March 14, 2011

By Claire McCarthy, M.D.
Boston Children's Hospital
There's something about having a tan that makes us all feel a bit more attractive.
So it's not surprising that tanning salons are popular with teens. Around a quarter of all teens and a third of 17-year-old girls have used a tanning bed at least once.
But as healthy as a tan may make you look, tans aren't healthy. In fact, tanning can be downright dangerous.
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Tanning's Dangers
Tanning is how the body protects itself from sun exposure. The skin produces more melanin, which darkens the skin and helps block ultraviolet radiation (UVR). But all that stimulation to skin cells isn't good. In general, a lot of sun exposure isn't good, because it can cause damage to the DNA of skin cells. This, in turn, can lead to skin cancer.
Skin cancer is on the rise. In fact, melanoma (one particularly serious kind of skin cancer) is the fifth most common cancer in men and the sixth most common in women. In 1935, the risk of invasive melanoma was in 1,500; in 2007, it was 1 in 63. This is a huge increase.
While skin cancer rarely affects children, parents still need to protect their kids from exposure to UVR in childhood. Whether it's from the sun or from tanning beds, UVR increases the risk of skin cancer in adulthood. Approximately 25% of a person's lifetime sun exposure occurs before the age of 18. Experts say that sun exposure and blistering sunburns may be more intense in childhood than in adulthood because kids are out in the sun more and less likely to protect themselves against the sun.
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The Scary Thing About Tanning Salons
Tanning beds can have UVR that is 10 to 15 times more powerful than the midday sun. People who frequently go to tanning salons can end up getting 1.2 to 4.7 times the dose of UVR that people get from normal sun exposure in a year. This is in addition to the normal sun exposure people who tan get.
This understandably alarms experts. In fact, in 2000 the National Institutes of Health said that exposure to sunlamps or tanning beds was a human carcinogen. In 1997, France banned indoor tanning for anyone under age 18. Some states ban children younger than 14 from using tanning salons, and some require parental consent. But these aren't enough.
Researchers also believe that tanning may be addictive. People who use tanning beds frequently report symptoms and behaviors that suggest physical and emotional dependence on tanning. Researchers theorize that exposure to UVR releases endorphins in the skin. Endorphins, like the ones released during exercise, give a natural high. But like any high, too much isn't a good thing.
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What Should Parents Do?
- Don't let your teen go to a tanning salon. There really isn't any good reason for it not even the prom.
- Help your teen understand that there is more to beauty than having a tan.
- Teach your teen about the danger of ultraviolet radiation. It's hard sometimes for teens to understand the concept of consequences that won't happen for a long time, but it's worth a try.
- If your teen really wants to have a tanned look, suggest using artificial tanners (spray tans and sunless tanning lotions). These contain dihydroxyacetone, a chemical that reacts with chemicals in the skin to form compounds called melanoidins. These turn the skin darker. This kind of "tan" does not protect against UVR, so it is very important to remind teens to use sunscreen!
Children of all ages need sunscreen when they are going to be out in the sun. Parents should also do everything they can to prevent their children from getting any blistering sunburns.
The sun isn't all bad. It helps our skin make vitamin D, which is crucial for our bones and for overall health. We want kids to go outside. They need some sunshine for vitamin D. But being outside also offers all sorts of opportunities for exercise that children need badly. As with everything in life and parenting it's a matter of balance.
To read the American Academy of Pediatric's policy statement on ultraviolet radiation and children, go to its website.
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Claire McCarthy, M.D., is an assistant professor in pediatrics at Harvard Medical School, an attending physician at Children's Hospital of Boston, and medical director of the Martha Eliot Health Center, a neighborhood health service of Children's Hospital. She is a senior medical editor for Harvard Health Publications.