Notes of a Heretic Dermatologist

C all me a heretic if you’d like. Tell me I’m turning my back on my specialty. Accost me at meetings and curse my name on the Internet. But you won’t change my mind. I’ll still believe that tanning beds shouldn’t be banned. Sure, tanning beds are bad for your skin and ultraviolet (UV) light causes skin cancer. But there’s a lot we don’t know about UV light and the effects of tanning beds. And we’re not completely sure whether the overall effect of avoiding UV exposure on the skin and other organ systems is a net benefit or not. Even if we assume the worst — negative effects of UV on the skin without any systemic benefits — we still don’t need to go so far as to ban tanning beds. No Need for New Law Yes, recommending that people avoid excessive UV makes good sense. But preventing them from going to tanning beds at pain of the law does not. Cigarettes are much worse for the public’s health than tanning beds, and I don’t think the government should ban them either. But regulation of that harmful product is a good thing. I’m glad restaurants and other public spaces choose to limit smoking in their facilities. I’m not interested in inhaling secondhand smoke. But until people start spraying strangers with secondary UV from handheld units in public places, I’m not too worried about other people’s tanning making me ill. Do we really want our government telling us how to live our lives if it isn’t directly hurting anyone else? Working Together There are good things about the way the government regulates tobacco, and the successes of those strategies could be paralleled in the tanning industry. As dermatologists, we might find the highest level of success working with the tanning industry to develop reasonable and effective guidelines. Here’s a scary thought: Maybe the people who own these establishments aren’t evil. And maybe they even care about their customers! I bet that if we worked in collaboration with the tanning salon owners and their representatives, we could come to some level of agreement that children under the age of 15 should not be able to use commercial indoor tanning establishments and that parental permission be required for 16 and 17 year olds. Appropriate warnings could be given about the risks of UV, including burns, skin cancer and photoaging. I’m afraid that our ‘No Compromise’ position on tanning beds isn’t giving us or anyone else any real benefit. Instead of turning our backs on the tanning industry, I propose we search for the places where our interests intersect. It will be at that crossroad that we’ll find a constructive answer to this question of the public’s health. Steven R. Feldman, M.D., Ph.D. Chief Medical Editor

C all me a heretic if you’d like. Tell me I’m turning my back on my specialty. Accost me at meetings and curse my name on the Internet. But you won’t change my mind. I’ll still believe that tanning beds shouldn’t be banned. Sure, tanning beds are bad for your skin and ultraviolet (UV) light causes skin cancer. But there’s a lot we don’t know about UV light and the effects of tanning beds. And we’re not completely sure whether the overall effect of avoiding UV exposure on the skin and other organ systems is a net benefit or not. Even if we assume the worst — negative effects of UV on the skin without any systemic benefits — we still don’t need to go so far as to ban tanning beds. No Need for New Law Yes, recommending that people avoid excessive UV makes good sense. But preventing them from going to tanning beds at pain of the law does not. Cigarettes are much worse for the public’s health than tanning beds, and I don’t think the government should ban them either. But regulation of that harmful product is a good thing. I’m glad restaurants and other public spaces choose to limit smoking in their facilities. I’m not interested in inhaling secondhand smoke. But until people start spraying strangers with secondary UV from handheld units in public places, I’m not too worried about other people’s tanning making me ill. Do we really want our government telling us how to live our lives if it isn’t directly hurting anyone else? Working Together There are good things about the way the government regulates tobacco, and the successes of those strategies could be paralleled in the tanning industry. As dermatologists, we might find the highest level of success working with the tanning industry to develop reasonable and effective guidelines. Here’s a scary thought: Maybe the people who own these establishments aren’t evil. And maybe they even care about their customers! I bet that if we worked in collaboration with the tanning salon owners and their representatives, we could come to some level of agreement that children under the age of 15 should not be able to use commercial indoor tanning establishments and that parental permission be required for 16 and 17 year olds. Appropriate warnings could be given about the risks of UV, including burns, skin cancer and photoaging. I’m afraid that our ‘No Compromise’ position on tanning beds isn’t giving us or anyone else any real benefit. Instead of turning our backs on the tanning industry, I propose we search for the places where our interests intersect. It will be at that crossroad that we’ll find a constructive answer to this question of the public’s health. Steven R. Feldman, M.D., Ph.D. Chief Medical Editor