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Warnings from health experts on the dangers of UV rays haven't deterred as many from tanning as one might think — many cities boast more salons than Starbucks or McDonalds.
By contributor
updated 3/12/2009 1:33:43 PM ET 2009-03-12T17:33:43

With all the studies and surveys and research linking UV radiation with skin cancer risks, one might think the sun would have set on the good old-fashioned fake and bake.

But a new study by San Diego State University public health researchers has found that not only are there still plenty of indoor tanning salons in America’s big cities, in many places there are more tanning salons than Starbucks or McDonalds.

The study, set to be published in the American Journal of Preventive Medicine, looked at the number and density (per 100,000 people) of indoor tanning facilities in 116 of the largest cities in the country and then compared tanning facilities with two “ubiquitous institutions.”

“Just to put the number into context, we counted the number of Starbucks and McDonalds, two frequently occurring businesses,” says Dr. Joni Mayer, professor of Health Promotion and Behavioral Sciences at the Graduate School of Public Health in San Diego State University. “We knew that there were a lot of indoor tanning facilities but we didn’t really know that they would exceed the number of Starbucks and McDonalds in most cases.”

According to Mayer’s findings, the city of Charleston, W. Va., took the prize for the highest density of tanning salons with a total of 18 facilities for a population of more than 53,000 (by comparison, the city boasts only one Starbucks and seven McDonald’s).

Other indoor tanning titans included Pittsburgh, Penn., with 93 salons for a population of just under 350,000; Akron, Ohio, with 57 salons serving just over 217,000 people; Portland, Maine, with 16 tanning parlors for 64,250 souls; and Columbia, South Carolina, with 28 indoor tanning facilities serving a population of about 116,000.

New York City had the most indoor tanning salons — a total of 183 facilities —but with its population of 8 million (and counting), it had one of the lowest rates of density.

Sarah Johnson, 28, of Manhattan, says she uses tanning salons (primarily during the winter months), but was still shocked at the findings.

“That’s amazing because Starbucks is everywhere,” says Johnson, who runs an online fashion and lifestyle directory. “But I have to say one of the draws for me is that (my tanning salon) is so close. It’s right next to my subway stop, so I’ll hop in there before I go to the office in the morning. I don’t know that I would go as often if it was more of a trek to get to.”

Cheap and ubiquitous
Mayer, whose recent density study is part of a larger project known as CITY 100 (Correlates of Indoor Tanning in Youth) which seeks to learn more about the factors that influence teens and young adults to use indoor tanning, says proximity does seem to trump prudence.

“We interviewed 6,000 teens across the country and those living within two miles of a tanning salon were significantly more likely to have used indoor tanning than those who didn’t,” says Mayer. “There’s a significant association between living close to a tanning salon and using indoor tanning.”

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Another factor that comes into play is the cheap pricing.

“The majority if not all tanning salons offer discount price packaging on UV tanning,” she says. “Which makes it very cheap per tanning session. It’s like an all-you-can-eat buffet. To get your ‘money’s worth,’ you tan more often.”

Unfortunately, tanning more often means upping your risk of melanoma and non-melanoma skin cancer such as squamous cell carcinoma and basal cell carcinoma. According to the American Academy of Dermatology, studies have also shown that excessive exposure to UV radiation during indoor tanning leads to skin aging, immune suppression and eye damage, including cataracts and ocular melanoma. Even the U.S. Department of Health & Human Services has declared both tanning beds — and that big fiery ball in the sky — to be known carcinogens.

Stacy White, a 37-year-old corporate communications officer from Chattanooga, Tenn., says her tanning salon’s proximity, extended hours and budget pricing have all encouraged her to continue tanning — despite the fact she’s had three suspicious moles removed in the last few years.

“I do worry about the health risks and the older I get, the more I worry about wrinkles,” she says. “But then I’ll see a sign with a place that advertises $19 a month for unlimited tanning and I’ll think, ‘Wow, what a bargain!’”

But to dermatologists like Dr. Arielle Kauvar, clinical associate professor of dermatology at New York University School of Medicine, it’s more of a deal with the devil.

“It’s a very cheap way to buy yourself a death wish,” she says.

Rashes and rationalizations
According to the AAD, more than 1 million people tan in tanning salons on an average day, nearly 70 percent of them girls and women aged 16 to 29.

Why are so many people still tanning, especially with all the evidence regarding the cumulative effects of UV radiation? There are nearly as many answers as there are tanning parlors.

Some people say they do it for the vitamin D. But the idea that an indoor tanning booth replenishes it a myth, says Kauvar. “If you need vitamin D, you don’t need to seek the sun,” she says. “Drink milk, eat cheese, eat fish or take vitamin supplements.”

Others — particularly those in the northern states — like the warmth and light of a tanning bed, claiming it lifts their spirits. Some talk about the restfulness of the tanning booth. Data does suggest tanning releases endorphins, which is why it’s associated with relaxation or pleasurable feelings and may even be addictive, says Kauvar, who recommends exercise as a healthier alternative. But some of these folks may suffer from Seasonal Affective Disorder , she suggests.

“There are light boxes that can help you get through the cloudy winter days,” says Kauvar. “They make use of broad spectrum light, not UV.”

Some feel it’s okay to tan if they use beds giving off “good UVA rays” as opposed to “bad UVB rays.” But Kauvar says there’s absolutely no truth to this notion. “There is very clear and strong data that UVA rays will cause skin cancer along with UVB and independent of UVB rays,” she says. “There’s no such thing as good UVA rays. They’re primarily what cause people to age.”

A handful say tanning helps with a skin condition like eczema or psoriasis. But these people should not seek treatment at a tanning salon, but at a doctor’s office, where they’ll know how much light they’re getting and the dose of light they’re getting, Kauvar says.

Most people are after color, claiming they feel “healthier” when they have a bronze tint to their skin. But those who really want color may want to try self-tanning lotions and spray-on tans, which Kauvar says are completely safe.

“A tan in a bottle is a much better way to do it,” she says. “They all have the same basic ingredient and it’s a completely safe molecule. You’re basically dyeing the outside layer of your skin. There are absolutely no health risks associated with that.”

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