About the campaign

It’s been drilled into our heads for years: Too much sun can lead to wrinkles, premature aging and even deadly cancers. But a recent campaign is attempting to change the public’s view about the sun, encouraging people that tanning, in moderation, isn’t just safe but a healthy and necessary practice.

Largely responsible for this campaign is the Indoor Tanning Association (ITA), a group made up of indoor tanning manufacturers and distributors. Claiming that it advocates "responsible" tanning and "sunburn prevention," the ITA's Web site, Sunlightscam.com, presents a multi-faceted argument that promotes deliberate tanning. In addition, the Smart Tan organization (Tanningtruth.com) also offers additional information on why tanning is essential.

The UV and melanoma connection

• ITA’s claim: "Since the 1970s, groups like the Skin Cancer Foundation and the American Cancer Society—which both received funding from sunscreen companies—have campaigned to increase awareness of skin cancer. Chief among their advice is to get regular skin cancer screenings. As a result, the supposed "epidemic" is most likely the result of increased screenings, not an increase in actual skin cancer rates."

Why it’s questionable: Yes, people have taken the warnings seriously and, today, dermatologists are better able to detect early cancers. But if early detection is becoming more common, why are deaths due to melanoma not decreasing?

Skin and Aging finds that not only are skin cancer diagnoses steadily rising, but skin cancer associated deaths are increasing as well: "Skin cancer cases, estimated at 1 million annually, including 60,000 malignant melanoma cases in 2007, now account for more than half of all malignancies in the United States, according to recent research. And the now widely cited statistic that melanoma is implicated in 80% of skin cancer-associated deaths, has put the rare disease on consumers’ radar screens."

What's more, "American Cancer Society figures show the number of estimated new melanoma cases has grown from 54,200 in 2003 to 62,480 for 2008. During that same period, yearly melanoma deaths are expected to rise from 7,600 to 8,420," explains William Hanke M.D., M.P.H., president of the American Academy of Dermatology (AAD), in an article on Modern Medicine.

• ITA’s claim: "Evidence linking getting a tan—either from the sun or from tanning beds—to melanoma is scant at best and demonstrably misleading at worst. The best science indicates that there is no connection between tanning and cancer, but that hasn’t stopped the sunscreen companies from using it to sell their products."

Why it’s questionable: While the ITA tries to prove there’s no connection between UV rays and cancer, organizations worldwide recognize that the evidence points to a strong link. Dermatologist Diane Baker, M.D., tells Skin and Aging that "It's true that there hasn’t been any direct, linear link between UV exposure and melanoma, but we do know that ultraviolet light is a carcinogen in and of itself. The evidence directly linking UV light damage to basal cell and squamous cell carcinoma is much stronger [than for melanoma], but that’s bad enough. The point is that we don’t have direct links for many things we think it might be in our best interest to avoid."

For the tanning industry to argue against a link between tanning and cancer actually makes sense, Kenneth Beer, M.D., director of the Palm Beach Esthetic Institute and clinical instructor of dermatology at University of Miami, tells Modern Medicine. He explains, "The tanning industry is simply doing what they need to (do) to survive in the face of mounting evidence that they are causing cancers for which there is no effective cure."

The bottom line: Just as cigarette companies will argue that there’s no direct link between tobacco and lung cancer, the tanning bed industry will offer evidence against a connection between UV rays and cancer.

Clearly, it’s in the interest of the individual to distinguish between the facts—and the hype used to sell products. If skin cancer wasn’t a serious concern, an increased number of cancer screenings would cause a decrease in the number of skin-cancer related deaths. But this hasn’t happened.

On "safe" tanning

• Smart Tan’s Claim: "What is sometimes called 'damage' to the skin from non-burning UV exposure is actually just the skin’s way of protecting itself from sunburn. If your body can develop a tan, doing so is natural. It is what your body is designed to do. It is one of the ways your body protects itself."

Why it’s questionable: The idea that sun exposure, short of a sunburn, isn’t damaging the skin is simply untrue. Jody A. Levine, M.D., tells WebMD: "Skin cancer comes from a mutation of DNA in the skin cells. A sunburn is not a sign you have mutated the DNA. It is very possible to damage your skin without a burn...It is the UVB radiation that is more likely to cause a sunburn, and UVA -- used in most sun beds -- causes deeper skin damage leading to skin cancer."

In addition, Ken Kraemer, M.D., of the National Cancer Institute tells Newsweek that both sunburns and "cumulative UV exposure" contribute to melanoma risk. "Intermittent but intense blasts of UV rays (the type you might get during occasional trips to the beach or tanning salon, for instance) may be particularly risky," writes Newsweek.

In fact, the Department of Health and Human Services considers UV radiation a carcinogen.

• ITA’s Claim: "Millions of Americans know that getting a base tan is a great way to protect your skin from the sun. In fact, a base tan gives your skin four times more protection than it would normally have. And unlike sunscreen, a base tan doesn’t need to be ’reapplied every two hours’ or wash off in the water."

Why it’s questionable: While the ITA claims that a base tan is "protecting" your skin, experts disagree. Dr. Levine tells WebMD that getting a base tan actually increases the amount of radiation you’re getting on your skin and gives people a false sense of security. She explains, "Tanning under the sun gives protection equal to only suntan lotion of SPF 3 -- and sun-bed tanning gives even less protection than natural sun tan. The risk is not just the double hit of radiation. After getting a base tan, people are more likely to go out in the sun without sunscreen under the false pretense of being protected."

The bottom line: Advising people that tanning is safe as long as you don’t burn is a dangerous suggestion, considering the damaging consequences that can result. As the saying goes, "there’s no such thing as a healthy tan."

The case against indoor tanning

• ITA’s claim: "While getting too much sun has been linked to some forms of cancer, indoor tanning is a government-approved, controlled environment designed to give you a tan without ever burning—which is the likely culprit in contracting cancer from sun exposure."

Why it’s questionable: Does a controlled environment truly mean your skin is immune to damage?

First off, the lamps at tanning salons actually emit more radiation. Dr. Levine explains, "There are these new high-pressure UVA beds that give an amount of UVA far exceeding that of sunlight." In fact, the newest beds at tanning salons emit 15 times more radiation than natural sunlight, according to Everyday Health.

Controlling the amount of time spent in a tanning bed doesn’t mean protection either. The Boston Globe reports that 20 minutes in a tanning bed is comparable to up to three hours of unprotected sun exposure outdoors.

Similarly, occasional tanning is also harmful. ABC News cautions consumers that, "Even one session at a tanning parlor can cause some of the same skin damage doctors see in early skin cancers, more than from natural sunlight. That’s because indoor tanning is so much more intense. The rays from tanning bulbs are 10 to 15 times stronger than sunlight. It results in a faster tan and a greater risk."

The so-called control, courtesy of tanning booths, doesn’t protect against cancer: Darrell Rigel, M.D., of the American Academy of Dermatology tells ABC News, "We’re seeing a dramatic increase in melanoma rates in young women. And the only behavior difference between young women and young men is the fact young women are four times more likely to go to a tanning salon."

Cancer is a disease that takes decades to develop, so the fact that more and more young people are being diagnosed with it is an alarming wakeup call that tanning beds — whose users include large numbers of teenage girls — are a source of the problem. One cancer survivor, who used to frequent tanning salons up to four times a week, tells ABC News: "It is not natural for a 19-year-old to be diagnosed with cancer that takes 30 to 40 years to develop."

The bottom line: Although the idea of a "controlled environment" might mean that an individual can use a tanning bed without ever burning, remember that you don’t need a sunburn to damage your skin; tanned skin is damaged skin.

Controlled environment or not, UV rays are considered carcinogens. According to the AAD, UV radiation from indoor tanning "can lead to skin aging, immune suppression and eye damage, including cataracts and ocular melanoma."

The true meaning of "moderation"

• Smart Tan’s claim: "The professional indoor tanning industry's scientifically supported position is summed up in this declaration: Moderate tanning, for individuals who can develop a tan, is the smartest way to maximize the potential benefits of sun exposure while minimizing the potential risks associated with either too much or too little sunlight."

Why it’s questionable: It’s true that some sun is healthy — 15 minutes a day max to get adequate vitamin D from sunlight — but this doesn’t mean that people need to seek out the sun from tanning beds or trips to the beach.

To get the benefits of vitamin D, for instance, Newsweek offers these tips: "All that is needed (is) to combine the incidental sun exposure people get in the course of normal living (running out for a sandwich at lunchtime or walking between their car and office) with supplements and foods high in vitamin D (fatty fish like salmon or vitamin D-enriched products like milk and juice)."

Still unconcerned about skin cancer? The damaging effects of UV rays are enough to convince most people to play it safe in the sun and avoid tanning. But for some, the warnings are lost amongst the dangerous consequences of other unhealthy habits like smoking and excessive drinking.

So, if skin cancer doesn’t bother you, then perhaps wrinkles will. The one point both dermatologists and the ITA agree on is premature aging. Newsweek reports that John Overstreet, ITA’s executive director, states: "People get the same thing from us that they get from the sun. They get wrinkles."

The bottom line: You don’t need to participate in "moderate tanning" to be healthy. In fact, any deliberate tanning is harmful. Limiting time spent in the sun and supplementing your diet with sources high in vitamin D will not only save your skin, but it might save your life as well.