neither high nor low).[
The late teens to early–mid 20s is the highest-prevalence age group.][Coups and Phillips (2012), 58.] In a national survey of white teenagers in 2003 in the US (aged 13–19), 24% had used a tanning facility. Indoor-tanning prevalence figures in the US vary from 30 million each year to just under 10 million (7.8 million women and 1.9 million men).
The figures in the US are in decline: according to the Centres for Disease Control and Prevention
The Centers for Disease Control and Prevention (CDC) is the national public health agency of the United States. It is a United States federal agency, under the Department of Health and Human Services, and is headquartered in Atlanta, Georgi ...
, usage in the 18–29 age group fell from 11.3 percent in 2010 to 8.6 percent in 2013, perhaps attributable in part to a 10% "tanning tax" introduced in 2010. Attitudes toward tanning vary across states; in one study, doctors in the northeast
The points of the compass are a set of horizontal, radially arrayed compass directions (or azimuths) used in navigation and cartography. A compass rose is primarily composed of four cardinal directions—north, east, south, and west—each se ...
and midwest
The Midwestern United States, also referred to as the Midwest or the American Midwest, is one of four Census Bureau Region, census regions of the United States Census Bureau (also known as "Region 2"). It occupies the northern central part of ...
of the country were more likely than those in the south
South is one of the cardinal directions or Points of the compass, compass points. The direction is the opposite of north and is perpendicular to both east and west.
Etymology
The word ''south'' comes from Old English ''sūþ'', from earlier Pro ...
or west
West or Occident is one of the four cardinal directions or points of the compass. It is the opposite direction from east and is the direction in which the Sunset, Sun sets on the Earth.
Etymology
The word "west" is a Germanic languages, German ...
to recommend tanning beds to treat vitamin D deficiency and depression.[Coups and Phillips (2012), 59.]
Tanning bed use is more prevalent in northern countries.[ In Sweden in 2001, 44% said they had used one (in a survey of 1,752 men and women aged 18–37). Their use increased in Denmark between 1994 and 2002 from 35% to 50% (reported use in the previous two years). In Germany, between 29% and 47% had used one, and one survey found that 21% had done so in the previous year. In France, 15% of adults in 1994–1995 had tanned indoors; the practice was more common in the north of France.][Hay and Lipsky (2012), 181–182.] In 2006, 12% of grade 9–10 students in Canada had used a tanning bed in the last year.[Hay and Lipsky (2012), 184.] In 2004, 7% of 8–11-year-olds in Scotland said they had used one.[Esther Addley (1 August 2009)]
"How Britain fell in love with the tan"
''The Guardian''. Tanning bed use is higher in the UK in the north of England.[ One study found that the prevalence was lower in London than in less urban areas of the country.][
]
Density of facilities
Tanning facilities are ubiquitous in the US, although the figures are in decline. In a study in the US published in 2002, there was a higher density in colder areas with a lower median income and higher proportion of whites. A study in 1997 found an average of 50.3 indoor-tanning facilities in 20 US cities (13.89 facilities for every 100,000 residents); the highest was 134 in Minneapolis, MN, and the lowest four in Honolulu, Hawaii. In 2006 a study of 116 cities in the US found 41.8 facilities on average, a higher density than either Starbucks
Starbucks Corporation is an American multinational chain of coffeehouses and roastery reserves headquartered in Seattle, Washington. It is the world's largest coffeehouse chain.
As of November 2021, the company had 33,833 stores in 80 c ...
or McDonald's
McDonald's Corporation is an American Multinational corporation, multinational fast food chain store, chain, founded in 1940 as a restaurant operated by Richard and Maurice McDonald, in San Bernardino, California, United States. They rechri ...
.[Coups and Phillips (2012), 36.] Of the country's 125 top colleges and universities in 2014, 12% had indoor-tanning facilities on campus and 42.4% in off-campus housing, 96% of the latter free of charge to the tenants.
There are fewer professional salons than tanning facilities; the latter includes tanning beds in gyms, spas and similar. According to the FDA, citing the Indoor Tanning Association, there were 25,000 tanning salons in 2010 in the US (population 308.7 million in 2010). Mailing-list data suggest there were 18,200 in September 2008 and 12,200 in September 2015, a decline of 30 percent. According to Chris Sternberg of the American Suntanning Association, the figures are 18,000 in 2009 and 9,500 in 2016.[Patrick Clark (5 October 2016)]
"Twilight of the Tanning Salons"
''Bloomberg''.
The South West Public Health Observatory found 5,350 tanning salons in the UK in 2009: 4,492 in England (population 52.6 million in 2010), 484 in Scotland (5.3 million), 203 in Wales (3 million) and 171 in Northern Ireland (1.8 million).["The Public Health etc (Scotland) Act 2008 (Sunbed) Regulations 2009: Regulatory Impact Assessment (RIA)"]
CMO and Public Health Directorate, Scottish Government, 2009.
Reasons
Overview
Reasons cited for indoor tanning include improving appearance, acquiring a pre-holiday tan, feeling good and treating a skin condition.[ Tanners often cite feelings of well-being; exposure to tanning beds is reported to "increase serum ]beta-endorphin
''beta''-Endorphin (β-endorphin) is an endogenous opioid neuropeptide and peptide hormone that is produced in certain neurons within the central nervous system and peripheral nervous system. It is one of three endorphins that are produced in ...
levels by 44%". Beta-endorphin is associated with feelings of relaxation and euphoria, including "runner's high
The neurobiological effects of physical exercise are numerous and involve a wide range of interrelated effects on brain structure, brain function, and cognition. A large body of research in humans has demonstrated that consistent aerobic exerci ...
".[
Improving appearance is the most-cited reason. Studies show that tanned skin has ]semiotic
Semiotics (also called semiotic studies) is the systematic study of sign processes ( semiosis) and meaning making. Semiosis is any activity, conduct, or process that involves signs, where a sign is defined as anything that communicates something ...
power, signifying health, beauty, youth and the ability to seduce. Women, in particular, say not only that they prefer their appearance with tanned skin, but that they receive the same message from friends and family, especially from other women. They believe tanned skin makes them look thinner and more toned, and that it covers or heals skin blemishes such as acne. Other reasons include acquiring a base tan for further sunbathing; that a uniform tan is easier to achieve in a tanning unit than in the sun, and a desire to avoid tan lines. Proponents of indoor tanning say that tanning beds deliver more consistent, predictable exposure than the sun, but studies show that indoor tanners do suffer burns. In two surveys in the US in 1998 and 2004, 58% of indoor tanners said they had been burned during sessions.
Vitamin D
Vitamin D
Vitamin D is a group of fat-soluble secosteroids responsible for increasing intestinal absorption of calcium, magnesium, and phosphate, and many other biological effects. In humans, the most important compounds in this group are vitamin D3 (c ...
is produced when the skin is exposed to UVB, whether from sunlight or an artificial source. It is needed for mineralization of bone and bone growth. Areas in which vitamin D's role is being investigated include reducing the risk of cancer, heart disease, multiple sclerosis
Multiple (cerebral) sclerosis (MS), also known as encephalomyelitis disseminata or disseminated sclerosis, is the most common demyelinating disease, in which the insulating covers of nerve cells in the brain and spinal cord are damaged. This d ...
and glucose dysregulation.[ Exposing arms and legs to a minimal 0.5 erythemal (mild sunburn) UVB dose is equal to consuming about 3000 IU of ]vitamin D3
Cholecalciferol, also known as vitamin D3 and colecalciferol, is a type of vitamin D that is made by the skin when exposed to sunlight; it is found in some foods and can be taken as a dietary supplement.
Cholecalciferol is made in the skin f ...
. In a study in Boston, MA, researchers found that adults who used tanning beds had "robust" levels of 25(OH)D (46 ng/mL on average), along with higher hip bone density
Bone density, or bone mineral density, is the amount of bone mineral in bone tissue. The concept is of mass of mineral per volume of bone (relating to density in the physics sense), although clinically it is measured by proxy according to optica ...
, compared to adults who did not use them.
Obtaining vitamin D from indoor tanning has to be weighed against the risk of developing skin cancer.[ The indoor-tanning industry has stressed the relationship between tanning and the production of vitamin D.] According to the US National Institutes of Health
The National Institutes of Health, commonly referred to as NIH (with each letter pronounced individually), is the primary agency of the United States government responsible for biomedical and public health research. It was founded in the late ...
, some researchers have suggested that "5–30 minutes of sun exposure between 10 AM and 3 PM at least twice a week to the face, arms, legs, or back without sunscreen usually lead to sufficient vitamin D synthesis and that the moderate use of commercial tanning beds that emit 2%–6% UVB radiation is also effective".["Vitamin D"]
Office of Dietary Supplements, National Institutes of Health, 11 February 2016. Most researchers say the health risks outweigh the benefits, that the UVB doses produced by tanning beds exceed what is needed for adequate vitamin D production, and that adequate vitamin D levels can be achieved by taking supplements and eating fortified foods.
Medical use
Certain skin conditions, including keratosis
Keratosis (from '' kerat-'' + '' -osis'') is a growth of keratin on the skin or on mucous membranes stemming from keratinocytes, the prominent cell type in the epidermis. More specifically, it can refer to:
* actinic keratosis (also known as solar ...
, psoriasis
Psoriasis is a long-lasting, noncontagious autoimmune disease characterized by raised areas of abnormal skin. These areas are red, pink, or purple, dry, itchy, and scaly. Psoriasis varies in severity from small, localized patches to comple ...
, eczema
Dermatitis is inflammation of the skin, typically characterized by itchiness, redness and a rash. In cases of short duration, there may be small blisters, while in long-term cases the skin may become thickened. The area of skin involved can ...
and acne
Acne, also known as ''acne vulgaris'', is a long-term skin condition that occurs when dead skin cells and oil from the skin clog hair follicles. Typical features of the condition include blackheads or whiteheads, pimples, oily skin, and ...
, may be treated with UVB light therapy, including by using tanning beds in commercial salons. Using tanning beds allows patients to access UV exposure when dermatologist-provided phototherapy is not available. A systematic review of studies, published in ''Dermatology and Therapy'' in 2015, noted that moderate sunlight is a treatment recommended by the American National Psoriasis Foundation, and suggested that clinicians consider UV phototherapy and tanning beds as a source of that therapy.
When UV light therapy is used in combination with psoralen
Psoralen (also called psoralene) is the parent compound in a family of naturally occurring organic compounds known as the linear furanocoumarins. It is structurally related to coumarin by the addition of a fused furan ring, and may be considered ...
, an oral or topical medication, the combined therapy is referred to as PUVA
PUVA (psoralen and UVA) is an ultraviolet light therapy treatment for skin diseases: eczema, psoriasis, graft-versus-host disease, vitiligo, mycosis fungoides, large plaque parapsoriasis, and cutaneous T-cell lymphoma, using the sensitizing e ...
. A concern with the use of commercial tanning is that beds that primarily emit UVA may not treat psoriasis effectively. One study found that plaque psoriasis is responsive to erythemogenic doses of either UVA or UVB. It does require more energy to reach erythemogenic dosing with UVA.[
]
Risks
Skin cancer
Exposure to ultraviolet radiation (UVR), whether from the sun or tanning devices is known to be a major cause of the three main types of skin cancer
Skin cancers are cancers that arise from the skin. They are due to the development of abnormal cells that have the ability to invade or spread to other parts of the body. There are three main types of skin cancers: basal-cell skin cancer (BCC) ...
: non-melanoma skin cancer (basal cell carcinoma
Basal-cell carcinoma (BCC), also known as basal-cell cancer, is the most common type of skin cancer. It often appears as a painless raised area of skin, which may be shiny with small blood vessels running over it. It may also present as a raise ...
and squamous cell carcinoma) and melanoma
Melanoma, also redundantly known as malignant melanoma, is a type of skin cancer that develops from the pigment-producing cells known as melanocytes. Melanomas typically occur in the skin, but may rarely occur in the mouth, intestines, or eye ( ...
. Overexposure to UVR induces at least two types of DNA damage: cyclobutane
Cyclobutane is a cycloalkane and organic compound with the formula (CH2)4. Cyclobutane is a colourless gas and commercially available as a liquefied gas. Derivatives of cyclobutane are called cyclobutanes. Cyclobutane itself is of no commercial ...
–pyrimidine dimers
Pyrimidine dimers are molecular lesions formed from thymine or cytosine bases in DNA via photochemical reactions, commonly associated with direct DNA damage. Ultraviolet light (UV; particularly UVB) induces the formation of covalent linkages bet ...
(CPDs) and 6–4 photoproducts (6–4PPs). While DNA repair enzymes can fix some mutations, if they are not sufficiently effective, a cell will acquire genetic mutations
In biology, a mutation is an alteration in the nucleic acid sequence of the genome of an organism, virus, or extrachromosomal DNA. Viral genomes contain either DNA or RNA. Mutations result from errors during DNA or viral replication, mit ...
which may cause the cell to die or become cancerous. These mutations can result in cancer, aging, persistent mutation and cell death. For example, squamous cell carcinoma can be caused by a UVB-induced mutation in the p53 gene.
Non-melanoma skin cancer includes squamous cell carcinoma (SCC) and basal cell carcinoma
Basal-cell carcinoma (BCC), also known as basal-cell cancer, is the most common type of skin cancer. It often appears as a painless raised area of skin, which may be shiny with small blood vessels running over it. It may also present as a raise ...
(BCC), and is more common than melanoma. With early detection and treatment, it is typically not life-threatening. Prevalence increases with age, cumulative exposure to UV, and proximity to the equator
The equator is a circle of latitude, about in circumference, that divides Earth into the Northern and Southern hemispheres. It is an imaginary line located at 0 degrees latitude, halfway between the North and South poles. The term can als ...
. It is most prevalent in Australia, where the rate is 1,000 in 100,000 and where, as of 2000, it represented 75 percent of all cancers.
Melanoma accounts for approximately one percent of skin cancer, and causes most of skin cancer-related deaths. The average age of diagnosis is 63,["Key statistics for melanoma skin cancer"]
American Cancer Society, 20 May 2016. and it is the most common cancer in the 25–29 age group and the second most common in the 15-29 group, which may be due in part to the increased UV exposure and use of indoor tanning observed in this population. In the United States, the melanoma incidence rate was 22.3 per 100,000, based on 2010-2014 data from the National Institutes of Health
The National Institutes of Health, commonly referred to as NIH (with each letter pronounced individually), is the primary agency of the United States government responsible for biomedical and public health research. It was founded in the late ...
Surveillance, Epidemiology and End Results (SEER) Program, and the death rate was 2.7 per 100,000. 9,730 people were estimated to die of melanoma in the United States in 2017, and these numbers are anticipated to continue rising. Although 91.7% of patients diagnosed with melanoma survive beyond 5-years, advanced melanoma is largely incurable, and only 19.9% percent of patients with metastatic disease survive beyond 5 years. An international meta-analysis performed in 2014 estimates that annually, 464,170 cases of skin cancer can be attributed to exposure to indoor tanning.
A 2012 analysis of epidemiological studies
Epidemiology is the study and analysis of the distribution (who, when, and where), patterns and determinants of health and disease conditions in a defined population.
It is a cornerstone of public health, and shapes policy decisions and evid ...
found a 20% increase in the risk of melanoma (a relative risk of 1.20) among those who had ever used a tanning device compared to those who had not, and a 59% percent increase (a relative risk of 1.59) among those who had used one before age 35. Additionally, a 2014 systematic review and meta-analysis found that indoor tanners had a 16 percent increased risk of developing melanoma, which increased to 23 percent for North Americans. For those who started tanning indoors before age 25, their risk further increased to 35% compared to those who began after age 25.
Other risks
Exposure to UV radiation is associated with skin aging
The human skin is the outer covering of the body and is the largest organ of the integumentary system. The skin has up to seven layers of ectodermal tissue guarding muscles, bones, ligaments and internal organs. Human skin is similar to ...
, wrinkle production, liver spot
The liver is a major Organ (anatomy), organ only found in vertebrates which performs many essential biological functions such as detoxification of the organism, and the Protein biosynthesis, synthesis of proteins and biochemicals necessary for ...
s, loss of skin elasticity, erythema
Erythema (from the Greek , meaning red) is redness of the skin or mucous membranes, caused by hyperemia (increased blood flow) in superficial capillaries. It occurs with any skin injury, infection, or inflammation. Examples of erythema not asso ...
(reddening of the skin), sunburn, photokeratitis
Photokeratitis or ultraviolet keratitis is a painful eye condition caused by exposure of insufficiently protected eyes to the ultraviolet (UV) rays from either natural (e.g. intense sunlight) or artificial (e.g. the electric arc during welding) ...
(snow blindness),[ ]ocular melanoma
Uveal melanoma is a type of eye cancer in the uvea of the eye. It is traditionally classed as originating in the iris, choroid, and ciliary body, but can also be divided into class I (low metastatic risk) and class II (high metastatic risk). Symp ...
(eye cancer),[ and infections.] Tanning beds can contain many microbes, some of which are pathogens that can cause skin infections and gastric distress. In one study in New York in 2009, the most common pathogens found on tanning beds were ''Pseudomonas
''Pseudomonas'' is a genus of Gram-negative, Gammaproteobacteria, belonging to the family Pseudomonadaceae and containing 191 described species. The members of the genus demonstrate a great deal of metabolic diversity and consequently are able ...
'' spp. ('' aeruginosa'' and '' putida''), ''Bacillus
''Bacillus'' (Latin "stick") is a genus of Gram-positive, rod-shaped bacteria, a member of the phylum '' Bacillota'', with 266 named species. The term is also used to describe the shape (rod) of other so-shaped bacteria; and the plural ''Bacill ...
'' spp., ''Klebsiella pneumoniae
''Klebsiella pneumoniae'' is a Gram-negative, non-motile, encapsulated, lactose- fermenting, facultative anaerobic, rod-shaped bacterium. It appears as a mucoid lactose fermenter on MacConkey agar.
Although found in the normal flora of the mo ...
'', ''Enterococcus
''Enterococcus'' is a large genus of lactic acid bacteria of the phylum Bacillota. Enterococci are gram-positive cocci that often occur in pairs (diplococci) or short chains, and are difficult to distinguish from streptococci on physical char ...
'' species, ''Staphylococcus aureus
''Staphylococcus aureus'' is a Gram-positive spherically shaped bacterium, a member of the Bacillota, and is a usual member of the microbiota of the body, frequently found in the upper respiratory tract and on the skin. It is often positive ...
'', and ''Enterobacter cloacae
''Enterobacter cloacae'' is a clinically significant Gram-negative, facultatively-anaerobic, rod-shaped bacterium.
Microbiology
In microbiology labs, ''E. cloacae'' is frequently grown at 30 °C on nutrient agar or at 35 °C in tr ...
''. Several prescription and over-the-counter drugs, including antidepressant
Antidepressants are a class of medication used to treat major depressive disorder, anxiety disorders, chronic pain conditions, and to help manage addictions. Common side-effects of antidepressants include dry mouth, weight gain, dizziness, hea ...
s, antibiotic
An antibiotic is a type of antimicrobial substance active against bacteria. It is the most important type of antibacterial agent for fighting bacterial infections, and antibiotic medications are widely used in the treatment and prevention of ...
s, antifungals and anti-diabetic medication
Drugs used in diabetes treat diabetes mellitus by altering the glucose level in the blood. With the exceptions of insulin, most GLP receptor agonists ( liraglutide, exenatide, and others), and pramlintide, all are administered orally and are th ...
, can cause photosensitivity Photosensitivity is the amount to which an object reacts upon receiving photons, especially visible light. In medicine, the term is principally used for abnormal reactions of the skin, and two types are distinguished, photoallergy and phototoxicity. ...
, which makes burning the skin while tanning more likely. This risk is increased by a lack of staff training in tanning facilities.
Young people
Children and adolescents who use tanning beds are at greater risk because of biological vulnerability to UV radiation. Epidemiological studies have shown that exposure to artificial tanning increases the risk of malignant melanoma and that the longer the exposure, the greater the risk, particularly in individuals exposed before the age of 30 or who have been sunburned.
One study conducted among college students found that awareness of the risks of tanning beds did not deter the students from using them. Teenagers are frequent targets of tanning industry marketing, which includes offers of coupons and placing ads in high-school newspapers.[Charlie Pokora (Spring 2010)]
"Indoor Tanning: Risk to Health vs. Risk to Freedom"
''The Triple Helix'', 21. Members of the United States House Committee on Energy and Commerce
The Committee on Energy and Commerce is one of the oldest standing committees of the United States House of Representatives. Established in 1795, it has operated continuously—with various name changes and jurisdictional changes—for more tha ...
commissioned a "sting" operation in 2012, in which callers posing as a 16-year-old woman who wanted to tan for the first time called 300 tanning salons in the US. Staff reportedly failed to follow FDA recommendations, denied the risks of tanning, and offered misleading information about benefits.[
]
Addiction
Addiction to indoor tanning has been recognized as a psychiatric disorder. The disorder is characterized as excessive indoor tanning that causes the subject personal distress; it has been associated with anxiety
Anxiety is an emotion which is characterized by an unpleasant state of inner turmoil and includes feelings of dread over anticipated events. Anxiety is different than fear in that the former is defined as the anticipation of a future threat wh ...
, eating disorder
An eating disorder is a mental disorder defined by abnormal eating behaviors that negatively affect a person's physical or mental health. Only one eating disorder can be diagnosed at a given time. Types of eating disorders include binge eating d ...
s and smoking
Smoking is a practice in which a substance is burned and the resulting smoke is typically breathed in to be tasted and absorbed into the bloodstream. Most commonly, the substance used is the dried leaves of the tobacco plant, which have bee ...
.[ The media has described the addiction as ''tanorexia''.][Carol E. Lee (13 May 2005)]
"It's Only May, and the Tanorexics Are Already Complaining"
''The New York Times''. According to the Canadian Pediatric Society, "repeated UVR exposures, and the use of indoor tanning beds specifically, may have important systemic and behavioural consequences, including mood changes, compulsive disorders, pain and physical dependency."
Regulation
Australia
Commercial tanning services are banned in all states, except the Northern Territory
The Northern Territory (commonly abbreviated as NT; formally the Northern Territory of Australia) is an states and territories of Australia, Australian territory in the central and central northern regions of Australia. The Northern Territory ...
where no salons are in operation.[Nick Mulcahy (20 January 2015)]
"Australia Bans Tanning Salons"
''Medscape''. Private ownership of tanning beds is permitted.[Megan Palin and Ken McGrego (13 January 2016)]
"Black market for suntans emerges following government bans on commercial use of solariums"
news.com.au.
Brazil
Brazil's National Health Surveillance Agency
Brazilian Health Regulatory Agency ( pt, Agência Nacional de Vigilância Sanitária, links=no, italics=yes, ''Anvisa'', literally National Health Surveillance Agency) is a regulatory body of the Brazilian government, created in 1999 during Presi ...
banned the use of tanning beds for cosmetic purposes in 2009, making that country the first to enact a ban. It followed a 2002 ban on minors using the beds.[
]
Canada
Indoor tanning is prohibited for under-18s in British Columbia, Alberta, Manitoba, Saskatchewan, Ontario, Quebec, and Prince Edward Island; and for under-19s in New Brunswick, Nova Scotia, Newfoundland and Labrador, and the Northwest Territories. Health Canada recommends against the use of tanning equipment.
European Union
In 1997 France became the first country to ban minors from indoor tanning. Under-18s are similarly prohibited in Austria, Belgium, Germany, Ireland, Portugal, Spain, Poland and the United Kingdom.[David Kearns (3 March 2015)]
"Irish Cancer Society seeks sun-bed tanning ban for fair-skinned people"
''Irish Independent''. In addition, Ireland prohibits salons from offering "happy hour" discounts.[
]
New Zealand
In New Zealand, indoor tanning is regulated by a voluntary code of practice. Salons are asked to turn away under-18s, those with type 1 skin (fair skin that burns easily or never tans), people who experienced episodes of sunburn as children, and anyone taking certain medications, with several moles, or who has had skin cancer. Tanners are asked to sign a consent form, which includes health information and advice about the importance of wearing goggles. Surveys have found a high level of non-compliance. The government has carried out bi-annual surveys of tanning facilities since 2012.
United States
The Food and Drug Administration
The United States Food and Drug Administration (FDA or US FDA) is a List of United States federal agencies, federal agency of the United States Department of Health and Human Services, Department of Health and Human Services. The FDA is respon ...
(FDA) classifies tanning beds as "moderate risk" devices (changed in 2014 from "low risk"). It requires that devices carry a black box warning
In the United States, a boxed warning (sometimes "black box warning", colloquially) is a type of warning that appears on the package insert for certain prescription drugs, so called because
the U.S. Food and Drug Administration specifies that it ...
that they should not be used by individuals under the age of 18, but it has not banned their use by minors. , the California
California is a U.S. state, state in the Western United States, located along the West Coast of the United States, Pacific Coast. With nearly 39.2million residents across a total area of approximately , it is the List of states and territori ...
, Delaware
Delaware ( ) is a state in the Mid-Atlantic region of the United States, bordering Maryland to its south and west; Pennsylvania to its north; and New Jersey and the Atlantic Ocean to its east. The state takes its name from the adjacent Del ...
, the District of Columbia
)
, image_skyline =
, image_caption = Clockwise from top left: the Washington Monument and Lincoln Memorial on the National Mall, United States Capitol, Logan Circle (Washington, D.C.), Logan Circle, Jefferson Memoria ...
, Hawaii
Hawaii ( ; haw, Hawaii or ) is a state in the Western United States, located in the Pacific Ocean about from the U.S. mainland. It is the only U.S. state outside North America, the only state that is an archipelago, and the only stat ...
, Illinois
Illinois ( ) is a U.S. state, state in the Midwestern United States, Midwestern United States. Its largest metropolitan areas include the Chicago metropolitan area, and the Metro East section, of Greater St. Louis. Other smaller metropolita ...
, Kansas
Kansas () is a state in the Midwestern United States. Its capital is Topeka, and its largest city is Wichita. Kansas is a landlocked state bordered by Nebraska to the north; Missouri to the east; Oklahoma to the south; and Colorado to the ...
, Louisiana
Louisiana , group=pronunciation (French: ''La Louisiane'') is a state in the Deep South and South Central regions of the United States. It is the 20th-smallest by area and the 25th most populous of the 50 U.S. states. Louisiana is borde ...
, , Minnesota
Minnesota () is a state in the upper midwestern region of the United States. It is the 12th largest U.S. state in area and the 22nd most populous, with over 5.75 million residents. Minnesota is home to western prairies, now given over to ...
, Nevada
Nevada ( ; ) is a U.S. state, state in the Western United States, Western region of the United States. It is bordered by Oregon to the northwest, Idaho to the northeast, California to the west, Arizona to the southeast, and Utah to the east. N ...
, New Hampshire
New Hampshire is a U.S. state, state in the New England region of the northeastern United States. It is bordered by Massachusetts to the south, Vermont to the west, Maine and the Gulf of Maine to the east, and the Canadian province of Quebec t ...
, North Carolina
North Carolina () is a state in the Southeastern region of the United States. The state is the 28th largest and 9th-most populous of the United States. It is bordered by Virginia to the north, the Atlantic Ocean to the east, Georgia and So ...
, Oregon
Oregon () is a U.S. state, state in the Pacific Northwest region of the Western United States. The Columbia River delineates much of Oregon's northern boundary with Washington (state), Washington, while the Snake River delineates much of it ...
, Texas
Texas (, ; Spanish language, Spanish: ''Texas'', ''Tejas'') is a state in the South Central United States, South Central region of the United States. At 268,596 square miles (695,662 km2), and with more than 29.1 million residents in 2 ...
, Vermont
Vermont () is a state in the northeast New England region of the United States. Vermont is bordered by the states of Massachusetts to the south, New Hampshire to the east, and New York to the west, and the Canadian province of Quebec to ...
and Washington
Washington commonly refers to:
* Washington (state), United States
* Washington, D.C., the capital of the United States
** A metonym for the federal government of the United States
** Washington metropolitan area, the metropolitan area centered o ...
have banned the use of tanning beds for minors under the age of 18. Other states strictly regulate indoor tanning under the age of 18, with most banning indoor tanning for persons under the age of 14 unless medically required, and some requiring the consent of a guardian for those aged 14–17. In 2010 under the Affordable Care Act
The Affordable Care Act (ACA), formally known as the Patient Protection and Affordable Care Act and colloquially known as Obamacare, is a landmark U.S. federal statute enacted by the 111th United States Congress and signed into law by Presid ...
, a 10% "tanning tax" was introduced, which is added to the fees charged by tanning facilities; it was expected to raise $2.7 billion for health care over ten years.
Tanning beds are regulated in the United States by the federal government's Code of Federal Regulations
In the law of the United States, the ''Code of Federal Regulations'' (''CFR'') is the codification of the general and permanent regulations promulgated by the executive departments and agencies of the federal government of the United States. ...
(21 CFR 1040.20). This is designed to ensure that the devices adhere to a set of safety rules, with the primary focus on sunbed and lamp manufacturers regarding maximum exposure times and product equivalence. Additionally, must have a "Recommended Exposure Schedule" posted on both the front of the tanning bed and in the owners' manual, and list the original lamp that was certified for that particular tanning bed. Salon owners are required to replace the lamps with either exactly the same lamp, or a lamp that is certified by the lamp manufacturer to be.
States control regulations for salons, regarding operator training, sanitization of sunbeds and eyewear, and additional warning signs. Many states also ban or regulate the use of tanning beds by minors under the age of 18.
American osteopathic physician
Doctor of Osteopathic Medicine (DO or D.O., or in Australia DO USA) is a medical degree conferred by the 38 osteopathic medical schools in the United States. DO and Doctor of Medicine (MD) degrees are equivalent: a DO graduate may become licen ...
Joseph Mercola
Joseph Michael Mercola (; born July 8, 1954) is an American alternative medicine proponent, osteopathic physician, and Internet business personality. He markets dietary supplements and medical devices. On his website, Mercola and colleagues adv ...
was prosecuted in 2016 by the Federal Trade Commission
The Federal Trade Commission (FTC) is an independent agency of the United States government whose principal mission is the enforcement of civil (non-criminal) antitrust law and the promotion of consumer protection. The FTC shares jurisdiction ov ...
(FTC) for selling tanning beds to "reverse your wrinkles" and "slash your risk of cancer".[''Federal Trade Commission v. Mercola'']
1:16-cv-04282
(N.D. Ill. 13 April 2016). The settlement meant that consumers who had purchased the devices were eligible for refunds totalling $5.3 million. Mercola had falsely claimed that the FDA "endorsed indoor tanning devices as safe", and had failed to disclose that he had paid the Vitamin D Council for its endorsement of his devices. The FTC said that it was deceptive for the defendants to fail to disclose that tanning is not necessary to produce vitamin D.
See also
*Indoor tanning lotion
Indoor tanning lotions accelerate the tanning process, by promoting the production of melanin. Increasing blood flow to the skin is a proposed mechanism, which may in turn stimulate production of melanin by melanocytes. Indoor tanning lotions u ...
* Light skin in Japanese culture
*Sunless tanning
Sunless tanning, also known as UV filled tanning, self tanning, spray tanning (when applied topically), or fake tanning, refers to the effect of a suntan without exposure to the Sun. Sunless tanning involves the use of oral agents (carotenids) ...
Notes
References
Bibliography
Book chapters are cited in short form above and long form below. All other sources are cited above only.
*Coups, Elliot J. and Phillips, L. Alison (2012). "Prevalence and Correlates of Indoor Tanning", in Carolyn J. Heckman, Sharon L. Manne (eds.), ''Shedding Light on Indoor Tanning''. Dordrecht: Springer Science & Business Media, 5–32.
*Hay, Jennifer and Lipsky, Samara (2012), "International Perspectives on Indoor Tanning", in Heckman and Manne (eds)., 179–193.
*Hunt, Yvonne; Augustson, Erik; Rutten, Lila; Moser, Richard; and Yaroch, Amy (2012). "History and Culture of Tanning in the United States", in Heckman and Manne (eds.), 33–68.
*Lessin, Stuart R; Perlis, Clifford S.; Zook, and Matthew B. Zook (2012). "How Ultraviolet Radiation Tans Skin" in Heckman and Manne (eds.), 87–94.
*Lluria-Prevatt, Maria; Dickinson, Sally E.; and Alberts, David S. (2013). "Skin Cancer Prevention", in David Alberts, Lisa M. Hess (eds.). ''Fundamentals of Cancer Prevention''. Heidelberg and Berlin: Springer Verlag, 321–376.
{{refend
IARC Group 1 carcinogens
Skin pigmentation
Tanning (beauty treatment)
Ultraviolet radiation