Sunless tanners could reduce sunbathing time: Study

By Dr. Ananya Mandal, MDDec 21 2011

Sunless tanners like creams and sprays that fake a tan may reduce their sunbathing time and tanning bed use, according to a new study. “Using the sunless tanners can change tanning behaviors,” says researcher Suephy C. Chen, associate professor of dermatology at Emory University School of Medicine. “People who used the sunless tanners decreased the number of times they laid out or went to tanning booths.”

In the study, nearly 37 percent of people who used sunless tanning products and sunbathed reported they cut down their sunbathing time. And 38 percent who used sunless tanners and tanning beds cut back on the tanning bed sessions. The study is published online in the Archives of Dermatology.

“There is a controversy among dermatologists about whether to promote sunless tanning,” Chen says. “Some think it sends a message that tanning is OK.” Others are more pragmatic, she says. They figure many people won't give up trying to tan, so they should point them to safer options that don't carry a risk of skin cancer.

Nearly 93 percent of the 415 women Chen polled said tanned skin is more attractive than pale. Nearly 80 percent said they feel better about themselves when tan. Chen's team set out to discover if using the sunless tanning products would reduce exposure to ultraviolet (UV) radiation from the sun and to tanning beds.

The team interviewed women aged 18 to 71 from the Emory University campus and the surrounding community. The average age was about 28. Most of the women had fair skin, classified as white or very white. While 201 women used self tanners; 214 did not. Those who used the self-tanners had an average age of 27. Thus among the women surveyed, 48.4% used self-tanning products at least once in the previous year. In addition, 70.6% tanned in the sun, 26% used tanning beds and 25.3% did both.

But among women who used tanning products and sunned themselves, 36.8% said they had cut back on tanning in the sun because they were using self-tanners. Among those who used the products along with tanning beds, 38% said they reduced their use of the devices. Chen found, the more they used the sunless tanning, the more likely they were to reduce the use of sunbathing or tanning beds.

Tanned skin was highly prized among the study participants - 92.7% of them felt that bronzed skin is more attractive than pale and 79.2% of them said they felt better when they had some color. What compelled them to use self-tanners in the first place? Women viewed them as safer than getting tan via the sun or tanning beds, and they were afraid of getting wrinkles.
The study authors noted that a history of skin cancer, regular use of tanning beds or sun tanning, and feeling better about oneself after tanning were among the predictors of self-tanning product use.

While the decline is welcome, Chen wishes it were a greater decline. The researchers did not specify which types of sunless tanning products the women used. Some used do-it-yourself products at home and others got their spray tans at salons. “The overwhelming majority did it at home,” Chen says. They studied only women because they are the primary users of the sunless tanning products.

The authors were encouraged by the drop in actual tanning among women who used self-tanning products. “If we can persuade them to use STPs periodically or before special occasions, when they may otherwise choose to visit a tanning bed or a sunny beach,” they wrote, “we may be able to significantly alter UV [radiation] tanning behaviors.”

“This is a very powerful study,” says Jeffrey S. Dover, an associate clinical professor of dermatology at Yale University, and a Boston-area dermatologist. He was not involved in the research. The findings are a welcome relief from all the negative skin cancer news, such as increases in skin cancers among younger people, says Dover, a spokesman for the American Academy of Dermatology. The finding that most women in Chen's study think they look better with a tan is an important message for dermatologists, Dover noted. Instead of discouraging patients from tans altogether, he says, they can point to the good news. “The positive message here is sunless tanning is safe; tanning beds and going to the beach is not.”

“[W]e would prefer that people were nicely pale and pasty, but it’s just not the way it is — people want to be tan,” Dr. Jonette Keri, an associate professor of dermatology at the University of Miami Miller School of Medicine said. “We need to get away from the idea that a tan is healthy. But if you want a tan, sunless tanning products are not a bad way to go.”

More than 2 million cases of non-melanoma skin cancer are diagnosed each year in the U.S. In 2010, more than 68,000 new cases of the more deadly skin cancer, melanoma, were found, according to the American Cancer Society.

Barbara Reed, a Denver dermatologist and clinical professor of dermatology at the University of Colorado Hospital, Denver, however warned that rashes have been reported by some using the products. The FDA cautions users not to inhale the sunless tanning creams and lotions. In most sunless tanning products, the active ingredient is DHA (dihydroxyacetone). It reacts with the cells found in the outermost skin layer to darken the appearance of the skin temporarily.