More than skin deep—when tanning poses health risks

Profiles of Norwegian Science

skin cancer - tanning

Photo: Ilan Kelman
Catching some rays (and melanoma?) in Senja in northern Norway.

ILAN KELMAN
Agder, Norway

Why do some people want a tan? The benefits tend to be artificial, driven by the presumption that a tanned skin feels better, is healthier, represents wealth and success, and is more attractive. We could easily change our perceptions to accept that anyone’s natural skin color is the most attractive, healthiest, and most successful for them.

Instead, many Norwegians, especially those with lighter skin colors, actively seek out the sun to bronze their skin. This might not be possible if holidays to southern climes are precluded by time or money, so some of them turn to artificial tanning.

A wealth of science shows how using sunbeds, solariums, and indoor tanning facilities increases the risk of different types of skin cancers. This clear connection does not deter numerous Norwegians, women typically at the forefront of customers at these services.

In fact, despite its northern latitudes, Norway sits among countries with the highest rates of skin cancers, much of which seems to come from tanning behavior. And it can become obsessive. Tanning addiction in Norway has been linked to being a single woman, suggesting that society instills the value that having tanned skin will give women a better chance of finding a fulfilling relationship.

Those advocating for indoor tanning explain how advances in the technology led to much safer ultraviolet light. Comparing tanning beds over decades, the evidence available does not seem to support this contention in terms of health outcomes. Consequently, based on the science available, the advice across Nordic health and radiation authorities remains that sunbeds should not be used by people younger than 18 or by those with skin that is especially sensitive to ultraviolet radiation.

Norway has banned people younger than 18 from using commercial sunbeds. Brazil and Australia have banned them entirely. The main reason for all this advice and regulation is a growing concern over skin cancer. More than 10 sessions in a sun bed appears to be particularly damaging, as is starting use as a child, youth, or young adult.

While screening programs and self-monitoring for signs of skin cancer have some effect on survival, prevention is far better than cure. The key to prevention is a healthy attitude toward being outdoors, particularly in sunny weather, with an emphasis on the importance of avoiding excessive exposure, sunburn, and particularly indoor tanning.

Evading all sunlight is not easy and might have its own adverse impacts, physically, mentally, and socially. One certain benefit from exposure to the sun is the body’s synthesis of vitamin D, which plays a significant and favorable role in our health. Studies have sought to determine the role of vitamin D in addressing cancers, osteoporosis, diabetes, multiple sclerosis, and many other ailments—often with positive links. Yet not all confounders can necessarily be factored in completely.

Does this mean that tanning is necessary for vitamin D? The answer is effectively “not really.” For those who can afford it, it is easy enough to take a daily vitamin D supplement without additives or sweeteners, although it is not fully understood how effective these supplements are compared to sunlight-related synthesis of the vitamin. An alternative or complementary approach is a short amount of daily sunlight exposure outside of the most intense times and without becoming tanned.

Achieving this balance is not easy and it assumes that enough sunlight is available for adequate exposures, along with the opportunity to be outdoors for it. This is not the case for much of Norway during the winter. Questions emerge regarding season-induced mood disorders, although it remains an open question whether exposure to artificial sunlight can assist.

Artificial and sun-related tanning for medical needs are one aspect to consider, without firm conclusions regarding their effectiveness. Given the alternatives for meeting health needs without indoor ultraviolet light, the scientific case for commercial sunbeds becomes weak.

The science is certain that aesthetic tanning, especially from sunbeds, is dangerous, supporting policy perspectives that it is unnecessary.

The papers about skin cancer in Norway or that are authored by Norway-based scientists used for this article are:

doi.org/10.1186/s12889-019-6503-0

www.duo.uio.no/handle/10852/73889

www.doi.org/10.1111/bjd.16480

www.medicaljournals.se/acta/content/abstract/10.2340/00015555-3482

www.doi.org/10.1002/ijc.28657

dx.doi.org/10.2471/BLT.17.021217

doi.org/10.1093/aje/kww148 with an invited commentary doi.org/10.1093/aje/kww149 and response doi.org/10.1093/aje/kww150

doi.org/10.1016/j.jaad.2013.11.050

doi.org/10.1111/jdv.15311

doi.org/10.1111/jdv.15316

doi.org/10.1111/jdv.15317

www.doi.org/10.1111/jdv.15319

From the Norwegian Radiation and Nuclear Safety Authority (DSA) www2.dsa.no/en/sunbeds.

This article originally appeared in the July 10, 2020, issue of The Norwegian American. To subscribe, visit SUBSCRIBE or call us at (206) 784-4617.

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