Just Say No . . . to Indoor Tanning

By Jane M. Grant-Kels, MD
Professor and Chair, Department of Dermatology
University of Connecticut Health Center

What are the dangers of indoor tanning?

There is no such thing as a “safe” tan. When you get a tan from either indoor tanning or time spent outdoors, you are damaging your skin. When skin becomes darker, it is because it is trying to protect itself from the cellular damage caused by natural or artificial light.

The darkening of the skin is due to increased melanin. If you look under a microscope at skin that is tan, you see increased melanin located above the nucleus of the skin cell, resembling the top of an umbrella. In this location the melanin is in a position to protect the cell’s nucleus from the harmful light rays.

Natural sunlight contains UVA and UVB rays. Tanning-parlor lights far exceed the UV radiation levels that have been calculated from natural sunlight even at its most intense. In addition, this artificial light is composed of an altered ratio of UVA and UVB light compared with natural light. There is now strong evidence that UV radiation from indoor tanning results in the future development of melanoma as well as non-melanoma skin cancers such as basal cell and squamous cell carcinomas.

Tanned skin is not healthy skin; it is damaged skin.

Do the dangers of indoor tanning vary according to age or ethnicity?

The dangers vary depending on skin type rather than age or race. Individuals with naturally darker skin (no matter their age or ethnicity) are less likely to sustain light-induced DNA damage to their skin cells because the melanin in darker skin is somewhat protective. Nonetheless even patients who never or rarely burn due to their darker natural skin type can damage their skin if they expose themselves to excessive amounts of natural or artificial light rays. Patients with darker skin are diagnosed with skin cancers, and these numbers are on the rise for everyone.

Does it help to get a “base” tan through indoor tanning before heading to the beach?

No! There is absolutely no evidence to support the claim that indoor tanning will afford any significant protection against subsequent natural-light exposure and DNA damage. The kind of tan one obtains from indoor tanning lights (which emit predominantly UVA rays) is not equal to the kind of tan one gets from natural sunlight (which contains UVA and UVB rays). Although a tan from UVB lights would provide some protection against subsequent UV damage, this comes at an unacceptable expense. The so-called protective tan from UVB is damaging to your skin. Any tan is unhealthy.

There is a lot of information in the news today about the many health benefits of vitamin D. Is indoor tanning a safe way to get vitamin D?

No. Vitamin D synthesis is caused by exposure of the skin to UVB light. Rather than continuing to increase vitamin D levels, repeated exposure to predominantly UVA light via indoor tanning has actually been shown to progressively damage skin cell DNA.

Is any amount of indoor tanning safe?

No. Any exposure to UVA or UVB light will cause damage to your skin. Ultraviolet exposure even without redness or a burn results in DNA damage.

Why, in your view, are young women, specifically, still seeking out indoor tanning?

There is in fact definitive evidence that women are significantly more likely to use tanning beds then men, although I don’t know why women—and especially young women—continue to seek out indoor tanning.

For women who believe they look healthier with a tan, can you suggest any alternatives to tanning?

I have no problem with sunless tanners. These products are safe and come in a variety of convenient sprays and creams. Recent studies have revealed, however, that users of sunless tanning products have a higher rate of sunbathing and indoor-tanning activities. Ultimately, I would prefer to change attitudes about tanning and encourage people to accept their natural skin color rather than seek an artificial bronzed appearance.