How many times have you seen a patient — usually a young woman — with wrinkled, mottled, terrible-looking skin, who tells you she’s tanning every day? When you ask why, she may say something to the effect that tanning makes her “feel so good” or “it’s so relaxing”? Have you ever wondered if these patients are tanning more for the feel than the look?
There’s growing evidence that tanning has addictive qualities. One survey of beachgoers assessed whether respondents’ tanning behavior met standard psychiatric criteria for substance abuse.1 They also used a questionnaire modified from an alcohol dependence questionnaire to see if UV exposure behavior had qualities associated with dependence. A high proportion of the beachgoers did meet criteria for dependence. The investigators concluded that UV exposure behavior could be a type of substance disorder.
A more recent study surveyed adolescents about their UV exposure behavior. A high proportion of tanners reported difficulty quitting, another sign of dependency.2 But is all this just a response to societal pressures to look dark? Not every extreme behavior is an addiction. A real addiction involves physiologic mechanisms.
Other studies suggest frequent tanning is driven by actual physiologic effects in addition to appearance. Our research group had frequent tanners use two tanning beds, one that emitted UV light and one that did not.3 Otherwise, these beds were identical. The frequent tanners used both beds first on Monday and then again on Wednesday, so they couldn’t determine which bed gave them a tan. When on Friday, they were allowed to choose from the two beds, almost invariably, they chose the UV bed, saying that tanning bed was more relaxing.
Ultraviolet light can cause skin cells to release endorphins. We wondered whether endorphins were involved in frequent tanners’ choice of the UV bed. To test this, we gave frequent tanners the narcotic blocker naltrexone, thinking that it would block their ability to tell the two beds apart.4 Sure enough, it did seem to reduce the tanners’ preference for UV. But something surprising happened: About half the tanners became jittery and nauseous from the naltrexone. While this would be expected in someone dependent on narcotics, it was unexpected in normal people receiving naltrexone treatment. It seemed that about half the frequent tanners had withdrawal symptoms when given a narcotic antagonist.
Tanning behavior does exhibit characteristics consistent with other substance abuse behaviors. It also seems to be more than just societal pressure driving the behavior in the frequent tanners. It appears that tanning has physiologic effects, too, contributing to an addiction in some of our frequent tanners. The next time you see one of these patients, ask them why it is that they are doing this to themselves and see if you think it’s an addiction or not.
Steven R. Feldman, M.D., Ph.D.
Chief Medical Editor
How many times have you seen a patient — usually a young woman — with wrinkled, mottled, terrible-looking skin, who tells you she’s tanning every day? When you ask why, she may say something to the effect that tanning makes her “feel so good” or “it’s so relaxing”? Have you ever wondered if these patients are tanning more for the feel than the look?
There’s growing evidence that tanning has addictive qualities. One survey of beachgoers assessed whether respondents’ tanning behavior met standard psychiatric criteria for substance abuse.1 They also used a questionnaire modified from an alcohol dependence questionnaire to see if UV exposure behavior had qualities associated with dependence. A high proportion of the beachgoers did meet criteria for dependence. The investigators concluded that UV exposure behavior could be a type of substance disorder.
A more recent study surveyed adolescents about their UV exposure behavior. A high proportion of tanners reported difficulty quitting, another sign of dependency.2 But is all this just a response to societal pressures to look dark? Not every extreme behavior is an addiction. A real addiction involves physiologic mechanisms.
Other studies suggest frequent tanning is driven by actual physiologic effects in addition to appearance. Our research group had frequent tanners use two tanning beds, one that emitted UV light and one that did not.3 Otherwise, these beds were identical. The frequent tanners used both beds first on Monday and then again on Wednesday, so they couldn’t determine which bed gave them a tan. When on Friday, they were allowed to choose from the two beds, almost invariably, they chose the UV bed, saying that tanning bed was more relaxing.
Ultraviolet light can cause skin cells to release endorphins. We wondered whether endorphins were involved in frequent tanners’ choice of the UV bed. To test this, we gave frequent tanners the narcotic blocker naltrexone, thinking that it would block their ability to tell the two beds apart.4 Sure enough, it did seem to reduce the tanners’ preference for UV. But something surprising happened: About half the tanners became jittery and nauseous from the naltrexone. While this would be expected in someone dependent on narcotics, it was unexpected in normal people receiving naltrexone treatment. It seemed that about half the frequent tanners had withdrawal symptoms when given a narcotic antagonist.
Tanning behavior does exhibit characteristics consistent with other substance abuse behaviors. It also seems to be more than just societal pressure driving the behavior in the frequent tanners. It appears that tanning has physiologic effects, too, contributing to an addiction in some of our frequent tanners. The next time you see one of these patients, ask them why it is that they are doing this to themselves and see if you think it’s an addiction or not.
Steven R. Feldman, M.D., Ph.D.
Chief Medical Editor
How many times have you seen a patient — usually a young woman — with wrinkled, mottled, terrible-looking skin, who tells you she’s tanning every day? When you ask why, she may say something to the effect that tanning makes her “feel so good” or “it’s so relaxing”? Have you ever wondered if these patients are tanning more for the feel than the look?
There’s growing evidence that tanning has addictive qualities. One survey of beachgoers assessed whether respondents’ tanning behavior met standard psychiatric criteria for substance abuse.1 They also used a questionnaire modified from an alcohol dependence questionnaire to see if UV exposure behavior had qualities associated with dependence. A high proportion of the beachgoers did meet criteria for dependence. The investigators concluded that UV exposure behavior could be a type of substance disorder.
A more recent study surveyed adolescents about their UV exposure behavior. A high proportion of tanners reported difficulty quitting, another sign of dependency.2 But is all this just a response to societal pressures to look dark? Not every extreme behavior is an addiction. A real addiction involves physiologic mechanisms.
Other studies suggest frequent tanning is driven by actual physiologic effects in addition to appearance. Our research group had frequent tanners use two tanning beds, one that emitted UV light and one that did not.3 Otherwise, these beds were identical. The frequent tanners used both beds first on Monday and then again on Wednesday, so they couldn’t determine which bed gave them a tan. When on Friday, they were allowed to choose from the two beds, almost invariably, they chose the UV bed, saying that tanning bed was more relaxing.
Ultraviolet light can cause skin cells to release endorphins. We wondered whether endorphins were involved in frequent tanners’ choice of the UV bed. To test this, we gave frequent tanners the narcotic blocker naltrexone, thinking that it would block their ability to tell the two beds apart.4 Sure enough, it did seem to reduce the tanners’ preference for UV. But something surprising happened: About half the tanners became jittery and nauseous from the naltrexone. While this would be expected in someone dependent on narcotics, it was unexpected in normal people receiving naltrexone treatment. It seemed that about half the frequent tanners had withdrawal symptoms when given a narcotic antagonist.
Tanning behavior does exhibit characteristics consistent with other substance abuse behaviors. It also seems to be more than just societal pressure driving the behavior in the frequent tanners. It appears that tanning has physiologic effects, too, contributing to an addiction in some of our frequent tanners. The next time you see one of these patients, ask them why it is that they are doing this to themselves and see if you think it’s an addiction or not.
Steven R. Feldman, M.D., Ph.D.
Chief Medical Editor
