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Ban the Tan?

FDA tanning bed warning proposed; adults-only rule could be next

16

Seven years ago, when Brittany Lietz, Miss Maryland 2006, was suffering from melanoma, she blamed her cancer on obsessive indoor tanning.

Barbara Gilchrest, a School of Medicine professor of dermatology, later heard Lietz speak at a federal meeting pondering regulation of tanning booths. Now, years after that meeting, the Food and Drug Administration has proposed that warning labels be placed on all tanning beds (as is already required in some states), and the agency says its next step may be a ban on the use of tanning beds by minors.

Gilchrest represented the American Academy of Dermatology at that long-ago meeting, and she has spoken out about tanning’s dangers amid industry pushback touting it as a source of illness-fighting vitamin D.

“The lifetime risk of melanoma is about one in 50 or higher for everybody,” says Gilchrest. “And you considerably increase those risks if you’re fair-skinned and tanning.” The Boston Globe reports that 70 percent of US users of tanning salons are women between 16 and 28, and melanoma rates for girls in the 15 to 19 age range have doubled since the 1970s. While direct evidence tying those rates to indoor tanning is wanting, the paper says, most dermatologists believe it’s the culprit.

Gilchrest spoke with BU Today about the FDA’s proposal.

BU Today: This nationwide requirement—why has it taken so long?

Gilchrest: I guess they’re busy at the FDA. I cannot explain why it should take that long. The FDA has just accepted a reclassification of sunscreens, to clarify in what way sunscreens protect or don’t protect, and that was under consideration for close to 20 years.

You’ve said many sunscreens don’t provide a lot of protection.

The revisions were to limit the SPF ratings that could be put on sunscreens. The new regulations don’t allow the label to say over 50. Now you can buy an SPF 100 sunscreen. When these products are tested according to the requirements of the FDA, those protection factors are correct. However, nobody puts on that much sunscreen. The amount that testing requires is literally layering it on. Most people put on about one-fourth as much as is required by the FDA for determining protection factors.

Does Massachusetts require warning labels on beds?

They’re required, and it’s required that a customer be informed of tanning risks. But if you check, usually there’s a little label on the UV device that maybe somebody looks at, maybe they don’t. And the operators in practice don’t seem to take the time to inform people of what it says on the warning label. There’s not a lot of enforcement.

So how effective will this national warning label regulation be?

I’m sure not as effective as one would like. Same thing for these age cutoffs: if you’re 17 and you need a note from your parents, does the operator remember to ask? Does she ask for proof of age?

Should minors be banned from tanning, and do you think the FDA will ever do that?

As a dermatologist, as a parent, I would strongly recommend to people that they not use tanning beds. In the range of destructive behaviors that young people engage in, I would put tanning low on that list, as opposed to binge drinking or drinking and driving or texting and driving.

But would you say that banning would go too far philosophically?

Probably. And I doubt we will get there.

Is there anything good to be said for tanning?

There was an international dermatology meeting in Edinburgh in May, and one of the abstracts presented was a study where the investigators showed that longer UV wavelengths of light that haven’t been much studied can drop blood pressure a little bit. Unlike the vitamin D craziness, which the Institute of Medicine and everyone else has found doesn’t hold water, it seems that this is a real effect. My guess is it will replace vitamin D, because that’s been totally discredited. The counterargument would be that there are essentially risk-free ways of achieving the same health benefit rather than exposing yourself to a known carcinogen.

The sad thing is that tanning, whether in a booth or at the beach, really destroys the appearance of your skin. I hear it every time I see patients: women in their 30s and 40s come in and say, I wish I hadn’t done that, I can’t believe I did this to myself. And so a thing that they did to improve their appearance has ruined it. You know that those 16-year-olds who are tanning as much as they can are going to be very unhappy that they did that in 30 years. Destroying the appearance of your skin is just about guaranteed. But people of that age simply don’t believe they will ever be middle-aged. They see that as some stupid mistake their parents made.

16 Comments
Rich Barlow

Rich Barlow can be reached at barlowr@bu.edu.

16 Comments on Ban the Tan?

  • Dereck on 06.05.2013 at 8:07 am

    Not sure how Barbara comes to the conclusion that the “vitamin D thing” doesn’t hold water. Do some google searches and you’ll see new studies every day connecting vitamin D deficiency to conditions ranging from several of the most prominent cancers, to asthma, to MS. To think all of those findings are a coincidence is ridiculous. Perhaps, as some groups like the sunscreen-funded Skin Cancer Foundation claim, her argument is that UV exposure is not an effective way to raise vitamin D levels. That of course, is one of the most absurd things ever uttered, as UV exposure is the ONLY NATURAL way to reach and maintain adequate vitamin D levels (short of eating multiple servings of freshwater fish every day). It seems that Barbara and groups like the Skin Cancer Foundation are pushing their own agendas with little regard for the facts on the other side of things.

  • You're talking past/around the point on 06.05.2013 at 10:11 am

    She didn’t say vitamin D deficiency isn’t a real thing, nor that UV rays don’t provide it; she said tanning beds aren’t a legitimate source of it, and she’s right.

    Tanning beds give off 95% UVA rays, which brown your skin. They only give off 5% of UVB, which is responsible for vitamin D. Moreover, sun exposure has been deemed less than ideal for getting vitamin D because of cancer risks–if it’s your best way of getting it, use a lot of sunscreen and go outside for 10-15 mins, you might even get a walk in, which will also lower blood pressure in addition to a litany of other health benefits. You can get vitamin d from mushrooms, fatty fish, pork (especially ribs), eggs, ricotta, and fish oils, and many milks and cereals come fortified with it, too. If you’re vegan, I understand why it seems problematic, but not impossible.

    Claiming a tanning bed is the best way to get vitamin d is akin to saying you should smoke in order to breathe much-needed oxygen.

  • Jane on 06.05.2013 at 10:34 am

    Shame on Dr. Gilchrest for mentioning Vitamin D in a negative manner. There is decent research being done with interesting results to read and from which to learn. It is a shame that Dr. Gilchrest uses this forum to continue a personal vendetta. That is so petty.

    • Aaron L'Heureux on 06.05.2013 at 11:01 am

      You’ve sort of taken the Vitamin D comment out of context. It’s really only being mentioned as not well sourced from tanning and not a tanning-related benefit, not that there’s a problem with Vitamin D.

      Comments starting with ‘shame on’ are rarely, if ever, constructive.

      • Jane on 06.05.2013 at 12:48 pm

        “”Unlike the vitamin D craziness, which the Institute of Medicine and everyone else has found doesn’t hold water,” it seems that this is a real effect. “My guess is it will replace vitamin D, because that’s been totally discredited.” The counterargument would be that there are essentially risk-free ways of achieving the same health benefit rather than exposing yourself to a known carcinogen.”

        Mr. L’Heureux, I think Dr. Gilchrest is saying precisely what I thought she said. See, above.

        • Aaron L'Heureux on 06.06.2013 at 2:09 pm

          Yes, the vitamin D craziness –> in the context of a tanning article. And that this other discovery *within the realm of tanning* will replace the vitamin D enthusiasts. And that vitamin D benefits *from tanning* have been totally discredited.

          You’re making my case for me. I’m certainly not going to suggest I know whether there are or are not vitamin D benefits from tanning, but I am going to say that you’re misreading the context of the statement and this person’s opinion appears to be that there is not a significant vitamin D benefit *from tanning*.

    • casey on 06.05.2013 at 11:08 am

      I think she’s dismissing the idea that tanning beds are a viable source of vitamin d, nothing about vitamin d deficiency. Tanning beds use uva radiation, which is near useless for vitamin d production.

      • Dereck on 06.05.2013 at 12:06 pm

        The primarily UVA ratio mimics that of the sun. All other questions aside, tanning beds most definitely do produce vitamin D. See my other replies for sources.

  • Tami on 06.05.2013 at 3:39 pm

    Putting sunscreen on then going outside will defiantly inhibit any vitamin D production as sunscreen blocks burning (uvb) which is also the same rays that stimulate Vitamin D production in the skin.
    most Tanning beds produce the same amount of uvb as the sun, and there are UVB meters and vitamin D meters that have been used on tanning units to prove this! You can obtain up to 10,000iu of vitamin D from a full session on these tanning units.

    Your actual risk which never makes it to the media of getting melanoma via UV exposure is only .035%, less than half a percent, which is a 75% increase (which is the scary number they like to blast) from .02% which is your risk without exposure. Funny thing though, the studies that got to these numbers had red heads who burn and cannot tan, which are turned away from professional salons, and when this skin type 1 group was removed from the studies, it showed no increase, and in some cases even a decrease as new studies are showing uv exposure is protective AGAINST melanoma. Do a little digging and you can find all this out for yourself.

    Even at .035% that is less than half a percent of a risk. Other things never show up on radar until they are 3% or higher. 5 teens in 10 years in Canada have died from melanoma, thats half a person per year, and there is no proof as to the cause. 7000 teens will die per year in transport accidents (driving, riding bikes etc) and drowning is a much higher risk, yet we never hear of a push to ban swimming.

  • Scott on 06.05.2013 at 4:24 pm

    Vitamin D from either the sun’s or a tanning bed’s UV rays are the ONLY way to get a proper amount. No human can by diet or supplements alone create or swallow enough Vitamin D. Dereck has correctly answered the questions about the mix of UVA and UVB being roughly equivalent in tanning beds as from the sun.

    Research now tells us that UV light (apart from Vitamin D) lowers blood pressure – reducing risks of stroke and heart disease – DWARFING the concerns (potentially unfounded) about a minuscule amount of skin cancer which somehow increases as our fear of the sun and UV rays increases as well (odd, no?).

    The dermatologist likely has “phototherapy” device in her office. It’s a stronger, unregulated tanning bed for which dermatologists charge up to 100x the price of a UV tanning session.

    The multi-billion dollar marriage between dermatologists with a profit motive and the cosmetic (“skin care”) industry was conceived in junk science and raised by selling snake oil. All of this while convincing the public that the source of all life on this planet is somehow really an insidious killer.

    Follow the money. Do the math. Question the science that has YET to prove a linkage. Keep your money, people. Live your lives. When you get a sunburn, you’ve got too much sun. Nature’s crazy like that.

  • Jamie on 06.06.2013 at 12:45 pm

    I’m pretty sure people got Vitamin D just fine before the invention of tanning beds….

  • Tami on 06.06.2013 at 10:12 pm

    Actually Jamie, the reason they started fortifying milk with Vitamin D was because of vitamin D deficiency’s causing rickets in children which was virtually eradicated until recently as its making a come back do to sunscreen use and more time spent indoors. In northern U.S states and Canada, after sept and until May the sun is at such an angle to the earth that UVB rays cannot reach us, preventing vitamin D production. indoor Tanners are the very few people during the winter months that do not suffer from vitamin D deficiency’s, which have been linked to even the common colds and flu’s. AS Vitamin D is actually a hormone, it plays far more rolls than we even know, but we do know being hormonally imbalanced can reek havoc on the body, and the more we learn, the more we’ve learned how even the health authorities current recommended amounts are not enough and were set only to keep rickets at bay.
    Using sunscreens prevent vitamin D production, but also most contain an ingredient called oxybenzone, (look at your bottle) which is in the “class 1 list” as a known carcinogen (cancer causing) so is it really tanning causing skin cancer, or the sunscreen we are using thinking we are preventing skin cancer?

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