1. Myths and Facts of
Artificial Sun Tanning
Rogerio Izar Neves, M.D., Ph.D., F.A.C.S.
Professor of Surgery, Dermatology, Pharmacology and Medicine
Deputy Director, Penn State Hershey Melanoma Center
Clinical Science Leader, Melanoma Therapeutics Program
Director, Cutaneous Oncology Program
Penn State Cancer Institute

2. Skin Cancer Facts

3. One in five Americans will
develop skin cancer during
his or her lifetime.
National Cancer Institute, 2012 SEER Database

4. One in 59 men and women
in US will be diagnosed with
melanoma during their
lifetime!
National Cancer Institute, 2012 SEER Database

5. One person dies almost
every hour of melanoma.
National Cancer Institute, 2012 SEER Database

6. Melanoma is the most common
form of cancer for young adults,
25-29 years old, and the second
most common form of cancer
for adolescents and young
adults, 15-29 years old.
National Cancer Institute, 2012 SEER Database

12. Motivations For Indoor Tanning
• Aesthetic preference for a tanned appearance
• Relaxation and mood enhancement
• Dependence or addiction to tanning

13. What is a tan?
Why some individuals
become addicted to tanning?

15. Tanning Salons Facts
• Multi-billion dollar industry
• 1 million times a day someone in US use artificial UV
radiation for skin tanning
• According to the indoor tanning industry, 30 million
Americans (10% of the US population) use tanning beds/
year
• Use rate among teenage girls by age:
• 7% at age 14, 15% at age 15 and 35% at age 17
• Median number of times of use: 20
Fisher & James, N Engl J Med 2010

16. Tanning Salons Facts
• Women 19-28 are the most frequent user
• Risk of melanoma increase to 75% for those who used
tanning beds before the age of 35
• 225% increased risk of Squamous Cell Carcinoma associated
with “ever use” of Indoor Tanning.
• Carcinogenic to humans, same category as plutonium, arsenic,
mustard gas and cigarettes in terms of cancer-causing potential.
Source: International Agency for Research on Cancer Working Group (WHO)

17. Does indoor tanning facilities allow
frequent tanning?
“I have fair skin…I’m 15 & have
never used a tanning bed…How
many times can I tan the 1st
week?”
Pichon LC et al. Youth Access to Artificial UV Radiation ExposurePractices of 3647 US Indoor
Tanning Facilities. Arch Dermatol. 2009;145(9):997

18. Does indoor tanning facilities allow
frequent tanning?
“I have fair skin…I’m 15 & have
never used a tanning bed…How
many times can I tan the 1st
week?”
71% of the salons said every day!
Pichon LC et al. Youth Access to Artificial UV Radiation ExposurePractices of 3647 US Indoor
Tanning Facilities. Arch Dermatol. 2009;145(9):997

19. Living Near a Tanning Salon and Use…
• 76% lived within 2 miles
of a tanning salon
• For teens having no
tanning salons within 2
miles of their home, 7%
used indoor tanning in
the past 12 months.
Pichon LC et al. Youth Access to Artificial UV Radiation ExposurePractices of 3647 US Indoor
Tanning Facilities. Arch Dermatol. 2009;145(9):997

20. Source: CITY100 -Controlling Indoor Tanning inYouth

21. Average Number of Businesses per City
0
12.5
25
37.5
50
19
29
42
Starbucks McDonald Tanning
Hoerster, K. et al. Density of Indoor Tanning Facilities in 116 Large U.S. Cities. Am J Prev Med 2009;36(3):243–246

22. Number of Indoor Tanning Salons in
Philadelphia
0
22.5
45
67.5
90
42
83
52
23
Average # of Tanning Salons per City
# of Tanning Salons in Philadelphia
McDonald
Starbucks
Hoerster, K. et al. Density of Indoor Tanning Facilities in 116 Large U.S. Cities. Am J Prev Med 2009;36(3):243–246

23. Number of Indoor Tanning Salons in
Pittsburgh
0
25
50
75
100
42
93
34
25
Hoerster, K. et al. Density of Indoor Tanning Facilities in 116 Large U.S. Cities. Am J Prev Med 2009;36(3):243–246
Average # of Tanning Salons per City
# of Tanning Salons in Pittsburgh
McDonald
Starbucks

24. Myths of the “Healthy Tan”
(or Tanning Industry Arguments)
• Melanoma is not really UV related
• Vitamin D is important in preventing cancer
development
• Tanning promotes vitamin D production
• Any increase in “non-lethal” skin cancers is offset
by a larger decrease in lethal visceral cancers
• Tanning beds are not dangerous sources of UV
radiation

25. Melanoma Is Really UV Related?
Pleasance et al. Nature 2010
The catalogue of somatic mutations in COLO-829

26. Melanoma Is Really Caused by
UV Exposure!
UV signature mutations
in a melanoma genome
Pleasance et al. Nature 2010

27. Melanoma Is Really Caused by
UV Exposure!
UV signature mutations
in a melanoma genome
Pleasance et al. Nature 2010

28. Sun Exposure andVitamin D
Gilcrest BA. Journal of Steroid Biochemistry & Molecular Biology 103 (2007) 655–663

29. Does more sun exposure
means moreVitamin D
photosynthesis?

30. No!
Just more sunburn and
DNA damage!

31. “Truth-In-Advertising”
• “You can achieve a deep year-round tan
with safe ultraviolet light.”
• “No harsh glare, so no goggles or eye
protection is necessary.”

32. The Myth of the “Healthy Tan”

33. Summary of the Report
• 90% of the salons stated that indoor tanning did not pose
a health risk.
• Nearly 80% of the salons asserted that indoor tanning
would be beneficial to the health of a fair-skinned teenage
girl.
• Nearly 75% of the tanning salons fail to follow FDA
recommendations on tanning frequency.
• Salons used many approaches to downplay the health risks
of indoor tanning.
• Tanning salons target teenage girls in their advertisements.

34. www.pennstatehershey.org/melanoma

35. What are the current regulations?
• Australia: New South Wales-total ban law just
passed in Feb 2012
• France, Germany, Austria, U.K.: Banned
tanning bed use for minors <18 years old
• Brazil: Total ban on the use and sale of tanning beds
• United States: 32 states have imposed some form
of restriction on tanning facilities access to minors

36. Brazil Leads the World
• Resolution #56 (November 9, 2009) prohibits
within the whole Brazilian territory, the import,
receipt as a donation, rental, commercialization
and the use of artificial tanning devices for
cosmetic purposes.

37. Reasons to Regulate the Tanning Industry
• UV radiation levels far exceed what is found in natural sunlight
• Tanning beds have very little supervision and guidelines
• Side effects are not monitored or regulated
• Certain practices are especially dangerous:
• Failure to wear goggles leading to eye injury
• Long exposures leading to burning
• Not following manufacturer-recommended exposure times
based on skin type
• Using certain medications or cosmetics while tanning

38. Artificial Tanning
Damage
No tan is worth dying for!

39. ThankYou!