Indoor Tanning Addiction Linked to Anxiety, Drug Abuse

People Addicted to Indoor Tanning Are More Likely to Have Anxiety and Substance Abuse Problems, Study Finds

By Denise Mann
WebMD Health News

Reviewed by Laura J. Martin, MD

April 19, 2010 -- Indoor tanning can be addictive, and people who are hooked on tanning beds may also be prone to anxiety and substance abuse problems, according to a new study in the Archives of Dermatology.

Despite the well-publicized risks of skin cancer, indoor tanning is on the rise among adolescents and young adults. Many people still feel that they look better when they are tan and report that the act of tanning is relaxing. The industry is booming, despite federal efforts aimed at regulating and taxing indoor tanning.

In the new study of 421 students from a large Northeastern university, 229 students had tanned in indoor salons. Of these, 160 met criteria for indoor tanning addiction. In general, indoor tanning addicts tanned more frequently than their non-addicted counterparts. The college students who were addicted to indoor tanning were also more likely to have symptoms of anxiety and/or greater use of alcohol, marijuana, and other substances, than their peers who were not addicted to indoor tanning.

"This study provides further support for the notion that tanning may be conceptualized as an addictive behavior for a subgroup of individuals who tan indoors," conclude study authors Catherine E. Mosher, PhD, of Memorial Sloan-Kettering Cancer Center in New York City and Sharon Danoff-Burg, PhD, of the University at Albany in New York.

If the link between anxiety, substance abuse, and indoor tanning addiction is confirmed by future studies, "treating an underlying mood disorder may be a necessary step in reducing skin cancer risk among those who frequently tan indoors," they write.

Indoor Tanning "Feels Good"

Ultraviolet (UV) light exposure from indoor tanning beds and the sun promotes the release of endorphins, which are our brain's natural "feel-good" chemicals.

"You just feel good afterward," says Darrell S. Rigel, MD, a clinical professor of dermatology at New York University Medical Center. "Tanning is an addiction, just like smoking, and there is a cancer outcome just like there is with smoking."

"If you are feeling stressed and anxious, you may feel better after tanning, but there are much healthier ways to reduce anxiety," says Carolyn J. Heckman, PhD, a psychologist in the cancer prevention and control program at Fox Chase Cancer Center in Philadelphia. "It is possible that if we treat the underlying anxiety, depression, substance abuse or body image issues, we would reduce indoor tanning and the health risks associated with indoor tanning."

John Overstreet, executive director of the Indoor Tanning Association in Washington, D.C., says labeling something as an addictive behavior is becoming something of a trend. "It is really popular to label a group or activity as an addiction such as Internet addiction, pornography addiction, or video game addiction, and this is a form of condemnation by labeling and I am not sure it is scientifically sound," he says.

Although too much of a good thing is always a possibility, Overstreet does not see indoor tanning as an addiction.

Risks of Indoor Tanning

"We are seeing women in their 20s with melanoma where the sun doesn't shine, but where the UV rays from tanning beds do, and we would have never seen this a decade ago," Rigel says.

"Indoor tanning is not safer than sunbathing and may even be more dangerous," Heckman says. Besides increasing risk of skin cancer, tanning also promotes wrinkles and age spots, she says.

"If you want to look tan, use sunless tanners," she says.

Indoor Tanning in the News

The new study may provide another blow to the indoor tanning industry. An advisory panel to the FDA recently met to discuss imposing new regulations on indoor tanning. The panel recommended banning the use of tanning beds among children and teens or requiring strict parental consent, as well as potentially banning the use of indoor tanning by people with extremely pale skin. In addition, the panel suggested that indoor tanning devices be re-classified so that they have stricter warning labels and are more firmly regulated to limit the levels of radiation the devices emit.

There is also a 10% tax on indoor tanning services included in the new health care reform bill. A tax won't make a dent in an addict's habit, Rigel says. A 10% tax on a $20 indoor tanning session, for example, is just $2. Still, "it can't hurt, but we have to get people to not think that tanning is wonderful," he says.

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Mosher, C. and Danoff-Burg, S. Archives of Dermatology, 2010; vol 146: pp 412-417.
Carolyn J. Heckman, PhD, psychologist, cancer prevention and control program, Fox Chase Cancer Center, Philadelphia.
Darrell S. Rigel, MD, clinical professor, dermatology, New York University Medical Center, New York.
John Overstreet, executive director, Indoor Tanning Association, Washington, D.C.
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