Taking a risk in the tanning booth

Here’s a story that recently made headlines: A mom in New Jersey is facing a criminal charge of child endangerment after allegedly allowing her 5-year-old daughter to use a tanning booth, leading to a rash and sunburn.

Patricia Krentcil, 44, whom some of the news accounts describe as “bronzed” or “deeply tanned,” has denied doing so, and it remains to be seen how the issue plays out in a courtroom. In the meantime, it has triggered a new round of interest and debate over indoor tanning safety.

Is it reckless for a mother to allow a child or teen to use a tanning booth? Is indoor tanning ever safe?

The cumulative weight of evidence says indoor tanning is more damaging to the skin than sunlight. A number of recent studies also have confirmed a higher risk of skin cancer, including melanoma, among tanning-booth users, especially those who began indoor tanning before the age of 35.

The Journal of Clinical Oncology recently focused on the issue, summing up much of the research and its implications for public health. The journal also published a study last month that tracked nearly 73,500 women from the well-known Nurses Health Study II cohort. The researchers found that women who engaged in indoor tanning not only were more likely to develop basal cell skin cancer later in life, but their risk also went up when they were exposed to tanning beds in their teens and 20s.

How often the women used a tanning bed seemed to matter as well. Those who were exposed more than six times a year, especially at a younger age, had a higher likelihood of later developing skin cancer.

These findings are “not exactly headline news,” writes Dr. Mary S. Brady, of Memorial Sloan Kettering Cancer Center, in an accompanying commentary. Yet “approximately 30 million Americans use tanning salons at least once a year,” she wrote. “Women and young people are the most frequent users.” She also notes that indoor tanning “is one of the most rapidly growing industries nationally, with a three-fold increase in the number of indoor tanners in the United States between 1986 and 1996.”

So why, in spite of everything that’s known about indoor tanning and skin cancer risk, is the message not resonating very well? According to a report released late last week by the U.S. Centers for Disease Control and Prevention, half of U.S. adults under the age of 30 reported being sunburned at least once in the previous year – an incidence unchanged since a decade ago. Women in their 20s also reported going to a tanning salon twice a week on average.

The summary in the Journal of Clinical Oncology offers a possible explanation for why it’s proving so difficult to get young people to change their tanning behavior: Perhaps they do it because it makes them feel good. In a small but fascinating study, a group of frequent tanners was exposed to both ultraviolet and non-ultraviolet light tanning beds twice a week for six weeks, then offered a third tanning session at the end of each week. Nearly all of them opted for the additional tanning; furthermore, most of them chose the UV light option, suggesting that the UV light exposure somehow reinforced their tanning behavior. The study participants also reported feeling more relaxed after UV exposure.

A number of other studies have found an addictive element to indoor tanning. Researchers also have identified an association between frequent indoor tanning, higher anxiety levels and use of alcohol, marijuana and other substances, although it’s not entirely clear how all of these are related.

Given the facts, it’s probably no wonder that a growing number of states are restricting the use of indoor tanning by underage users. It has become difficult to ignore the science about ultraviolet light exposure and skin damage. The real question is whether people’s habits will ever catch up with the evidence.