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1.
 http://www.youtube.com. Accessed December 19, 2007
2.
Keelan  JPavri-Garcia  VTomlinson  GWilson  K YouTube as a source of information on immunization: a content analysis. JAMA 2007;298 (21) 2482- 2484
PubMedArticle
3.
Freeman  BChapman  S Is “YouTube” telling or selling you something? tobacco content on the YouTube video-sharing website. Tob Control 2007;16 (3) 207- 210
PubMedArticle
4.
US Department of Health and Human Services, Public Health Service, National Toxicology Program, Report on Carcinogens, 11th edition. http://ntp.niehs.nih.gov/ntp/roc/eleventh/profiles/s183uvrr.pdf. Accessed December 19, 2007
5.
International Agency for Research on Cancer Working Group on Artificial Ultraviolet (UV) Light and Skin Cancer, The association of use of sunbeds with cutaneous malignant melanoma and other skin cancers: a systematic review. Int J Cancer 2007;120 (5) 1116- 1122
PubMed
6.
Lim  HWGilchrest  BACooper  KD  et al.  Sunlight, tanning booths, and vitamin D. J Am Acad Dermatol 2005;52 (5) 868- 876
PubMedArticle
Research Letter
October 20, 2008

YouTube as a Source of Information on Tanning Bed Use

Arch Dermatol. 2008;144(10):1395-1396. doi:10.1001/archderm.144.10.1395

YouTube is a free online video streaming service that allows users to view and share videos as well as post comments in a threaded discussion format. Since its creation in 2005, YouTube has grown immensely in popularity, currently offering over 59 million videos.1 YouTube is an ideal place to broadcast information and has increasingly become a public forum, hosting major events such as the CNN/YouTube presidential debates in 2007 and 2008.

Any user may post videos regardless of the message contained; this may be a source of medical misinformation. Two recent articles have found that YouTube has misinformation regarding immunization safety and utility,2 while another article found both positive and negative views on tobacco use.3 We thought that this might also be true of information on tanning bed use. Therefore, we undertook a search of YouTube for videos pertaining to tanning bed use, specifically on the safety, risks, and benefits of tanning.

Methods

On December 19, 2007, we searched http://www.YouTube.com for the following individual phrases: tanning bed, tanning booth, tanning salon, and tanning parlor. Videos were included in the study only if they commented on the pros or cons of tanning. Videos that appeared under more than 1 search phrase were reviewed once. Most videos reviewed were judged to be irrelevant to the study.

Videos were assigned to 1 of 3 groups based on overall tanning message: positive (described mostly the benefits or safety of tanning), negative (described mostly the risks and adverse effects of tanning or discouraged patients from tanning), or neutral. If specific benefits and risks of tanning were mentioned, that was also recorded. We also made note of whether the video appeared to be professionally made or amateur. All video results were viewed conjointly by both of us, but we independently assessed and categorized them. In cases of disagreement, final categorization of the video was made after a brief discussion and eventual agreement.

Results

All video results for each search phrase were reviewed by both authors (N = 534). Seventy-two videos were relevant to the study. Of these, 39 were professionally made videos (54%), and 33 were amateur videos (46%).

Forty-nine videos took an overall positive position on tanning (68%) and 17 were negative (24%). Six videos were neutral, all of them discussing sunless tanning without mentioning tanning bed use (8%).

Of the tanning benefits cited in the 49 positive videos, 47 included appearance (96%). Two videos mentioned vitamin D as another benefit of tanning (4%).

The most common adverse events mentioned were burns (53%; n = 9) and skin cancer (47%; n = 8). Other adverse effects cited were wrinkles (18%; n = 3); lack of cleanliness of tanning salons, booths, and/or beds (18%; n = 3); and detriment to appearance (6%; n = 1).

Twenty-five videos were advertisements for specific tanning salons (35%), while another 10 were advertisements for apartments or condominiums that had an on-site tanning bed (14%). We reviewed 1 American Academy of Dermatology–sponsored video that specifically mentioned skin cancer, burns, and wrinkling as adverse effects of tanning bed use.

Comment

Ultraviolet radiation is a known carcinogen4; a recent systematic review linked ever-use of tanning beds with risk of melanoma and squamous cell carcinoma.5 Furthermore, tanning beds cannot be recommended to enhance vitamin D levels.6 Despite this information, our study showed that most of the videos on YouTube portrayed tanning positively and that most videos appealed to appearance. There were more advertisements for tanning salons than total number of videos purveying the dangers of tanning. Tanning salon owners have been aggressive in their marketing and have more rapidly adopted YouTube than has the dermatology community. Our search found but one video sponsored by the American Academy of Dermatology. Making additional videos to post on YouTube would be inexpensive, and exposure would be instantaneous. This may be an effective and economical way to broadcast accurate information and educate the public regarding the dangers of tanning.

It is important to recognize the Internet and Web sites such as YouTube as increasingly important and readily available sources of information to the public. Our patients may be using YouTube or other unreliable sources of information about tanning bed use. The dermatology community may be able to use these venues for broadcasting safer skin practices.

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Article Information

Correspondence: Dr Hossler, Geisinger Medical Center, Department of Dermatology, 100 N Academy Ave, Danville, PA 17822 (ewhossler@geisinger.edu).

Author Contributions:Study concept and design: Hossler and Conroy. Acquisition of data: Hossler and Conroy. Analysis and interpretation of data: Hossler. Drafting of the manuscript: Hossler. Critical revision of the manuscript for important intellectual content: Hossler and Conroy. Administrative, technical, and material support: Hossler.

Financial Disclosure: None reported.

References
1.
 http://www.youtube.com. Accessed December 19, 2007
2.
Keelan  JPavri-Garcia  VTomlinson  GWilson  K YouTube as a source of information on immunization: a content analysis. JAMA 2007;298 (21) 2482- 2484
PubMedArticle
3.
Freeman  BChapman  S Is “YouTube” telling or selling you something? tobacco content on the YouTube video-sharing website. Tob Control 2007;16 (3) 207- 210
PubMedArticle
4.
US Department of Health and Human Services, Public Health Service, National Toxicology Program, Report on Carcinogens, 11th edition. http://ntp.niehs.nih.gov/ntp/roc/eleventh/profiles/s183uvrr.pdf. Accessed December 19, 2007
5.
International Agency for Research on Cancer Working Group on Artificial Ultraviolet (UV) Light and Skin Cancer, The association of use of sunbeds with cutaneous malignant melanoma and other skin cancers: a systematic review. Int J Cancer 2007;120 (5) 1116- 1122
PubMed
6.
Lim  HWGilchrest  BACooper  KD  et al.  Sunlight, tanning booths, and vitamin D. J Am Acad Dermatol 2005;52 (5) 868- 876
PubMedArticle
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