A new study from the US suggests that some people who frequently use indoor tanning beds may become addicted to the habit and are also more likely to be prone to anxiety, use alcohol and other substances, suggesting that exposure to UV light may lead to behavior patterns typical of substance-related disorders.

You can read about the study by Dr Catherine E Mosher, of Memorial Sloan-Kettering Cancer Center, New York, and Dr Sharon Danoff-Burg, of University at Albany, State University of New York, in the online April issue of Archives of Dermatology.

Mosher and Danoff-Burg noted that indoor tanning for recreational use is still increasing among young adults, despite efforts to educate people about the risks of exposure to UV from the sun and non-solar sources.

Young adults make use of indoor tanning not only to enhance appearance, but also to improve mood, relax and socialize, they added, which led them to compare this habit to substance-related disorders, which are also characterized by an often repeated behavior reinforced by pleasurable outcomes, to the point where long term health is at risk: ie the pattern of addiction.

For the study the researchers enrolled 421 college students and asked them to fill in well known questionnaires used to screen for alcohol and substance misuse, and also to assess anxiety, depression and mood.

These included the written versions of CAGE (Cut down, Annoyed, Guilty, Eye-opener) and DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision), which the researchers modified to evaluate addiction for indoor tanning.

The results showed that:

  • 229 (54 per cent) of the participants used indoor tanning facilities.
  • The average number of visits per year among these indoor tanning users was 23.
  • 90 of the indoor tanning users (39.3 per cent) met DSM-IV-TR criteria for indoor tanning addiction.
  • 70 (30.6 per cent) met CAGE criteria for indoor tanning addiction.
  • Participants who met DSM-IV-TR and CAGE criteria for indoor tanning addiction also reported higher symptoms of anxiety, greater use of alcohol, marijuana, and other substances, compared to those who did not meet the criteria.
  • They did not however, report higher symptoms of depression.

In their discussion, Mosher and Danoff-Burg commented that some researchers have proposed that people addicted to all year round tanning may require a different approach to those who have an episodic pattern linked to specific mood changes or events.

They concluded that:

“… interventions to reduce skin cancer risk should address the addictive qualities of indoor tanning for a minority of individuals and the relationship of this behavior to other addictions and affective disturbance.”

“Further research should evaluate the usefulness of incorporating a brief anxiety and depression screening for individuals who tan indoors. Patients with anxiety or depression could be referred to mental health professionals for diagnosis and treatment.”

The US Food and Drug Administration (FDA) is considering tightening restrictions on tanning beds.

The FDA currently classes tanning beds as Class 1 devices, the same category as items that have minimal potential to cause harm, and which includes things like adhesive bandages and tongue depressors.

Professional medical bodies such as the American Academy of Dermatology want the FDA to put them in Class 2, and regulate them more tightly, such as limit the amount of radiation they emit, make manufacturers keep a registry of device usage, and put large warning signs on them that tell users about the risks of tanning.

Last year, the World Health Organization’s International Agency for Research on Cancer reclassified sunlamps and tanning beds from “probably carcinogenic” to carcinogenic to humans” and have now placed the devices in their highest risk category.

The Indoor Tanning Association say the evidence linking tanning lamps to cancer comes from decades-old studies whose data was just pooled and reanalyzed by the WHO: they maintain the industry is already sufficiently well-regulated and there is a lot if misinformation about it.

“Addiction to Indoor Tanning: Relation to Anxiety, Depression, and Substance Use.”
Catherine E. Mosher and Sharon Danoff-Burg.
Arch Dermatol, Vol. 146 No. 4, April 2010, pp 412-417.

Source: JAMA/Archives, MNT archives, MedlinePlus.

Written by: Catharine Paddock, PhD