July 7, 2004 — The promise of darker skin lures people to tanning beds. But the relaxing effects of ultraviolet (UV) light keep them coming back, a new study shows.
This newest study examines the complex reasons why people keep returning to tanning beds, despite the skin cancer dangers. Is it just for the darker skin? Or is something else happening? Recent research shows that UV exposure puts tanners in a better mood.
“We believe that ultraviolet light has an effect on mood that tanners value,” says researcher Steven Feldman, MD, PhD, a dermatologist with Wake Forest University School of Medicine in Winston-Salem, N.C. His study appears in the current issue of the Journal of the American Academy of Dermatology.
“This may be creating a reinforcing effect that influences tanning behavior,” he explains.
Feldman’s six-week study involved 14 college students who regularly used tanning beds. They had tanning sessions on Mondays and Wednesdays — dividing their time between two identical-looking tanning beds — one with a UV light and the other without. On Fridays, they could choose which tanning bed they wanted to use.
Before and after each tanning session, researchers asked the students to rate their mood.
When given a choice, 92% of the volunteers chose the UV tanning bed exclusively. The strongest reason for tanning was “relaxation” followed by “prepare for special event,” reports Feldman.
“Increasing people’s knowledge of the skin cancer risk associated with UV light exposure does not by itself reduce ,” he notes. “UV light itself has a reinforcing effect that is valued by tanners and contributes to tanning behavior.”
UV light may trigger mood-improving endorphins in the skin, he explains.
SOURCE: Feldman, S. Journal of the American Academy of Dermatology, July 2004.
She continued to think that until, at 24, she was diagnosed with stage I melanoma after finding a brown and black mole with irregular edges in the middle of her back. Her doctor scooped it out, leaving a 5-inch-long scar. “I had a local anesthetic, but I could hear the cutting of my skin,” Gorneault recalls.
Four years later, she felt a lump under her left arm. Some remaining cancer cells—undetectable in skin checks—had spread beneath her skin. She now had stage III melanoma.
After surgery to remove 11 lymph nodes from under her arm, Gorneault began immunotherapy, a grueling course of intravenous alpha-interferon designed to kick-start her immune system. As the treatments went on, the side effects worsened. Gorneault felt exhausted, achy and fuzzy-headed, as if she had a months-long flu. She started to lose her hair. And she was depressed—barely able to get herself out of bed.
Slowly, Gorneault became stronger, and two years later, she is cancer-free. But she lives with the knowledge that cancer could return at any time. Her doctors have also told her it’s possible that the interferon has compromised her fertility. “To know that something I’ve dreamed of my whole life might be taken away was harder than the illness itself,” Gorneault says. “If I’d known going to the tanning beds would affect me at such a young age, I absolutely would not have done it.”
Initially, Gorneault thought tanning had benefits. She took note of posters in the salon touting tanning as a healthy way to get vitamin D. “It helped me justify going there,” she says. She couldn’t know the message was part of a well-funded effort to convince patients—and doctors—that tanning is therapeutic.
Take the UV Foundation, funded in part by tanning-bed bulb makers, distributors and the Indoor Tanning Association. The foundation has channeled money into more than a dozen studies by Michael F. Holick, M.D., a professor of medicine at Boston University, whose research promotes the idea that sunlight decreases risk for chronic diseases. The UV Foundation also supports SUNARC, a pro–vitamin D nonprofit led by physicist William Grant, Ph.D. Grant is a board member of The Vitamin D Council, a group that argues “humans are needlessly suffering and dying from vitamin D deficiency.” Meanwhile, the tanning industry uses any research that shows the benefits of vitamin D to justify its claims that tanning is beneficial.
Late last year, the Institute of Medicine, an independent nonprofit that strives to find consensus on health advice, released a report that reviewed more than 1,000 vitamin D and calcium studies and determined that most of the new findings were not well proven or were too new to be conclusive except for the large amount of evidence that D is good for bones. But even if more D does turn out to equate to better health, indoor tanning is not the best way to get it. It’s exposure to UVB rays—not the primarily UVA light that comes from a tanning bed—that triggers the production of D (by converting 7-dehydrocholesterol in skin to vitamin D). “Sending a patient to a tanning salon for vitamin D is the definition of insanity,” Dr. Brod says. Even Dr. Holick, despite his industry support, told self, “I don’t really see a need to tan. Supplements work just as well.”
These days, Gorneault is a nanny, waiting to hit the five-year survival mark to decide if she’s healthy enough to have a baby of her own—one she’ll live long enough to see grow up. She tells everyone she can how tanning imperiled her dream of starting a family. To her, it’s an insult that doctors would send patients to a tanning bed. “I’m appalled,” Gorneault says. “Maybe if doctors heard what I went through, they would never tell a patient to tan. Tanning beds cause cancer. How does it make any sense?”
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Tony Cenicola/The New York TimesThe brains of frequent tanners may be similar to those of addicts.
People who frequently use tanning beds experience changes in brain activity during their tanning sessions that mimic the patterns of drug addiction, new research shows.
Scientists have suspected for some time that frequent exposure to ultraviolet radiation has the potential to become addictive, but the new research is the first to actually peer inside the brains of people as they lay in tanning beds.
What the researchers found was that several parts of the brain that play a role in addiction were activated when the subjects were exposed to UV rays. The findings, which appear in the coming issue of the journal Addiction Biology, may help explain why some people continue to tan often despite awareness about risks such as skin cancer, premature aging and wrinkles.
“What this shows is that the brain is in fact responding to UV light, and it responds in areas that are associated with reward,” said Dr. Bryon Adinoff, a professor of psychiatry at the University of Texas Southwestern Medical Center and an author of the study. “These are areas, particularly the striatum, that we see activated when someone is administered a drug or a high-value food like sugar.”
Despite all the public warnings about skin cancer, tanning remains as popular as ever, with nearly 30 million Americans tanning indoors every year, and more than a million visiting tanning salons on an average day. Frequent users say they simply enjoy the way they look with darker skin.
But in recent years, scientists also began to wonder whether deliberately ignoring the potentially lethal side effects of regular UV exposure was a sign that the motivation for frequent tanners was more than skin-deep. Could habitual tanning be an addictive behavior?
A study in 2005 did show that a large proportion of sunbathers met the psychiatric definition of a substance abuse disorder, based on their answers to a variation of a test often used to help diagnose alcohol addiction.
But Dr. Adinoff and his colleagues decided to go a step further. They recruited a small group of people from tanning salons who said that they liked to tan at least three times a week and that maintaining a tan was important to them. The frequent tanners agreed to be injected with a radioisotope that allowed researchers to monitor how tanning affected their brain activity.
On one occasion, the study subjects experienced a normal tanning session. But on another occasion, the researchers used a special filter that blocked only the UV light, although the tanners weren’t told of the change.
Brain images later showed that during regular tanning sessions, when the study subjects were exposed to UV rays, several key areas of the brain lighted up. Among those areas were the dorsal striatum, the left anterior insula and part of the orbitofrontal cortex – all areas that have been implicated in addiction. But when the UV light was filtered out, those areas of the brain showed far less activity.
The researchers also found evidence that the tanners appeared to know — on a subconscious level, at least — when they had undergone sham tanning sessions and not received their usual dose of UV rays. The tanners, questioned after each session, expressed less desire to tan after the real sessions, indicating they had gotten their fill. But on days when the tanners were unknowingly deprived of the UV rays, their desire to tan after the session remained as high as it was before the session began.
“They all liked the session where they got the real UV light,” said Dr. Adinoff. “There was some way people were able to tell when they were getting the real UV light and when they were not.”
Dr. Adinoff said the research suggests that some people appear addicted to tanning, a finding bolstered by the fact that many longtime tanners have a difficult time stopping or even just cutting back on tanning sessions. He said the research was inspired by a colleague, based on her experiences with dermatology patients.
“She approached me because of her concern about young adults who were coming to see her with these beautiful bronze tans,” he said. “And she would cut out skin cancers, and they would immediately go back to tanning.”
Can Indoor Tanning Help S.A.D.?
Seasonal Affective Disorder affects many people as winter sets in, but can indoor tanning help with this problem?
According to WebMD, there are actually two seasonal patterns for SAD, and what is often known as winter depression affects people this time of year. Many believe that the reduced levels of sunlight during the winter months affects the hormones that the brain produces, and SAD can develop. Sometimes this brings about increased fatigue, loss of appetite and loss of concentration, among other things.
Getting out into the natural light on a daily basis can help, so a brisk walk outdoors increases your blood flow, provides fresh oxygen throughout your system, and exposes you to the natural lighting that can make a difference for your day.
But what about those chilly, snowy and blowy days when it may not be safe for a hike around the neighborhood? Many people rely on light therapy to combat the gloominess of SAD, and there are specific light boxes available for purchase.
However, people who use indoor tanning booths or beds on a regular basis throughout the winter not only see the benefits of a tanned glow to their appearance, but the warm lighting for brief, regular periods of time also decreases the symptoms that are often associated with SAD.
Eating a healthy diet and regular exercise will also benefit people who notice winter depression, as well as keeping active within the community or with groups of people you know. Your doctor can determine the best course of action for you if SAD affects you very much, but indoor tanning is an option to bring the sunshine inside during the gloomy winter months!