By Dr. Mercola
In the latest breaking news, researchers have determined that indoor tanning is just as dangerous as the sun. Imagine that – the risks of overexposure to ultraviolet (UV) rays are the same whether they come from the natural sun outdoors or the artificial "sun" in a tanning bed…
This is far from shocking, isn't it? And it's also precisely the point, because just as the risks of UV rays from the sun and tanning beds are similar, so, too, are the benefits.
As with many things in life, the difference between healthy UV exposure and unhealthy exposure lies in the dose, and one of the worst choices you can make is to avoid the sun.
Too Much Sun, or Indoor Tanning, Is Linked to Cancer
New research found that melanoma patients were about four times as likely to be indoor tanners as people without melanoma, even if they'd never reported experiencing sunburn.1
The researchers concluded that indoor tanning (without burning) must then be a risk factor for melanoma, but past research has found quite the opposite. In 2012, researchers concluded that tanning bed use was not associated with melanoma.
In fact, it can prevent 10 times more cancers than they might potentially contribute to because they improve your vitamin D levels.2 They pointed out in Public Health Nutrition:3
"The overall health benefit of an improved vitamin D status may be more important than the possibly increased CMM [cutaneous malignant melanoma] risk resulting from carefully increasing UV exposure."
Myth: Indoor Tanning Increases Melanoma Risk by 75 Percent (It's Actually Less Than 1 Percent!)
It's also commonly stated by the US Food and Drug Administration (FDA) and other health agencies that if you begin indoor tanning before the age of 35, your risk of melanoma increases by 75 percent.4
This is again misleading because, though true statistically, it doesn't tell you your actual risk of developing melanoma from indoor tanning (which is actually below 1 percent). Ivan Oransky, M.D., editor of Reuters Health, explained it well:5
"If you read the FDA's 'Indoor Tanning: The Risks of Ultraviolet Rays,' or a number of other documents from the WHO [World Health Organization] and skin cancer foundations, you won't find your actual risk.
That led AHCJ [Association of Healthcare Journalists] member Hiran Ratnayake to looking into the issue… after Delaware passed laws limiting teens' access to tanning salons. The 75 percent figure is based on a review of a number of studies, Ratnayake learned. The strongest such study was one that followed more than 100,000 women over eight years.
But as Ratnayake noted, that study 'found that less than three-tenths of 1 percent who tanned frequently developed melanoma while less than two-tenths of 1 percent who didn't tan developed melanoma.'
By only presenting the relative risk increase (the 75 percent increase), officials make the risk of tanning sound rather unreasonable. Meanwhile, your absolute riskof developing skin cancer from sun exposure or indoor tanning is still, at worst, below one percent!6
FDA Calls for Black-Box Warning Label on Tanning Beds
In keeping with their crusade against UV light, the FDA has reclassified tanning beds as "moderate-risk devices" (up from the previous "low-risk" classification). They will also require tanning beds to carry a black-box warning, the FDA's strongest, stating the devices should not be used by people under the age of 18. While this doesn't outlaw tanning-bed use by minors, certain states have already imposed such controversial restrictions.
Children, teens, and adults alike should certainly not overuse tanning beds or overdo sun exposure. This is potentially carcinogenic and not recommended. But a black-box warning? You have to wonder how they will get the same label applied to the sun, since they've equated these 'risks'.
The biggest difference between sunlamps are important to note, some lamps emit only UVA - I don't recommend using those beds. Find lamps that emit UVB rays, which are crucial to help your body produce vitamin D, and UVA rays, which not only help you produce a tan, but also naturally protect your body from sunburn. They can actually help protect you from overdosing on vitamin D produced from too much UVB.
It is unnecessary to use beds in the summer, provided you spend adequate time outdoors with your skin exposed. In winter, vitamin D levels plummet when UVB exposure is no longer possible. If you want to maintain proper vitamin D levels, you must consume supplements or use UVB emitting lights when it is not possible to receive this benefit from the sun.
Remember that vitamin D produced by UVB exposure to your skin is far superior to oral vitamin D. My recommendation is continue to use natural sunlight to get all the ultraviolet and other radiation you need, but if that is not an option and you use a tanning bed, be aware that some actually have less of the potentially dangerous UVA than sunlight (while others may emit more UVA).
This is where you should do your research to find out just how much UVA vs. UVB your tanning bed is emitting. Furthermore, high-quality tanning beds may also offer exposure to red light, which may support skin rejuvenation, infrared light, which may offer pain relief, and blue light, which is also beneficial for skin health.
What Are You Missing If You Shun the Sun?
Appropriate sun exposure is the best way to optimize your vitamin D levels, but if you can't get enough sunshine, then a high-quality tanning bed would be your next best option. If you avoid the sun, you risk becoming vitamin-D deficient or insufficient, like approximately 50 percent of the US population.
Increasing levels of vitamin D among the general population could potentially prevent chronic diseases that claim nearly 1 million lives throughout the world each year. Incidence of several types of cancer could also be slashed in half.
New research shows, for instance, that people aged 55 and older who have low levels of vitamin D are twice as likely to die prematurely as those with a blood vitamin D level of 30 ng/ml or more.7 It’s estimated that two-thirds of the US population has a vitamin D level below 30 ng/ml (and more recent data suggests levels of 50 ng/ml or higher are actually necessary for optimal health).
As mentioned during my interview with leading vitamin D researcher Dr. Michael Holick, one of the Nurses' Health Studies showed that nurses who had the highest blood levels of 25-hydroxyvitamin D, averaging about 50 ng/ml, reduced their risk of developing breast cancer by as much as 50 percent.
Similarly, a Canadian study done by Dr. Knight showed that women who reported having the most sun exposure as a teenager and young adult had almost a 70 percent reduced risk of developing breast cancer. It's quite frankly insane not to take advantage of this prevention strategy. In addition, optimizing your vitamin D levels can help protect against:
- Cardiovascular disease. Vitamin D is very important for reducing hypertension, atherosclerotic heart disease, heart attack, and stroke. According to Dr. Holick, one study showed that vitamin D deficiency increased the risk of heart attack by 50 percent.8
- Autoimmune diseases. Vitamin D is a potent immune modulator, making it very important for the prevention of autoimmune diseases, like multiple sclerosis (MS) and inflammatory bowel disease.
- Infections, including influenza. It also helps you fight infections of all kinds. A study done in Japan, for example, showed that schoolchildren taking 1,200 units of vitamin D per day during the winter reduced their risk of contracting an influenza A infection by about 40 percent. I believe it's far more prudent, safer, less expensive, and most importantly, far more effective to optimize your vitamin D levels than to get vaccinated against the flu.
- DNA repair and metabolic processes. One of Dr. Holick's studies showed that healthy volunteers taking 2,000 IUs of vitamin D per day for a few months upregulated 291 different genes that control up to 80 different metabolic processes, from improving DNA repair to having effect on autoxidation (oxidation that occurs in the presence of oxygen and /or UV radiation, which has implications for aging and cancer, for example), boosting the immune system, and many other biological processes.
At present, based on the evaluation of healthy populations that get plenty of natural sun exposure, the optimal vitamin D range for general health appears to be somewhere between 50 and 70 ng/ml. For treatment of chronic disease such as cancer, recommendations go even a bit higher than that.
There Are Benefits of UV Light Even Beyond Vitamin D
While discussions about the health benefits from UV exposure typically center around vitamin D, UVB exposure actually has a number of other health effects unrelated to vitamin D production – whether it's from the sun or a high-quality tanning bed. Ultraviolet radiation affects a number of other pathways. For example, UV exposure may help improve your mood through the release of endorphins, and may even help reduce fibromyalgia pain. Several skin diseases can be treated with sun exposure or phototherapy, i.e. the use of a tanning bed, including:
- Atopic dermatitis
- Autoimmune diseases like scleroderma and Crohn's
Symptoms of multiple sclerosis can also be suppressed with UV exposure, independent of vitamin D synthesis (which is also beneficial for MS. In fact, vitamin D deficiency may be a contributing factor in nearly 60 percent of MS cases). Additionally, UVA radiation, which is generally more harmful in terms of its potential to cause skin cancer, is not entirely without merit. For example, UVA generates nitric oxide (NO), which can help reduce blood pressure and has a beneficial effect on cardiovascular health, in addition to having an antimicrobial effect.9
How to Minimize Your Risks from Indoor Tanning
It's always important, whether you're using a tanning bed or the sun, to use sensible exposure and avoid getting burned. The first few days, you should limit your exposure to UV light to allow your body's melanocyte cells to increase their production of the protective pigmentation melanin that not only gives you a tan, but also serves to help protect you against overexposure to the sun. If you are a fairly light-skinned individual that tends to burn, you will want to limit your initial exposure to a few minutes, especially if it is in the middle of summer. Dr. Holick recommends only going in for half the time recommended for tanning.
The more tanned your skin will get, and/or the more tanned you want to become, the longer you can stay in the sun. If it is early or late in the season and/or you are a dark-skinned individual, you could likely safely have 30 minutes on your initial exposure. If you are deeply pigmented and your immediate ancestors are from Africa, India, or the Middle East, it is possible you may not even have to worry about how long you are exposed. Always err on the side of caution however, and let it be your primary goal to never get sunburned. When using a tanning bed, the following considerations can also help to minimize any potential risks:
- Avoid magnetic ballasts: Most tanning equipment use magnetic ballasts to generate light. These magnetic ballasts are well known sources of electromagnetic fields (EMFs) that can contribute to cancer. If you hear a loud buzzing noise while in a tanning bed, it has a magnetic ballast system. I strongly recommend you avoid these types of beds and restrict your use of tanning beds to those that use electronic ballasts.
- Be sure it includes UVB: Make sure the tanning bed you're using is putting out UVB radiation. There are some on the market that only put out UVA, as this is what creates a tan. UVA rays are also the ones responsible for skin damage, however, and they do NOT make your skin produce vitamin D. Beds tend to vary between 3 to 10 percent UVB, and the higher the percentage of UVB, the better. There are also beds that make UVB only. They're not as popular since they won't make you tan, but if you're doing it solely for the health benefits, then a UVB tanning bed is certainly an option.
- Protect your face: The skin around your eyes and on your face is typically much thinner than other areas on your body and is a relatively small surface area so will not contribute much to vitamin D production. It is strongly recommended to protect this fragile area of your body, as is at a much higher risk for cosmetic photo damage and premature wrinkling. You can use a safe sunblock in this area or wear a hat, like I do, to keep your face in the shade. During an indoor tanning session, you can even place the hat over your entire face. Some tanning beds actually take care of this for you, however, by putting blue/red bulbs in the facial area, which will offer benefits to your skin as opposed to damage.