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Editor's Note
February 2015

We Can See the (Risks of UV) Light

JAMA Intern Med. 2015;175(2):311-312. doi:10.1001/jamainternmed.2014.6703

In the United States, it has been estimated that in the past year more than one-third of adults used indoor tanning facilities, exposing themselves to high-pressure sunlamp products that emit UV light and radiation.1 Rates exceeded 50% among university students and were nearly 20% among adolescents. Unfortunately, it has taken years for the cultural mystique of the “healthy tan” to be replaced by an informed understanding of the risks of tanning, both indoor and outdoor, including premature skin aging, eye damage, and melanoma and other skin cancers.2 Citing these risks in 2013, the US Food and Drug Administration reclassified sunlamp products from a low-risk device (class I) to a moderate-risk device (class II) requiring premarket notification through the 510k clearance process; the agency also strongly cautioned against the use of these products among children younger than 18 years.

Guy and colleagues3 characterized another important risk of indoor tanning facilities: skin burns and other injuries. From 2003 through 2012, more than 3200 indoor tanning–related injuries on average were treated annually in US hospital emergency departments, half of which were among those younger than 25 years. The good news: these injuries have declined markedly from nearly 6500 in 2003 to fewer than 2000 in 2012. This decline suggests that either the facilities are being managed more appropriately, limiting individuals’ UV exposure such as through the use of tanning bed timers, or that the facilities are being used less frequently. The bad news: nearly 2000 injuries occurred in 2012 and this is likely a substantial underestimate as it does not include the large number of injuries that did not require emergency department care, only use of aloe vera gel, moisturizing lotions, and nonsteroidal anti-inflammatory medicines for pain. More should be done to limit the use of indoor tanning among young adults and adolescents; a half dozen states restrict indoor tanning to those older than 14 years while Wisconsin and California restrict indoor tanning to those older than 16 and 18 years, respectively.4 Although most other states require some level of parental consent for those younger than 18 years to use indoor tanning facilities,4 the risks of UV light and radiation are plain to see.

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Conflict of Interest Disclosures: None reported.

References
1.
Wehner  MR, Chren  MM, Nameth  D,  et al.  International prevalence of indoor tanning: a systematic review and meta-analysis. JAMA Dermatol. 2014;150(4):390-400.PubMedArticle
2.
Chang  C, Murzaku  EC, Penn  L,  et al.  More skin, more sun, more tan, more melanoma. Am J Public Health. 2014;104(11):e92-e99.PubMedArticle
3.
Guy  GP  Jr, Watson  M, Haileyesus  T, Annest  JL.  Indoor tanning–related injuries treated in a national sample of US hospital emergency departments [published online December 15, 2014]. JAMA Intern Med. doi:10.1001/jamainternmed.2014.6697.
4.
Pawlak  MT, Bui  M, Amir  M, Burkhardt  DL, Chen  AK, Dellavalle  RP.  Legislation restricting access to indoor tanning throughout the world. Arch Dermatol. 2012;148(9):1006-1012.PubMedArticle
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