The Push for More Regulation of Tanning Beds

In my former practice, patients often asked me about tanning salons. I still get questions from friends and family now. I thought it would be helpful to provide an update on some proposed regulations regarding tanning to give you a sense of the issues.

FDA Proposed Rules

In December 2015, the Food and Drug Administration (FDA) issued a proposed rule that bans indoor tanning for those under the age of 18 years. In addition to the age restriction, the FDA drafted new requirements for more “prominent” safety warnings, an emergency shut-off switch, and limits on the amount of penetrable light through the protective eyewear worn in the beds.

The FDA is considering some other tanning restrictions for adults that would directly impact how often a person may use sunbeds. These include requiring regular tanners to sign a waiver twice a year, as well as a “Recommended Exposure Schedule.”  This schedule consists of a 48-hour waiting period between tanning sessions, a limit of two sessions per week, and an unspecified annual limit.

Status

But months have passed without issuance of a final rule. On Friday, March 18, four House Representatives, Carolyn Maloney (D-N.Y.), Charles Dent (R-Pa.), Rosa DeLauro (D-Conn.), and Ted Lieu (D-Calif.), led the push for the FDA, at the least, to officially ban sunbeds for minors and raise restrictions for adults. Along with 18 others, they drafted a letter to FDA Commissioner, Robert Califf, pressing him to finalize the rule “as soon as possible.”

The persuasive letter included alarming statistics, reading: “Across the world, more cases of skin cancer are caused by indoor tanning each year than there are lung cancer cases due to smoking.” And continued: “At the same time as incidence rates for other cancers are decreasing, melanoma and skin cancer are among the fastest-growing cancers in America, and treatment costs have grown to over $8 billion each year.” The lawmakers cited a January 2014 report from JAMA Dermatology, a peer-reviewed medical journal, which found that indoor tanning increases one’s risk for skin cancer by 59 percent, particularly among young people. The report attributed more than 419,000 cases of skin cancer, about 11,000 cases of which were melanoma, to indoor tanning activities.

For now, these are proposals, not written mandates. But the medical community eagerly awaits stricter FDA regulation. For instance, the American Academy of Pediatrics particularly lauded restricting minors from indoor tanning. In December, Academy president Sandra Hassink stated, “There is no safe level of tanning bed use for young people…. Exposure to ultraviolent radiation causes skin cancer, and tanning beds are designed to directly expose the skin to radiation in amounts several times greater than that provided by natural sunlight.” She continued, “Alarmingly, the earlier a teen begins to tan indoors, the more hours of UV exposure he or she will accumulate over a lifetime, increasing the chances of developing melanoma and other skin cancers.”

Response from the Tanning Industry

The tanning salon industry is speaking out against these proposed federal rules, referring to the effort as a “punitive, job-killing government overreach and ‘borderline harassment.'” In an interview with InsideSources, American Suntanning Association board member, Chris Sternberg, stated, “We don’t think the decision of whether a minor should tan should be left to the federal government…. Parents ought to make that call, and most, if not all, states have a parental consent law.”

Sternberg objected to other proposed rules for adults, as well, referring to them as “borderline harassment,” and stating, “Requiring adults to sign this ‘risk acknowledgement certification’ every six months in order to be able to use a sunbed is ludicrous.”

Going Forward

While it’s hard to predict what will happen, it seems likely that FDA will go forward with some form of regulation in the near term. The statistics regarding health impacts seem pretty straightforward, and the only rebuttal I could find to them is what I noted above – most of which does not relate to health, but rather state laws, parental responsibility, and inconvenience. I will provide updates as the situation progresses.