Risk Is Even Greater for Women, Study Shows
By Denise Mann
WebMD Health News
Reviewed by Laura J. Martin, MD
Dec. 14, 2011 -- Indoor tanning has been under heavy fire the last few years, and a new study will do nothing to tone down the assault.
Indoor tanners are close to 70% more likely to develop the most common type of skin cancer before their 40th birthday, a new study shows.
The skin cancer, basal cell carcinoma, looks like open sores, red patches, pink growths, or shiny bumps. This type of skin cancer is usually not lethal but can be disfiguring.
Many previous studies have linked indoor tanning to melanoma, a potentially fatal form of skin cancer. Growing numbers of people younger than 40 -- especially women -- have developed basal cell skin cancer in recent years. The findings, which appear in the Journal of the American Academy of Dermatology, suggest that indoor tanning may play a role in this increase. As many as 28 million people use indoor tanning beds each year, according to the Indoor Tanning Association.
Study: Risk Greatest Among Women
Researchers analyzed data from the Yale Study of Skin Health in Young People. It included more than 750 people under 40. Of these, slightly more than 69% were women.
Overall, people who had used indoor tanning beds were 69% more likely to develop basal cell skin cancer before age 40 when compared to people who did not.
The risk was greatest among women, the study showed. Women who tanned were more than twice as likely to develop basal cell skin cancer as those who never tanned.
Exactly why the effects of indoor tanning seem to be worse in women is not known. Women may start tanning earlier and tan more frequently than men, the study authors write. About 43% of basal cell skin cancers occurring at an early age in women could be prevented if there were a ban on indoor tanning beds, they point out.
Other factors that increased risk in the presence of indoor tanning were:
- History of more than one basal cell skin cancer
- History of a sunburn particularly at the site of the cancer
- Use of high-speed, high-intensity, or high-pressure tanning beds
- Genetic predisposition to skin cancer
Indoor Tanning Is a Public Health Issue
"It is hard for even the most skeptical and resolute tanners -- and tanning salon owners -- to refute or ignore an increased risk of 69%," says Heidi Waldorf, MD. She is a dermatologist at Mount Sinai Medical Center in New York City. "The fact that the link was strongest in women and that we see so many younger women going to indoor tanning salons is particularly concerning. This really is a public health issue."
The rest of the country should follow California's lead and ban teenagers under 18 from indoor tanning, she says: "We keep kids from buying alcohol and cigarettes; it makes sense to block another easily avoidable cancer risk until they are old enough to make a more informed decision."
This study provides even more evidence that indoor tanning increases the risk for all types of skin cancer, says Babar K. Rao, MD. He is the acting chair of dermatology at the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School in New Brunswick, N.J.
While basal cell skin cancer is not feared the way that melanoma is, "it means that your skin has been damaged enough by ultraviolet rays that you can get any type of skin cancer," he says.
Many tanning salons advertise that exposure to ultraviolet light will increase the body's production of vitamin D and improve health. "There are other ways to get vitamin D," Rao tells WebMD. "Eat healthy foods and take supplements. You don't need indoor tanning."
Indoor Tanning Advocate: Getting Burned Is the Real Issue
John Overstreet is the executive director of the Indoor Tanning Association, an industry trade group. He says the real culprit is getting burned, not indoor tanning.
"You shouldn't get sunburn. Everybody agrees with that," Overstreet says. "It is easier to avoid sunburn when you tan indoors because it so much more controlled."
"Moderation is key. If you avoid burning either indoors or outdoors, there are benefits," he says, referring to increased vitamin D production. Vitamin D deficiency has been linked to a host of health problems including brittle bones, heart disease, and diabetes.
Michele Green, MD, is a dermatologist at Lenox Hill Hospital in New York City. "The rays that cause skin cancer are the ones that give you the best tan," she says, and these are the rays used at indoor tanning salons.
Green says the new findings mirror what she is seeing in her practice, namely more people -- especially women -- younger than 40 with skin cancers. "It's an epidemic and we should ban tanning booths."
SOURCES: Ferrucci, L. Journal of the American Academy of Dermatology, published online Dec. 12, 2011.Michele Green, MD, dermatologist, Lenox Hill Hospital, New York City.Heidi Waldorf, MD, associate clinical professor of dermatology, Mount Sinai Medical Center, New York City.Babar K. Rao, MD, acting chair, dermatology, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick.John Overstreet, executive director, Indoor Tanning Association, Washington, D.C.
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