Ever since junior high school and throughout her teens and 20s, there was one place you could surely find Kelly Wiley at least four or five times a week - the tanning salon.
"I was going on vacation with family, and they took me to get a base tan so I wouldn't burn," said Wiley, who is now 31.
She continued her weekly ritual until one day about two years ago. She found a strange spot on her belly and decided to get it checked out. Then, she got the news that changed everything.
"I had a biopsy and the next day. I got a call and found out it was melanoma. I stopped tanning right away."
Back then, there were no laws to keep girls like Wiley out of salons. Now, more than 30 states have laws restricting minors' access to indoor tanning beds. Despite that, a new study suggests these regulations are not keeping teens out of tanning salons.
The study, published in the latest issue of the American Journal of Public Health, found after interviewing more than 6,000 teenagers ages 14 to 17 over a one-year period, 17.1 percent of girls and 3.2 percent of boys used indoor tanning within that year. The data also showed that about the same number of teens went tanning in states with laws that have age restrictions or require parental consent. Older teenage girls went tanning most often.
"Our data, as well as those of others, suggest that the current laws ... are not working," wrote the authors, led by Joni A. Mayer of the Institute for Behavioral and Community Health in San Diego.
The researchers go on to say there are a number of reasons the laws may not be working -- parents may allow children to go tanning, children go to facilities that don't require parental consent, parents and teenagers may not be aware of the laws or the age limit of states requiring consent is too low.
"The high rate of indoor tanning by older adolescent girls suggests that better laws are needed, preferably in the form of bans for those younger than 18 years," the authors wrote.
In the summer of 2009, the International Agency for Research on Cancer, part of the World Health Organization (WHO), placed tanning beds in its Class 1 carcinogen category, the same classification given to cigarettes, plutonium and ultraviolet radiation from the sun.
WHO, as well as the American Academy of Pediatrics (AAP), the American Academy of Dermatology and the American Medical Association support banning teens from going to tanning salons. Last year, a U.S. Food and Drug Administration advisory panel met to assess the risks of indoor tanning. In addition, a number of states are now considering stricter laws, and the health care reform bill imposes a 10 percent tax on customers at tanning salons.
The Indoor Tanning Association, a group that represents thousands of tanning equipment manufacturers, distributors, salon owners and their members responded to the AAP's statement on the need to outlaw teen tanning. The association said on its web site the decision about whether to allow teens to tan should be left up to parents and that scientific evidence showing a relationship between ultraviolet radiation and melanoma is inconclusive.
Despite the laws that are already in place, experts say regulations need to be even stricter, including the outright ban supported by advocacy organizations. Parents and children need to be better educated about the dangers of tanning, because it seems that message isn't getting through.
"Melanoma and other skin cancers, including squamous cell cancers are on the rise in children," said Dr. James Fahner, division chief, pediatric hematology/oncology at Helen DeVos Children's Hospital in Grand Rapids, Mich. "The science is unequivocal. This is high-risk behavior for kids."
Tanning may not be harmful right away, but its effects can be devastating later on.
"It's cumulative, continuous exposure that's harmful," said Fahner.
Experts say not everyone who tans will get skin cancer, and the risk of developing it varies from person to person. But they say they cannot overstress the dangers of indoor tanning.
"If you start tanning at a young age, you're going to increase your risk of cancer," said Dr. Joshua Zeichner, director of cosmetic and clinical research at Mount Sinai Medical Center in New York.
Parental Role is Key
"We need to better educate parents and teens about the dangers of these places," said Dr. Sophie Balk, an attending pediatrician at The Children's Hospital at Montefiore in New York. Balk helped write the American Academy of Pediatrics statement supporting a ban on teen tanning. "I don't think parents are educated enough, because most parents , if they knew about it, would not allow their kids to have this exposure."
Balk also said the government needs to treat tanning the same way as another dangerous underage activity.
"We should think about tanning laws the same way we think about smoking laws," she said.
The study authors also say that parents can help lower their child's risk for developing skin cancer by avoiding tanning salons themselves, not allowing their children to go, prohibiting their children from using their allowance for tanning or speaking out in favor of better laws.
"This study is similar to previous studies that have been performed that have shown that parents significantly influence their children's behaviors," said Zeichner, who is also a spokesperson for the Skin Cancer Foundation.
Societal attitudes about beauty also play a role in many young people's desire to have darker skin at any cost.
"It's also a cultural belief that being tan is healthy and it looks better, but in fact it's not healthy. You get DNA damage when you tan, which is not healthy," said Balk.
Part of the reason adolescents may not heed repeated warnings is because they are just being typical teenagers who believe they are invincible.
"They're going to assume it doesn't apply to them. They assume they're young and healthy and have nothing to worry about."
That's exactly what Kelly Wiley thought, too.
"I never thought it would happen to me. I even went tanning right after I had my biopsy," she said. "Well, it can happen, and it does happen."