The End of Tanning?

In the early 1970s, the German scientist Friedrich Wolff was using ultraviolet lights to analyze the impact of sun exposure on athletes. He noticed an intriguing side effect: The men took on a golden hue. Wolff turned the oddity into a selling point, and the first tanning beds were born.

Appearances are the primary motivator for "laying out:" Surveys have consistently shown that people find tans attractive. One D.C. woman I spoke with was eager to point out that she is by no means a "tanorexic." At the same time, she added, "from a woman's perspective, it's almost the same thing as make-up. [A tan] can help camouflage certain flaws. I have dark circles under my eyes, and it kind of evens out my skin tone a bit.”

When Baker talks about the reasons why people tan, he circles back to what he calls the "look good/feel good,” as though the two states are inseparable.

Other than the look good/feel good, he says customers usually cite "I'm going on vacation, or I'm going to a wedding and I have to wear this dress, or Halloween's coming up and I have a costume that I need to look tan in."

Tanning has become so ingrained, in other words, that "looking tan" is in some ways its own rationale. You need to look tan in that dress. That is the kind of dress one looks tan in.

* * *

Ultraviolet radiation is unique among carcinogens in that it both helps you and, with enough exposure, can kill you. The sun's (or sunbed's) rays spur the production of vitamin D. They also bombard skin cells, mutating DNA and causing wrinkles. Crucially, UV radiation also summons a specific type of immune cell that prompts cancerous growths. Far from protecting against sunburn, a "base tan" is a sign that skin damage has already occurred. According to the CDC, people who tan are more likely to get sunburned.

The skin’s darkening effect is caused by the rapid production of melanin, a type of skin pigment.

“When skin cells develop melanin, it's doing so in response to the damage,” said Len Lichtenfeld, an oncologist and deputy chief medical officer of the American Cancer Society. “It's not doing that because it's a healthy sign.”

The tanning process itself can be addictive: Sunlight stimulates the release of endorphins, resulting in feelings of relaxation or euphoria—the phenomenon sometimes called "runner's high."

"Tanning makes you feel good. But so does methamphetamine," said Joel Hillhouse, a professor of public health at East Tennessee State University who has studied the psychology of tanning. He said some of his study subjects have stolen money or broken into tanning salons to get their fix.

Using tanning beds increases the risk of developing melanoma, the most deadly form of skin cancer, by 59 percent. More than 60,000 new melanomas are diagnosed in the U.S. annually, but treatment of other types of skin cancers increased by nearly 77 percent between 1992 and 2006. Skin cancer is now the most common type of cancer in the U.S.

Melanoma Incidence Rates by Gender

Data from the National Cancer Institute, projected after 2010 (Surgeon General's office)

Public health authorities have responded swiftly and, tanning salon owners say, severely. In 2009, the International Agency for Research on Cancer classified tanning beds as a Group 1 carcinogen, in the same category as cigarette smoke and asbestos. The 2010 Affordable Care Act included a 10 percent tax on indoor tanning services.

Earlier this month the surgeon general released a report calling attention to the dangers of tanning, saying in an introductory letter that "tanned skin is damaged skin." It was the first time a surgeon general had focused on skin cancer specifically.

The FDA also recently reclassified the safety level of tanning beds from low-risk—on par with Band-Aids—to moderate-risk, like condoms and wheelchairs. On top of that, the agency mandated that the beds carry a black-box warning stating that they should not be used by minors.

Age Restrictions on Indoor Tanning

Data from the National Conference of State Legislatures (Surgeon General's office)

Because sunburns during childhood cause a particularly sharp increase in the likelihood of developing skin cancer, in recent years nine states have barred anyone under the age of 18 from using tanning beds. Thirty-two others regulate the devices’ use by minors.

* * *

The laws and warnings have prompted widespread outrage among tanning enthusiasts. Today, the conversation on the science behind skin cancer can be as vicious as the one about climate change.

"We're agrarian by nature," said Rob Quinn, CEO of a chain of 40-some Tan Pro stores in Ohio, referring to humanity. "We crave nourishment, water, and sunlight. I can't imagine our Creator would be that mean to say, 'Okay I'm going to introduce you to this light, and I'm going to make you crave it and love it, but it's bad for you.'"

Quinn believes that the recent anti-tanning push is a conspiracy by the world's dermatologists, and that we will yet see the lasting negative repercussions of keeping a generation of humans out of the sun. He said that Ohio has lost 40 percent of its registered tanning salons, and that the customer headcount in some stores is down by nearly half.

Baker is hyper-aware, and hyper-sensitive, to accusations that people who use sunbeds have a higher risk of developing skin cancer.

"I've read enough to know that it's very difficult to say that one thing or another is causing this or that," he said. "I don't agree [that there's a strong link between indoor tanning and melanoma]. There's a lot of factors that go into that type of serious disease."

When I asked what conclusions he's drawn from his readings, he declined to comment.

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Olga Khazan is a staff writer at The Atlantic, where she covers health.

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