"Long before it's in the papers"
January 27, 2015


Is indoor tanning addictive?

April 20, 2010
Courtesy of JAMA/Archives Journals 
and World Science staff

Might gossip mag­a­zines soon start fea­tur­ing tales of TV and Holly­wood per­son­al­ities go­ing in­to “tan­ning re­hab”?

A new re­port claims in­door tan­ning—al­ready linked by studies to can­cer and fast­er skin ag­ing—may al­so be ad­dic­tive. 

And while the re­port stops short of rec­om­mend­ing re­ha­bilita­t­ion for se­ri­al tan­ners, it does sug­gest “mo­tiva­t­ional in­ter­view­ing” and treat
­ment of un­der­ly­ing mood dis­or­ders as a way to help those who may be hooked.

A new re­port claims in­door tan­ning—al­ready linked to skin can­cer risk—may al­so be ad­dic­tive. (Im­age cour­tesy U.S. FDA)

Tan­ners who meet cri­te­ria for ad­dic­tion appear to be prone to symp­toms of anx­i­e­ty and sub­stance use, adds the re­port, pub­lished in the April is­sue of the re­search jour­nal Ar­chives of Der­ma­tol­o­gy.

“De­spite ongo­ing ef­forts to ed­u­cate the pub­lic” about the risks of both na­tur­al and in­door tan­ning, “recrea­t­ional tan­ning con­tin­ues to in­crease among young adults,” the au­thors wrote. While cit­ing no spe­ci­fic chem­i­cal pro­cess that might cause tan­ning ad­dict­ion, they pointed to “the de­sire for ap­pear­ance en­hance­ment... re­laxa­t­ion, im­proved mood and so­cial­iz­a­tion” as fac­tors that keep hab­i­tual tan­ners com­ing back for more.

“Giv­en these re­in­force­ments, re­peat­ed ex­po­sure to ul­tra­vi­o­let light used in tan­ning may re­sult in be­hav­ior pat­terns si­m­i­lar to those ob­served seen sub­stance-related dis­or­ders,” the au­thors wrote.

The au­thors, Cath­er­ine Mosher of Me­mo­ri­al Sloan-Kettering Can­cer Cen­ter and Shar­on Dan­off-Burg of the Uni­vers­ity at Al­ba­ny, both in New York, re­cruited 421 col­lege stu­dents in 2006. Two writ­ten ques­tion­naires typ­ic­ally used to screen for al­co­hol abuse or sub­stance-related dis­or­ders were mod­i­fied to eval­u­ate stu­dents for ad­dic­tion to in­door tan­ning. Par­ti­ci­pants were al­so as­sessed us­ing stand­ard­ized meas­ures of anx­i­e­ty, de­pres­sion and sub­stance use.

Among 229 par­ti­ci­pants who had used in­door tan­ning facil­i­ties, the av­er­age num­ber of vis­its in the past year was 23, the re­search­ers found. Out of two meas­ures of ad­dict­ion, 39 per­cent of stu­dents met cri­te­ria for tan­ning ad­dic­tion on one, and 31 per­cent met cri­te­ria on the oth­er, Mosher and Da­noff-Burg said. Stu­dents who met the cri­te­ria were al­so found to be like­li­er to re­port symp­toms of anx­i­e­ty and use of al­co­hol, ma­ri­jua­na and oth­er sub­stances.

The “re­sults sug­gest that treat­ing an un­der­ly­ing mood dis­or­der may be a nec­es­sary step in re­duc­ing skin can­cer risk among those who fre­quently tan in­doors,” the au­thors wrote. “Re­search­ers have hy­poth­e­sized that those who tan reg­u­larly year round may re­quire more in­ten­sive in­ter­ven­tion ef­forts, such as mo­tiva­t­ional in­ter­view­ing,” they con­tin­ued.

“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.”

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Might celebrity magazine covers soon be peppered with tales of stars and starlets going into “tanning rehab”? A new report claims indoor tanning—already linked to skin cancer risk—may also be addictive. And while the report stops short of recommending rehabilitation for serial tanners, it does raise the possibility of treating underlying mood disorders in some of these people as a way to reduce the unhealthy behavior. Tanners who meet criteria for addiction are in fact more prone to symptoms of anxiety and substance use, notes the report, published in the April issue of the research journal Archives of Dermatology. “Despite ongoing efforts to educate the public about the health risks associated with natural and non-solar UV radiation, recreational tanning continues to increase among young adults,” the authors wrote. “In addition to the desire for appearance enhancement, motivations for tanning include relaxation, improved mood and socialization.” Given these reinforcements, repeated exposure to ultraviolet light used in tanning may result in behavior patterns similar to those observed seen substance-related disorders, the authors note. The authors, Catherine Mosher of Memorial Sloan-Kettering Cancer Center and Sharon Danoff-Burg of the University at Albany, both in New York, recruited 421 college students in 2006. Two written questionnaires typically used to screen for alcohol abuse or substance-related disorders were modified to evaluate students for addiction to indoor tanning. Participants were also assessed using standardized measures of anxiety, depression and substance use. Among 229 participants who had used indoor tanning facilities, the average number of visits in the past year was 23, the researchers found. Thirty-nine percent of students met criteria for tanning addiction on one measure of addiction, and 31 percent met criteria on the other measure, Mosher and Danoff-Burg said. Students who met the criteria were also found to be likelier to report symptoms of anxiety and use of alcohol, marijuana and other substances. The “results suggest that treating an underlying mood disorder may be a necessary step in reducing skin cancer risk among those who frequently tan indoors,” the authors wrote. “Researchers have hypothesized that those who tan regularly year round may require more intensive intervention efforts, such as motivational interviewing, relative to those who tan periodically in response to mood changes or special events.” “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.”