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by dermatologist Antonis Seretis

How dangerous are tanning beds, or sunbeds? What is the risk of using them, even once? Who should avoid fake tanning? These questions, among others, concern many of those who want to achieve tanned skin, especially now that summer is approaching.

What are tanning beds?

They are machines with UV lamps, either standing booths or covered beds. The lamps emit UV light onto the body, similar to the UV radiation from sunlight, which contributes to the tanning of the skin.

How do tanning beds work?
The lamps emit dense UV radiation (UVA). In reality, they can emit UVA up to five times more than the sun at midday during the summer. UVA stimulates cells to produce melanin, making skin appear more tanned. Tanning through a sunbed is quick, as the UV radiation is more intense than the natural radiation from the sun.

Truth and lies 
Tanning beds have got fans around the world, and are especially popular in countries of central and north Europe where there is not much sunlight during most of the year. However, people who live in warmer, sunnier countries also use them, especially during the spring, to prepare themselves so that they are already tanned when the summer begins.

Advocates of tanning beds say that they are a safe way of achieving a tan, and that fake tanning actually protects you against natural radiation from sunlight. This is only partly true. This is because the natural protection that the skin has when it has been exposed to artificial radiation is not greater than the protection that an SPF4 sunscreen offers. Advocates also say that fake tanning with sunbeds helps with the following:

• Feeling more calm
• Reducing cardiovascular disease
• Reducing blood pressure
• Increase and production of vitamin D3, which is responsible for bone health
• Decreasing cholesterol
• Treating neurodermatitis
• Strengthening the immune system
• Improving acne and psoriasis

However, tanning beds should not be considered safe, even if our skin isn't sensitive to radiation from the sun. The UVA radiation it emits, despite being 'less harsh' than UVB (UVB causes burns and is considered the main culprit for skin cancer, but we now know that UVA also plays an important role in this), it is dangerous and can be carcinogenic. Whenever our skin is exposed to UV radiation, artificial or natural, damage to skin cells accumulates, increasing overall chances of developing skin cancer, even in young people, while UVA is also responsible for premature ageing of the skin.

Extensive research in 10 EU Member States, during which over 500 sunbeds at 300 spas, gyms and tanning salons were tested, shows that in many cases, the intensity of the UV radiation is higher than what is deemed safe, resulting in increased risk of developing skin cancer and speeding up the process of premature ageing of the skin.

Other risks associated with tanning beds
According to the above study, many tanning beds are allowed to be used by those under the age of 18 (which is normally prohibited, since sun damage is more dangerous at a younger age), and there is a lack of documentation to inform people of the harmful effects of UV radiation. These findings have led the European Commission to set new safety guidelines. At the same time, it advises consumers to check what the duration of their tanning session should be, according to their phototype (skin colour) and to use a protective cover for their eyes, as UV radiation can cause significant damage to the eyes as well. Those under the age of 18 are advised to avoid using sunbeds.

The Council on Cancer in Australia notes that safe tanning is a myth, as tanning harms the skin. It has estimated that between 12 and 62 of skin cancer cases every year in Australia are due to tanning machines. Melanoma is the most common form of cancer in those aged 15-40. About 43% of these cases could be prevented if sunbeds were avoided.

Researchers predict that the number of deaths associated with tanning beds will increase in the next 20 years.  Out of the 64.000 cases of skin melanoma that are diagnosed every year in 18 European countries, around 3.438, equivalent to 5,4%, are linked to the use of tanning beds, according to the analysis carried out by the International Prevention Research Institute (IPRI) in Lyon and the Istituto Europeo di Oncologia (IEO) in Milan. 

Based on 27 studies that have been published in this topic, the researchers at these two institutes say that "the risk of developing melanoma is increased by around 20% for those who have used tanning beds at least once." The researchers add that the risk of developing melanoma is doubled for those who used tanning beds before the age of 35, and they insist that in many cases, skin cancer can be avoided if people don't use these machines.

"Preventing the harmful effects of tanning beds that use radiation should be backed up more rigorously," the researchers say, calling the World Health Organisation (WHO) to impose restrictions on the use of tanning beds by underage individuals and to ban tanning salons that have not passed a check. According to the WHO, the incidents of melanoma have increased globally, more than any other form of cancer, with a 3-7% increase per year for the past 40 years among the white populations of different countries around the world.

More specifically, the cases in young women (under the age of 40) are 8 times higher compared to 40 years ago. One of the suspected factors for this increase is the popularity of tanning beds amongst young women.

Tanning beds should be avoided by everyone. They are even more harmful to the following high risk groups:

• Those who get sunburn easily
• Those who don't tan much naturally
• Those with freckles
• Those who have many moles on their body
• Those with a family history of melanoma
• Young people under the age of 18

So, it would be good to avoid fake tanning, or if for some reason you do use tanning beds, you should consult with your dermatologist first, for advice.