Few tanning salons tell the truth about the health risks of indoor bronzing, according to an investigative report conducted by the U.S. House Energy and Commerce Committee.
The committee requested an investigation to determine whether indoor tanning salons provide factual and sufficient information on the health risks associated with the practice.
Committee investigators posed as fair-skinned 16-year-old girls, and contacted 300 indoor tanning salons throughout the country. Of the salons contacted, 90 percent told the "girls" that indoor tanning did not pose health risks, and more than half the salons denied that the fake sun increased risk of cancer. Many described such statements as "rumor" and "hype," according to the report, and more than three-quarters of salons said indoor tanning is actually beneficial to the health of a teen girl.
"The potential effect of this report is huge," said Dr. Suzanne Connolly, vice president of the American Academy of Dermatology. "We must grab the attention of our population and educate them. It's a big opportunity for improving health by reducing risk through education."
Connolly said the AAD applauds the committee for taking the initiative to undertake the investigation.
"Tan represents damage," she said. "That is a fact."
Salons told the "teens" that the intense UV rays treat depression, induce vitamin D production, prevent and treat arthritis and help with weight loss, cellulite, depression and self-esteem. Employees also often referred to industry-sponsored websites that downplay or disregard the copious research that has found indoor tanning causes melanoma, the deadliest type of skin cancer.
"Their statements are in many cases directly contrary to the compelling, irrefutable evidence that the use of indoor tanning devices increase your risk of skin cancer," said Dr. William James, immediate past president of the American Academy of Dermatology.
While the FDA recommends against indoor tanning more than three times per week, the investigation found that salon employees told callers who were concerned about safety that, "it's got to be safe, or else [government regulators] wouldn't let us do it," according to the report.
James said he did "not find this report surprising at all." In fact, James said his own patients sometimes argue the same point.
"The comment that if indoor tanning was dangerous, the government or the FDA would not allow it is something my patients have said to me," said James.
But medical research has found that indoor tanning is a cause of skin cancer, including melanoma, the deadliest form of the disease. The World Health Organization grades indoor tanning beds as a "Group 1" carcinogen. Other "Group 1" substances include tobacco smoke and arsenic.
According to the International Agency for Research on Cancer, risk of melanoma increases by 75 percent when people begin using tanning beds before the age of 30. And according to the report, a recent study found that 76 percent of melanoma cases in people between the ages 18 and 29 years old was connected to indoor tanning bed use.
Melanoma rates have significantly increased in the last 10 years, says Dr. Darrell Rigel, clinical professor of dermatology at New York University Medical Center.
"The only attributable reason is the major increasing use of tanning beds, or, as we call them, 'tanning coffins,' in that age group over the last 10 to 15 years," said Rigel.
But John Overstreet, executive director of the Indoor Tanning Association, refuted the dangerous claims, calling the report "bias." He said there is insufficient evidence to prove such health risks, and argued that parents join their teen daughters at the tanning salons and sign consent forms, which explain the health risks of tanning beds.
"I don't think you can draw conclusions from a report where a person is posing as a 16-year-old over the phone," said Overstreet, who said he regularly uses indoor tanning salons. "Asking questions over the phone is not what they're going to hear face-to-face with a parent beside them."
Asked whether he agrees with the FDA recommendation that people limit their tanning salon visits to no more than three times per week, Overstreet said, "you can't make a blanket recommendation for everyone."
Parental consent laws exist in 30 states, but Connolly said that, even where it is regulated, there is poor compliance. California is the only state that has banned indoor tanning for minors. Connolly said she hopes other states follow suit.
But Dr. Steven Feldman, professor of dermatology at Wake Forest Baptist Medical Center, disagreed, and said there is already too much government regulation regarding such matters.
"I think people should educate themselves and be responsible for the risks they take," said Feldman, who noted that people who tan will destroy their skin. "However, this report suggests that tanning bed operators are, in some cases, misleading and mis-educating people. That should not be allowed."
A number of countries have enacted stricter regulations regarding indoor tanning including five Australia states, Britain, Brazil, France, Belgium, Spain, Scotland, Germany, Portugal and the province of New Brunswick in Canada, Connolly noted. The WHO has recommended stricter legislation that would prohibit the use of indoor tanning for those under 18 years of age.
"We must do this in our country," Connolly said.