Tanning beds: safe alternative to sun?

By Heidi Mallis, B.A.
September 2009


Tanning beds are advertised as a safe alternative to a natural suntan. Nearly 30 million people in the U.S. use tanning beds each year1, 2.3 million of whom are adolescents.2 A study of young adults found that there are several popular reasons why people use tanning beds and these include:

  • Create a base tan before a sunny vacation
  • To look healthy
  • Lack of opportunity to tan in natural sunlight
  • Friends do it
  • Treat skin problems such as acne or psoriasis3

Despite the hype about safety, recent studies suggest that tanning beds can increase the risk of skin cancer, especially among teenagers and young adults. So, how safe are they?

Tanning beds expose the user to a lot of artificial UV radiation in a short period of time. In the past, tanning beds gave off primarily UVA radiation with a small amount of UVB. Now, many manufacturers are increasing the amount of UVB radiation emitted from tanning beds to better duplicate solar UV light and speed up the tanning process.4 This is of great concern because UVB radiation is more likely to cause cancer than UVA radiation.

Regardless of how often a person uses a tanning bed, just one 8-20 minute session exposes a person to more UV radiation than an entire afternoon spent in natural sunlight. It is possible to compare UV radiation received from a tanning bed with that received from natural sunlight by looking at the minimal erythema dose (MED). The MED is the amount of UV radiation a person’s skin can take before burning. For a person who occasionally uses an indoor tanning bed (approximately 20 sessions per year, at 2 MED/session), their annual UVA exposure from a tanning sunlamp can range from half to nearly two times as high as that received from the sun. For a frequent tanning bed user (approximately 100 sessions per year, at 4 MED/session), annual UVA exposure can be up to five times as high as what they would receive from the sun. A newer kind of “high-pressure” sunlamp exposes users to even more UVA — eight to twelve times the amount of UVA they would otherwise receive from the sun.5

A study conducted by Dr. S. Elizabeth Whitmore and Dr. Warwick Morison of Johns Hopkins University School of Medicine in 2000 found that ten tanning sessions in two weeks produced evidence of a suppressed immune system among participants. This means that the body is less capable of fighting off infectious agents.6 Tanning bed use is also associated with faster skin aging because the UV radiation destroys skin fibers and damages elasticity. Characteristics of skin aging include wrinkles, dark spots, and a leathery texture.7

In July 2009, the International Agency for Research on Cancer released a report that placed tanning beds in its highest cancer risk category, “carcinogenic to humans.” This means that there is enough evidence to conclude that tanning beds can cause cancer in humans. The agency, which is part of the World Health Organization (WHO), previously classified tanning beds as “probably carcinogenic.” The change comes after an analysis of more than 20 epidemiological studies indicating that people who begin using tanning devices before age 30 are 75% more likely to develop cutaneous melanoma, the most serious type of skin cancer.8

Skin cancer is the most common form of cancer, with more than one million cases diagnosed each year in the U.S. There are three types of skin cancer: squamous cell, basal cell, and melanoma. Squamous cell carcinomas typically occur on surfaces exposed to excessive sunlight, such as the ears or face. This type of skin cancer can spread quickly to other organs in the body. Basal cell carcinomas account for 8 out of 10 skin cancers. They grow very slowly and rarely spread to other parts of the body (as a result, they are highly treatable). Melanomas are the third and most dangerous type of skin cancer. They are less common than basal and squamous cell carcinomas but much more serious.9 Melanomas usually present as a change to an existing mole or an entirely new mole that is black or has a blue-black area. Their diameter is typically larger than that of a pencil eraser. If caught early, melanomas are often completely curable. However, they are much more likely to spread to other parts of the body if not found early.10

Risk factors for all three types of skin cancer include:

  • Lifetime exposure to UV radiation (from natural or artificial sources)
  • Family history of skin cancer
  • Geographic location (people who live close to the equator as well as in the mountains are exposed to higher levels of UV radiation)
  • Fair skin that freckles or burns easily
  • Severe sunburns as a child
  • Radiation therapy

Here are a few ways to lower your risk and avoid wrinkles and other skin damage:

  • Avoid direct sun exposure during midday hours (from 10 am-4 pm),
  • Use sunscreen with a sun protection factor (SPF) of at least 15
  • Regularly check your skin for any new moles, sores, or scaly patches (and visit a dermatologist if you notice the lesion changing form or color), and
  • Avoid using a tanning bed (particularly if you are a teenager or young adult).11

It should be noted that skin self exams are an easy way to be proactive about your skin health. An updated recommendation from the U.S. Preventive Services Task Force suggests that if you are not at an increased risk of developing skin cancer, there is no need for yearly skin checks by a dermatologist.12

Continue to monitor any existing or new moles and contact your doctor if you detect any significant changes in size, shape, or color.

  1. Indoor Tanning Association (2005). Positive effects of UV light. http://www.theita.com/indoor/faq.cfm#ans5 (Accessed August 31, 2009).  
  2. American Academy of Dermatology (2009, July 30). American Academy of Dermatology commends reclassification of tanning beds as carcinogenic.  
  3. Knight JM, Kirincich AN, Farmer ER, Hood AF. Awareness of the risks of tanning lamps does not influence behavior among college students. Archives of Dermatology, 2002; 138(10): 1311-1315.  
  4. WHO (March 2005). Sunbeds, tanning and UV exposure. Fact sheet No. 287. http://www.who.int/mediacentre/factsheets/fs287/en/ (Accessed August 31, 2009).  
  5. Miller SA, Hamilton SL, Wester UG, Cyr WH. An analysis of UVA emissions from sunlamps and the potential importance for melanoma. Photochemistry and Photobiology. 1998;68:63-70.  
  6. Whitmore SE, Morison WL. The effect of suntan parlor exposure on delayed and contact hypersensitivity. Photochemistry and Photobiology, 2000; 71(6): 700-705.  
  7. FDA (2009, May 5). The risks of tanning. U.S. Department of Health and Human Services. http://www.fda.gov/Radiation-EmittingProducts/RadiationEmittingProductsandProcedures/Tanning/ucm116432.htm (Accessed September 3, 2009).  
  8. WHO International Agency for Research on Cancer Monograph Working Group (2009, July 29). A Review of Human Carcinogens—Part D: Radiation. The Lancet Oncology, August 2009; 10 (8): 751-2.  
  9. American Cancer Society (2009, May 6). What are basal and squamous cell skin cancers? http://www.cancer.org/docroot/CRI/content/CRI_2_2_1x_What_Is_Nonmelanoma_Skin_Cancer_51.asp?sitearea= (Accessed September 4, 2009).  
  10. National Cancer Institute (2003, March 31). Signs and symptoms of melanoma. U.S. National Institutes of Health. http://www.cancer.gov/cancertopics/wyntk/melanoma/page8  
  11. National Cancer Institute (2009, July 30). What you need to know about skin cancer. U.S. National Institutes of Health. http://www.cancer.gov/cancertopics/wyntk/skin (Accessed September 2, 2009).  
  12. U.S. Preventive Services Task Force (2009, February 3). Screening for skin cancer: U.S. Preventive Services Task Force recommendation statement. Agency for Healthcare Research and Quality. Annals of Internal Medicine, 2009; 150(3): 188-193. (Accessed September 8, 2009).