Dermatology • Jul 21, 2014

Is there such thing as a “healthy tan?”

*Thanks to guest bloggers Drs.  Sarah Garwood and Kavya Reddy, on special assignment to

“Mom, it’s just a sunburn!  Everyone gets them!”  With summer more than half way over, my daughters and my patients are showing the telltale signs of sunscreen deficiency with tanned legs and peeling shoulders.  We all know using sunscreen is important to prevent skin cancer, but what about the safety of tanning beds for the “protective” base tan or using bronzers and spray tans?

Tanning Salons/Tanning Beds The use of tanning salons is a common practice among teenagers. One survey found that 24% of non-Hispanic, Caucasian teenagers 13-19 years old used a tanning facility at least once. The intensity of ultraviolet radiation (UVR) produced by large, powerful tanning units may be 10-15 times higher than that of the midday sun. There is a myth that a “pre-vacation tan” obtained when visiting tanning salons to prepare skin for sunny vacation protects against subsequent skin damage.  The truth is it actually leads to extra radiation exposure not only before the vacation but also afterward because people use less sun protection during the vacation, believing mistakenly that the tan will protect them. AAP policy “recommends that children and adolescents younger than 18 should be prohibited from using tanning beds.”  The World Health Organization, American Medical Association and the American Academy of Dermatology also support this ban.  In 2012, some states introduced bills banning teen tanning bed use. These states include California, Arizona, Illinois, New York, and Minnesota to name a few. Other states considered a bill that would require parental consent to use a tanning bed for those younger than 18. These states include Florida, Missouri, Colorado, and Pennsylvania. SummerFun

Sunless Tanning Sunless tanning or spray tans use dihydroxyacetone (DHA), a chemical that reacts with amino acids in the top layer of the skin, to form brown-black compounds called melanoidins which deposit in the skin. It has not been shown to be carcinogenic in animal studies.  Bronzers are water-soluble dyes that temporarily stain the skin and are easily removed with soap and water. Spray tans with DHA become apparent in 1 hour and maximal darkening occurs in 8-24 hours. The tan usually disappears over 5-7 days. There are no recommendations against sunless tanning, however there are important points to remember. Sunless tanning does not protect from UVR. Sunburn and sun damage may occur unless sunscreen and other sun protection methods are used. Sunless tanning products that contain added sunscreen only provide protection for a few hours after application. Additional sunscreen must be used afterwards every 2 hours.

Applying sunscreen and wearing protective clothing are the most important things to remember to protect your skin.  Sunscreen with SPF of at least 15 should be applied liberally 15-30 minutes prior to sun exposure to allow for absorption into the skin and to decrease the likelihood that the sunscreen will be washed off. Sunscreen should be reapplied every 2 hours after swimming, sweating or drying off with a towel. Higher SPF provides somewhat greater protection, but proper application and reapplication are more important. Clothing is an excellent UVR barrier since the protection does not diminish throughout the day unless the clothing becomes wet. Seeking shade is somewhat useful, but people can still sunburn because light is scattered and reflected. For example a fair-skinned person sitting under a tree can burn in less than an hour.

Skin Cancer Prevention The incidence of skin cancer is increasing in young adults and sun exposure is the main environmental cause. The factors that are contributing to this increased incidence include clothes that allow more skin exposure and increased exposure to artificial sources of UVR for tanning purposes. Melanoma is the 2nd most common cancer of women in their 20s and the 3rd most common cancer of men in their 20s. Prevention is key! The best way to prevent skin cancer is diligent use of sunscreen and wearing protective clothing. Also, plan outdoor activities before 10am and after 4pm to limit exposure to peak intensity midday sun.

Take-Home Points:

  • Do not burn
  • Avoid sun tanning and tanning beds
  • Wear protective clothing and hats
  • Seek shade
  • Use extra caution near water and sand -(even snow!)
  • Apply sunscreen
  • Wear sunglasses


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