The 2012 edition of The Skin Cancer Foundation Journal features medically reviewed, reader-friendly articles such as tanning, the increasing incidence of skin cancer diagnoses among young women, & the prevalence of melanoma among white males over 50.
LIFESTYLE
tanning behavior, this does not fully explain tanning's effect on mood and the physical dependence reported in recent studies. In our 2011 study, when we queried 100 patrons of a tanning salon regarding their reasons for tan- ning, two of the top three reasons were "to feel good" and "relaxation."16 It has recently been shown that
some tanners may suffer from seasonal affective disorder (SAD), a psychiatric condition consisting of depressive episodes "that occur at a certain time of the year, usually during winter."17 In one study, 80 percent of frequent tanners reported symptoms of SAD, and investigators suspect that some tanners use UV-emitting tanning beds to improve their moods.18
(SAD
is properly treated by the use of a light box that emits visible, not UV, light.) In controlled (and blinded) studies by our group19
and others,20 subjects were
unknowingly exposed to both a UV- emitting tanning bed and an identical bed from which the UV light had been filtered. When asked which tanning session they preferred, the vast major- ity favored the real UV-emitting bed, even though they did not know which bed this was. After exposure to the real tanning bed, tanners reported a more relaxed mood and subsequent decreased craving to tan.20 There is even preliminary evidence for the existence of UV withdrawal
the drug before tanning, 50 percent of frequent tanners reported nausea after tanning, a symptom consistent with withdrawal, while infrequent tanners experienced no symptoms. Our own recent research19
explored
the effect of UV light on the brain activity of frequent tanners. We ex- posed tanners who met the criteria for dependent behavior to a UV-emitting tanning bed and a "sham" one, while simultaneously using functional brain
HEIDI JACOBE, MD, MSCS, is Assistant Professor, Department of Dermatology, University of Texas Southwestern Medical Center at Dallas. She is a member of The Skin Cancer Foundation's Photobiology Committee.
References available on p.96.
(distressing physical symptoms after discontinuation of UV radiation ex- posure), similar to the withdrawal reported for opioid drugs such as heroin. In one 2006 study comparing the effects of UV-emitting and "sham" tanning beds, researchers randomly administered either an opioid antago- nist (to block the pleasurable effects of tanning) or a placebo to both frequent and infrequent tanners.21
When given
In one investigation, 70 percent of frequent UV tanners met criteria for UV light substance abuse or dependence disorders.
imaging. Our preliminary results indi- cate that exposure to the real (but not "sham") tanning bed activated centers in the brain associated with pleasure.
IMPLICATIONS Identifying tanning as an addiction changes the model for prevention and treatment. Traditional techniques of advertising the adverse consequences are likely ineffective among the individuals who are at greatest risk of addiction due either to their age or habit.4,5,6,7,22,23
Instead, approaches
similar to those used in other addic- tive disorders are indicated. It is also important to remember that as with alcohol and illegal drugs, addicted tan- ners might be self-treating underlying psychiatric disorders like SAD and BDD. These individuals should be identified and treated psychologically. Of course, prevention is always the
safest route. If you haven't started tanning, don't.
ARIANNE S. KOUROSH, MD, is at the University of Texas Southwestern Medical Center at Dallas.
TANNING IN THE USA 30 Million
Number of Americans visiting indoor tanning salons annually, fueling a $5 billion dollar a year industry
Percent of young adults who have reported using tanning beds.
35 40
In one study, 80 percent of frequent tanners reported symptoms of
SAD, and investigators suspect that some tanners use UV-emitting tanning beds to improve their moods.
SK IN CANCER FOUNDAT ION JOURNA L