Sun & Skin News 18.4: Regulations Don't Make Tanning Salons Safe

The evidence mounts, but nothing seems to change. In a recent study, people exposed to 10 full-body tanning salon sessions had a significant increase in skin repair proteins typically associated with sun damage.

That's the latest study showing that ultraviolet radiation (UV) from indoor tanning is as dangerous as UV from the sun. As far back as 1994, a respected Swedish study found that women 18-30 years old who visited tanning parlors 10 times or more a year had 7 times greater incidence of melanoma, the deadliest form of skin cancer, than women who did not use tanning parlors.

Despite such evidence, tanning parlors in the U.S. remain legal, and 28 million Americans use them annually.

The Skin Cancer Foundation has long fought to make safety rules governing tanning salons more stringent. In 1999, for example, physicians representing the Foundation presented evidence to the U.S. Food and Drug Administration (FDA) that indoor tanning for non-medical purposes was a high-risk activity that must be better regulated. The question remains what impact such efforts have had.

Government Hesitation
The FDA is still weighing stricter controls over tanning devices, but has not yet instituted changes. Meanwhile, several states have enacted their own regulations. The tanning industry has fought all of this. "Tanning machine manufacturers and salon owners keep lobbying the FDA and state agencies to soften regulations, claiming that tanning is healthful," says James M. Spencer, MD, director of dermatologic surgery at Mount Sinai Medical Center in New York City, and a member of The Skin Cancer Foundation's Medical Council.

According to Dr. Spencer, the tanning industry relies on two misleading arguments: first, that since melanoma is mainly caused by sunburn, "controlled" tanning helps prevent melanoma by building up the protective pigment melanin; second, that UV exposure makes the skin produce vitamin D, which helps prevent breast cancer, melanoma, and other diseases.

Medical experts refute these arguments. They point out that our diet (especially vitamin D-rich foods such as dairy products and salmon) generally provides all the vitamin D we need. Furthermore, tanning to increase melanin is counter-productive, they say: Tanning, like burning, causes genetic damage. "You can't protect the skin by damaging it," says Dr. Spencer. "Tanning not only increases risk for melanoma and squamous cell carcinoma, but accelerates skin aging."

A Miss Is As Good As a Mile
Unfortunately, regulating the tanning industry haven't solved the problems. "Regulations can't make tanning safe," declares Michael Franzblau, MD, clinical professor of dermatology, University of California School of Medicine, San Francisco. "Banning salons is the only answer."

He should know, because he was instrumental in the passage of legislation regulating tanning facilities in California. The law, passed in 1988, unfortunately had no mechanism for registration of tanning parlors or collection of fees from the owners. "Hence, there is no enforcement," notes Dr. Franzblau.

Some states require salons to provide UV-protective eyewear or have machine operators remain present throughout a client's session. Others require a sign on the booth warning people who always sunburn that tanning puts them at high risk for skin damage. Whatever the regulations, says Dr. Franzblau, there's no assurance they will be complied with. "I've taken teams of scientists into salons where not one requirement was being followed."

Eliminating tanning salons, he says, "would be 100 percent more effective" than regulating them. And it could save millions of lives.

Dr. Spencer believes that organizations such as The Skin Cancer Foundation have offered the FDA sufficient evidence to show why tanning salons should be banned. "Once the Agency has reviewed everything, it has the power to institute a ban immediately," he says. "It has the right to ban any device that is a threat to the public. And tanning machines are such a threat."

Also check out Sun & Skin News 18.3: As Sun Safety Grows, So Do The Benefits of Sunless Tanning