FDA Wants Tighter Rules for Indoor Tanning

In an ongoing effort to minimize risks from tanning beds, the U.S. Food and Drug Administration (FDA) proposed new rules in May to increase regulation on the devices and require warning labels that recommend increased screening for cancer.

Indoor tanning concerns increased after a 2006 analysis found that indoor tanning under age 35 results in a 75% increased risk of melanoma.

“People are becoming more aware of the health hazards of indoor tanning,” says Meg Watson, MPH, epidemiologist in the Centers for Disease Control and Prevention (CDC) Division of Cancer Prevention and Control. “It seems like low-hanging fruit since it's a source of carcinogen that is completely avoidable.”

Yet CDC surveys find that indoor tanning is still popular, particularly among those for whom skin cancer rates are increasing: non-Hispanic white women ages 18–29, approximately 30% of whom admit to tanning.

“The biggest misconception is that tanning improves appearance,” says Watson. “Unfortunately, the same process that creates a tan leads to wrinkles, damage to skin, and even cancer.”

“There's no question that the science supports the fact that indoor tanning increases the risk of skin cancer,” says Mary Maloney, MD, chair of the Regulatory Policy Committee at the American Academy of Dermatology (AAD), who has seen an increase in melanoma cases among young women over the last 10 to 15 years.

While most people understand that melanoma is deadly, the existence of effective treatments for both basal and squamous cell carcinoma may give a false sense of security. “They think you can just cut it off,” remarks Watson. “But treatment can be disfiguring.”

The proposed FDA rules raise awareness of the risks of tanning through warning labels, including cautions about use by anyone younger than 18.

The rules also aim to reclassify tanning beds from a Class I, low-risk medical device, a category that includes bandages and tongue depressors, to Class II, for moderate- to high-risk devices. This classification allows the FDA to regulate the devices and ensure that they have safety features, such as automatic shutoffs, and that they emit consistent doses of UV radiation from one session to the next to prevent burning.

Along with the FDA's effort, an increasing number of states have sought to limit the use of tanning beds by teenagers.

While regulations and legislation are crucial steps toward increased safety, their effects on public perception of tanning remain to be seen. “If there's more legislation tightening up regulation on a product, people might perceive it as more risky,” says Dawn Holman, MPH, a CDC behavioral scientist. “Alternatively, people might think that since tanning beds are regulated, they are safer to use.”

To address this public health concern, a coordinated approach is needed.

“Clinicians, parents, schools, and the media can all play a role in encouraging people to avoid tanning and embrace their natural skin color,” says Holman.

In some high schools, for example, students are pledging not to tan before their prom. Maloney says she cheers when she hears that, but, ultimately, the AAD's goal is to work with the FDA to ban tanning for those under age 18.