Some call for ban of tanning bed use by Ky. minors as FDA issues 'black box' warning label

agarau@herald-leader.comJune 11, 2014 

  • Ky., U.S. tanning facts

    • About 2.3 million teens use indoor tanning beds every year, according to the American Academy of Dermatology.

    • Studies from the International Agency for Research on Cancer have shown that the risk of acquiring cutaneous melanoma, melanoma that occurs on the skin, increases by 75 percent when someone starts using tanning devices before age 30.

    • Nationally, Kentucky had the sixth highest death rate from melanoma from 2002-2006 and the rate of new melanoma diagnoses is 14 percent higher in Kentucky than the national average.

    • The American Cancer Society predicted that about 9,710 people in the United States will die from melanoma in 2014.

    Can tanning be addictive?

    Recent studies have shown that there is a scientific reason for people reporting a sense of well-being after time in the beds. By damaging the skin, UV light triggers the body's production of endorphins and serotonin, which are used by the body to relieve pain. Doctors believe that these natural opioids are the reason frequent tanners have been shown to exhibit signs of both psychological and physical dependence on tanning, or a tanning addiction.

Like cigarette packs, tanning beds will soon come with a visible "black box" warning that the products should not be used by anyone younger than 18.

But doctors, tanning companies and legislators say the warning won't be enough to keep teenagers out of the beds. Consequently, some want a new Kentucky law prohibiting bed use by minors.

The new federal regulations, which were announced by the U.S. Food and Drug Administration on May 29, move sunlamps out of the category of low-risk devices, such as dental floss and tongue depressors, to moderate-risk devices.

As a result, performance standards will be implemented for sunlamp manufacturers. The "black-box" is the FDA's strictest warning, but the administration stopped short of banning minors from using the devices.

Studies have shown that tanning beds are dangerous because of their emission of ultraviolet rays, which also come from the sun. Besides causing wrinkles and eye damage, ultraviolet rays have been shown to cause skin cancers, including basal cell carcinoma, squamous cell carcinoma and melanoma, the most deadly type of skin cancer, according to the FDA and local doctors.

"There's really no way to get a tan right now without incurring the risk of cancer," said Dr John D'Orazio, a researcher and pediatric oncologist at Kentucky Children's Hospital. "I don't want to tell people not to go outdoors at all, because that would be ridiculous, but the actual ultraviolet radiation from the beds can be up to ten times more than from standing in the sun."

The FDA's announcement was applauded by many, but some people think stricter regulations are necessary, especially for teenagers.

"I think it's a great first step," D'Orazio said. "I'm a pediatrician, and for me, the worry is that the minors, the kids under 18, have access to these devices."

Several states, including California, Illinois and Texas, have banned minors from tanning beds, but Kentucky requires only signed parental consent for teens ages 14 to 17 and in-person parental consent for anyone younger than 14.

Andrea Dean, 18, began tanning when she was 15.

"Now I only go a couple of times a month, but when I first started, I would go like three times a week," Dean said. "I like being tan. I feel happier, I look better, and it also helps a ton with acne."

Dean said new warnings will probably not deter customers; most people already are aware of the risks. Mark Wells and Cheryl Ledford, co-owners of Southern Rays Tanning, agreed with Dean's prediction.

"I don't think it will keep anyone away," Ledford said. "There has always been some kind of warning on the beds, and they haven't stopped people from tanning."

Wells said they get 100 to 300 customers a day at the company's five tanning salons in and around Lexington.

"It (a warning) can't hurt the business any more than what the government is already doing to us," he said, referring to the new health care law's tanning tax, which added a 10 percent tax to tanning bills to discourage the practice. "The main goal in our business is education; anything is bad for you if you don't use it correctly, like smoking or drinking," Wells said. "There are health benefits to tanning that the government doesn't tell you about."

The benefits cited by Wells are: The body makes essential Vitamin D when exposed to tanning lamps; lamps can help people with psoriasis and acne; and getting a "base tan" indoors can prevent burning in the summer sun. D'Orazio, the pediatric oncologist, debunked those benefits.

"A base tan is not going to help you avoid the risks," he said. "You're still getting ultraviolet radiation while you're getting that base tan. Also, it really only takes about one minute of standing in the sun to get enough vitamin D. This idea that you need to bask in the sun to get an adequate dose is just not true.

"This is a multibillion-dollar industry. That's a lot of money going into downplaying the negative consequences."

The American Academy of Dermatology recognizes some medical benefits to using sunlamp products, but it says treatment should not be sought in tanning salons.

"The AADA opposes indoor tanning and supports prohibiting the sale and use of commercial indoor tanning equipment," said the AADA's president, Dr. Brett Coldiron.

"Dermatologists may prescribe phototherapy as a treatment," he said. "The difference between phototherapy and indoor tanning is that phototherapy is closely monitored and supervised by a dermatologist. This type of medical care is not provided at an indoor tanning salon, where operators have minimal knowledge about the potential side effects of UV light and tanning bed lamps have variable amounts of UVA and UVB light."

The debate over tanning consequences played out in in January in Kentucky's Capitol. Rep. David Watkins, a Democrat from Henderson, said he is alarmed by the recent increase in skin cancer, and he wants legislation to prohibit Kentucky minors from using tanning devices without a medical prescription. The House passed Watkins' bill 61-31, but it was struck down by the Senate Health and Welfare committee in March.

"When people are 18 and above, we're going to have to assume that they're responsible enough to make this decision, though I would encourage anyone against using these devices," Watkins said. "We owe it to the kids because I'm not sure they realize the risk."

Rep. Michael Meredith, a Republican from Brownsville, opposed the bill but found the new FDA regulations acceptable.

"I do think going to the extent of an outright ban is a little extreme," Meredith said. "I don't think anyone needs to be overusing a tanning bed, obviously, but minors are going to be out in the sun, and if it's spring, they might just need a little color."

"We've had smoking bans for years, but I think there's more guaranteed proof that those cause problems," he said. "The reasoning for banning smoking with minors is because it is habit-forming, but I don't think that's generally the case with tanning beds."

Dean agreed that the ban would be too extreme.

"I would be so mad," she said. "So many people go tanning for prom and homecoming and stuff. I feel like high schoolers are old enough to make that decision for themselves."

Watkins is not ready to give up.

"I think I'm going to have to work a little harder and make sure my colleagues in the Senate understand that I'm not trying to limit freedoms," Watkins said. "I'm trying to protect some of our most vulnerable constituents."

Annie Garau: (859) 231-1685. Twitter: @agarau6.

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