Original Article

The Effect of Sunless Tanning on Behavior in the Sun: A Pilot Study

Authors: Daniel J. Sheehan, MD, Jack L. Lesher, Jr, MD

Abstract

Background: In the United States, indoor tanning is a booming industry and contributes to the ultraviolet light (UVL) burden that ultimately leads to skin cancer. “Sunless” tanning methods that avoid UVL exposure may represent a safe alternative. However, the effects of sunless tanning methods on ultraviolet light-related behaviors have never been investigated.


Methods: Anonymous survey of 121 individuals who underwent a spray-on sunless tanning treatment between February and May 2004.


Results: Women completed 107 surveys. Men completed 14 surveys. The majority of individuals reported that they had not or would not change their time spent outdoors or their sunscreen use as a result of undergoing sunless tanning. However, 73% of individuals who had used UVL tanning beds said they had decreased or would decrease their UVL tanning bed use.


Conclusion: Sunless tanning is associated with a self-reported decrease in traditional UVL tanning bed use among tanning bed users. Physicians should advocate the use of sunless tanning to their patients who use traditional UVL tanning beds as a means of decreasing their UVL exposure and cancer risk.


Key Points


* Sunless tanning methods using dihydroxyacetone are a safe way of achieving a tanned skin appearance without ultraviolet light exposure.


* This study demonstrated that use of sunless tanning methods were not associated with a change in self-reported outdoor sun exposure or sunscreen use, but sunless tanning methods were associated with a self-reported decrease in ultraviolet tanning bed use.


* Physicians should recommend sunless tanning methods to their patients who want a tanned appearance, as this may lead to a decrease in ultraviolet light exposure and long-term risk of skin cancer.

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References

1. Albert MR, Ostheimer KG. The evolution of current medical and popular attitudes toward ultraviolet light exposure: Part 3. J Am Acad Dermatol 2003;49:1096–1106.
 
2. Demko CA, Borawski EA, Debanne SM, et al. Use of indoor tanning facilities by white adolescents in the United States. Arch Pediatr Adolesc Med 2003;157:854–860.
 
3. Rigel EG, Lebwohl M, Rigel AC, et al. Daily UVB exposure levels in high-school students measured with digital dosimeters. J Am Acad Dermatol 2003;49:1112–1114.
 
4. Warthan MM, Uchida T, Wagner RF. UV light tanning as a type of substance-related disorder. Arch Dermatol 2005;141:963–966.
 
5. Feldman SR, Liguori A, Kucenic M, et al. Ultraviolet exposure is a reinforcing stimulus in frequent indoor tanners. J Am Acad Dermatol 2004;51:45–51.
 
6. Pinnell SR. Cutaneous photodamage, oxidative stress, and topical antioxidant protection. J Am Acad Dermatol 2003;48:1–19.
 
7. Karagas MR, Stannard VA, Mott LA, et al. Use of tanning devices and risk of basal cell and squamous cell skin cancers. J Nat Cancer Inst 2002;94:224–226.
 
8. Diffey BL. A quantitative estimate of melanoma mortality from ultraviolet A sunbed use in the U.K. Brit J Dermatol 2003;149:578–581.
 
9. Bataille V, Winnett A, Sasieni P, et al. Exposure to the sun and sunbeds and the risk of cutaneous melanoma in the UK: a case-control study. European J Cancer 2004;40:429–435.
 
10. Hornung RL, Magee KH, Lee WJ, et al. Tanning facility use: Are we exceeding Food and Drug Administration limits? J Am Acad Dermatol 2003;49:655–661.
 
11. Sun & Skin News, Vol. 20, No. 3, 2003.
 
12. Akin FJ, Marlowe E. Non-carcinogenicity of dihydroxyacetone by skin painting. J Environ Pathol Toxicol Oncol 1984;5:349–351.
 
13. Wittgenstein E, Berry HK. Staining of skin with dihydroxyacetone. Science 1960;132:894–895.
 
14. Maibach HI, Kligman AM. Dihydroxyacetone: A suntan-simulating agent. Arch Dermatol1960;82:505–507.
 
15. Goldman L, Blaney DJ. Dihydroxyacetone. Arch Dermatol 1962;85:730–734.
 
16. Johnson JA, Fusaro RM. Protection against long ultraviolet radiation: Topical browning agents and a new outlook. Dermatologica 1987;175:53–57.
 
17. Levy SB. Dihydroxyacetone-containing sunless or self-tanning lotions. J Am Acad Dermatol1992;27:989–993.
 
18. Johnson JA, Fusaro RM. Persistence of skin color and fluorescence after treatment with dihydroxyacetone. Dermatology 1994;188:247.
 
19. Fu JM, Dusza SW, Halpern AC. Sunless tanning. J Am Acad Dermatol 2004;50:706–713.
 
20. Goldman L, Barkoff J, Blaney D, et al. Investigative studies with the skin coloring agents dihydroxyacetone and glyoxal. J Invest Dermatol 1960;35:161–164.
 
21. U.S. News & World Report. May 15, 2000, vol 128, issue 19, p 56.
 
22. USA Today. June 10, 2004, p 9D.
 
23. The New York Times. June 13, 2004, section 9, pp 1, 12.
 
24. The Atlanta Journal-Constitution. July 10, 2004, pp D1, D3.
 
25. Draelos ZD. Cosmetics to imitate a summer tan. Skin Therapy Letter 2000;6:3–4.
 
26. Draelos ZD. Self-tanning lotions: Are they a healthy way to achieve a tan? Am J Clin Dermatol2002;3:317–318.