The Risks of Artificial Tanning and Prolonged Exposure to the Sun?

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This sample health essay focuses on the dangers of artificial tanning and long-term exposure to the sun, as well as an overview of UV radiation.

Background on the dangers of artificial tanning and sun exposure

Over 35% of adults, 59% of university students and 17% of teenagers in the United States have admitted to using an artificial tanning bed at some point in their lives (Wehner et al.). The artificial tanning industry has grown consistently over the last decade and is worth nearly $3 billion annually, with over 10,000 retail locations for artificial tanning located in the United States (IBIS World).

The Food and Drug Administration (FDA) is responsible for regulating all products that emit radiation, including artificial sun lamps found in tanning beds, and set all required manufacturer specifications. The National Cancer Institute partnered with the FDA in 2008 to deliver a report to the federal government about the radiation emitted from artificial tanning.

UV exposure statistics

It was revealed that the UV exposure levels in a tanning bed are four times the level necessary to attain a comparable cosmetic result (Food and Drug Administration). However, there were no resulting changes to manufacturer specifications and efforts to emphasize the consumer warning labels are still pending approval (National Cancer Institute).

The risks associated with prolonged sun exposure have been the topic of research for decades and with the popularity of artificial sun exposure consistently increasing, the Surgeon General issued a report outlining the inherent risk of sun exposure, both natural and artificial, the areas of concern included:

1. Medical contraindications
2. Addiction
3. Molecular damage
4. Loss of vision
5. Skin cancer

Each of these conditions has potentially fatal consequences.

Medical contraindications associated with sun exposure and tanning beds

A medical contraindication a situation where it may be dangerous to engage in an activity based on a current medication or physical condition (Vorvick). There are two main types of ultraviolet (UV) light drug reactions. They are classified as:

1. Photoallergy
2. Phototoxicity

These reactions occur when sun-sensitizing pharmaceuticals are used in conjunction with prolonged exposure to the sun.

• Photoallergy occurs when medicine is applied topically, to the surface of the skin, and can cause a rash and other skin irritations (Epstein).

• Phototoxicity occurs after a medication is taken orally or intravenously. Phototoxicity can occur with many drugs, including common, over-the-counter medication such Ibuprofen with symptoms persisting for up to 20 years after discontinuing the use of the product (Institute for Safe Medicine Practices).

Addiction to tanning beds

Although there have been public warnings about the risks of artificial tanning, thousands of individuals still do not protect their skin when outdoors or visiting a tanning salon (Knight et al.). The continued participation in an activity that is known to be harmful seems unusual and researchers have discovered a connection between that the drive to engage in prolonged sun exposure and an individual’s mental health (Skin Cancer Foundation).

Psychological dependence is related to the brain's reward system and its recollection of past events which have triggered positive emotional outcomes. The resulting positive sensations encourage repeated use of stimuli (Donovan). Treating addictions typically require a readjustment of these reward systems.

During a 2006 study utilizing a drug that blocks the positive endorphins related to artificial tanning, nearly 50% of participants who frequented tanning salons experienced withdraw symptoms such as nausea and jitters due to the lack of physical response to the activity (Kaur et al.). This result indicates the presence of psychology and physical dependence to the UV rays delivered by natural or artificial sunlight.

Molecular damage caused by the sun and tanning bed UV radiation

A study by the University of Michigan’s Dermatology Department revealed that molecular damage from Ultraviolet A1 (UVA1), the major component in UV radiation from the sun and artificial tanning, can begin after just two daily exposures (Wang et al.) Skin cell damage at the molecular level causes the development of molecules which destroy collagen, which makes the skin firm and youthful, causing premature aging of the skin (Krutmann, Morita and Chung).

In addition to visible changes to the skin, exposure has the potential to alter DNA molecules with the creation of photons that are absorbed by the DNA and causing a rearrangement of electrons (University of Minnesota). This damage prevents the skin cells from repairing themselves and repeated exposure can lead to the inability to prevent the development of the mutated cells responsible for skin disease and cancer (American Academy of Dermatology).

A tan is simply damaging to the skin and the production of additional pigmentation to protect itself against additional radiation exposure. Years before the new studies revealing just how dangerous the pursuit of a tan can be, Dr. Neal Schultz, a prominent New York dermatologist, urged people to abandon the pursuit of:

“…that summer glow we used to call a healthy tan. Now we know there’s nothing healthy about it. A tan is a testimony to damage done by the sun, and the next step is incubation of that damage, which causes skin cancer” (Breslow 84).

Loss of vision

Sunglasses are the normal reaction to the bright sun when outdoors and their indoor equivalent come in the form of safety goggles that absorb the UV rays emitted by artificial sun lamps. However, the exposure within a tanning bed are nearly 100 times higher than those encountered in natural sunlight due to the proximity of the bulb in relation to the eye, compared to the distance of the sun (Bennet & Bloom).

Extended periods of intense exposure can cause severe damage to the eye, including photokeratitis, cataracts, macular degeneration and corneal infections. This damage is cumulative and may not have an immediate effect, however, these conditions can cause damage to vision and eventual blindness. The current federal regulation requires the use of protective goggles that block 99% of the UV light and many states require that the indoor tanning facility provides them free of charge (21 C.F.R. § 1040.20).

Cancers associated with UV rays

Although the genetics that influence skin characteristics, such as freckles or fair-skin, can play a part in increasing the risks of sunlight, extended exposure to UV light is the strongest link to occurrences of cancer (United States Department of Health and Human Services). There are three main categories of skin cancer:

1. Basal cell carcinoma (BCC)
2. Squamous cell carcinoma (SCC)
3. Melanoma

These types of cancer make up more than 99% of all skin cancer occurrences (Donepudi, DeConti and Samlowski). In a 2014 study, Wehner, et al. estimated that nearly 400,000 of those can be directly attributed to the use of indoor tanning.

Basal Cell Carcinoma

As its name indicates BCC starts in the basal cells, the place where new skin cells are created. Most common on the face, neck and other areas with consistent sun exposure, BCC is caused by long-term exposure to ultraviolet radiation (Mayo Clinic). The most common form of skin cancer, statistics show that one person is diagnosed with BCC every 20 seconds in the United States (American Academy of Dermatology).

During a review of BCC and its correlation with artificial tanning Ferrucci et al. found that the majority of people diagnosed with BCC are vacationing collegege students who spend more time at the beach and women over the age of 50 who have used artificial tanning beds. Additionally, Ferrucci et al. stated that the majority of these patients would not have been considered high risk if they had refrained from artificial tanning.

Squamous Cell Carcinoma

Forming on the outer layer of the skin, SCC is known to spreading rapidly through the thin flat squamous cells and it is not typically known to be fatal (Mayo Clinic). Although SCC is attributed to both natural and artificial sunlight, prolonged exposure is the key and developing SCC in areas not typically exposed to the natural sun is indicative of artificial tanning (American Academy of Dermatology).

Melanoma

Although fewer people are being diagnosed with most types of cancer, melanoma unique in that the number of people diagnosed each year is consistently rising (American Academy of Dermatology). Melanoma is currently the most common cancer among people ages 25-29 and the second or third most common diagnosis in all other age groups (Center for Disease Control).

According to the American Cancer Society thousands of people die each year from melanoma yet, despite that fact, consumers continue to utilize indoor tanning facilities which increase their risk of developing melanoma by 59%.

Works Cited

American Academy of Dermatology. 'Diseases and Treatments'. N.p., 2015. Web. 13 Nov. 2015.

Bennett, D, and S Bloom. 'The Effects of Indoor Tanning on Your Eyes'. Eye Centers. N.p., 2012. Web. 12 Nov. 2015.

Breslow, S. 'Healthy Summer Skin'. New York Magazine 1993: 84. Print.

Donepudi, Sreekanth, Ronald C. DeConti, and Wolfram E. Samlowski. 'Recent Advances in the Understanding of the Genetics, Etiology, and Treatment of Merkel Cell Carcinoma'. Seminars in Oncology 39.2 (2012): 163-172. Web.

Donovan DM, Dennis M. Assessment of Addictive Behaviors. New York: Guilford Press; 2005.

Epstein, John H. 'Phototoxicity and Photoallergy'. Seminars in Cutaneous Medicine and Surgery 18.4 (1999): 274-284. Web.

Ferrucci, Leah M. et al. 'Indoor Tanning and Risk of Early-Onset Basal Cell Carcinoma'. Journal of the American Academy of Dermatology 67.4 (2012): 552-562. Web.

IBIS World. 'Tanning Salons in the US Market Research'. N.p., 2015. Web. 14 Nov. 2015.

Institute for Safe Medicine Practices. 'Drug-Induced Photosensitivity'. N.p., 2015. Web. 14 Nov. 2015.

Kaur M, Liguori A, Land W, et al. Induction of withdrawal-like symptoms in a small randomized, controlled trial of opioid blockage in frequent tanners. J Am Acad Dermatol 2006; 54:709–11

Knight, J. Matthew et al. 'Awareness of the Risks of Tanning Lamps Does Not Influence Behavior among College Students'. Arch Dermatol 138.10 (2002): N.p. Web.

Krutmann, Jean, Akimichi Morita, and Jin Ho Chung. 'Sun Exposure: What Molecular Photodermatology Tells Us about Its Good and Bad Sides'. J Investig Dermatol 132.3 (2011): 976-984. Web.

Mayo Clinic. 'Basal Cell Carcinoma'. N.p., 2015. Web. 12 Nov. 2015.

National Cancer Institute,. 'Sun Exposure and Indoor Tanning - Risk Factor Monitoring & Methods'. N.p., 2015. Web. 13 Nov. 2015.

21 C.F.R. § 1040.20 2015.

Skin Cancer Foundation. 'Tanning Addiction: The New Form of Substance Abuse'. N.p., 2015. Web. 14 Nov. 2015.

United States Department of Health and Human Services. The Surgeon General's Call to Action to End Skin Cancer. Washington, D.C.: United States Department of Health and Human Services | Office of the Surgeon General, 2014. Print.

University of Minnesota. 'UV: Molecular Mechanism of Action'. N.p., 2013. Web. 14 Nov. 2015.

Wang, Frank et al. 'Dermal Damage Promoted By Repeated Low-Level UV-A1 Exposure despite Tanning Response in Human Skin'. JAMA Dermatol 150.4 (2014): 401. Web.

Wehner, Mackenzie R. et al. 'International Prevalence of Indoor Tanning'. JAMA Dermatol 150.4 (2014): 390. Web.

World Health Organization. Artificial Tanning Sunbeds: Risks and Guidance. Geneva: N.p., 2003. Print.