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A sunbed, with lights off.
A 'tanning bed' or 'sunbed' is a device emitting ultraviolet radiation (typically 95% UVA and 5% UVB, +/-3%) used to produce a cosmetic tan. There are a few units called "high pressure" beds that generate primarily UVA with some UVB but these are much less common and much more expensive. Regular tanning beds use several fluorescent lamps that have phosphor blends designed to emit UV in a spectrum that is somewhat similar to the sun. Smaller home tanning beds usually have 12 to 28 100 watt lamps while systems found in salons can run from 24 to 60 lamps each consuming 100 to 200 watts.
The maximum exposure time in most tanning beds is 20 minutes, but varies from bed to bed. This is calculated by the manufacturer according to the amount of time needed to produce 4 MEDs (minimal erythemal doses). This is essentially 4 times the amount of UV that is required to produce a reddening on unexposed skin. A person would start with a much shorter session time and work their way to the maximum exposure time in about 4 weeks. Every tanning bed is required to have a "Recommended Exposure Schedule" on both the front of the tanning bed and in the owners manual. It must also list the original lamp that was certified for that particular tanning bed, and salon owners must replace the lamps with either the exact same lamp, or a lamp that is certified by the lamp manufacturer to be legally equivalent. Lamp replacement and salon compliance is regulated by the individual state in the USA, whereas the manufacturing and sale of new equipment is regulated by the federal government.
Since many factors can change the performance of any given individual lamp, the FDA requires that every tanning bed model is certified separately, and lamps themselves do not have MED ratings. Lamps do have typical TE (or Time Exposure) ratings, but these are not used for certifying beds. Session times on beds can range from 5 minutes to 45 minutes, depending on many factors.
Because of several alleged adverse effects on human health, the World Health Organization does not recommend the use of UV tanning devices for cosmetic reasons[1]. For example, using a sunbed without goggles may lead to a condition known as arc eye.
Typical Usage
Typical tanning lamp with F71T12 markings. This example is a 71 inch, bi-pin, 100 watt model, the most common.
Europeans may enjoy tanning seasonally, but less so than Americans. This is due to many areas in Europe having significantly fewer days of sunshine than the USA, so Europeans are more likely to use a tanning bed all year long, for both the cosmetic and mood altering benefits. European tanning beds generally use a different type of lamp as well, with UVB ratings in the 1% to 3% range (using US measuring methods) whereas most tanning beds sold in the US use 4.2% to 6.5% UVB ratings, and aftermarket lamps with up to 8.5% or higher being popular. Of course, these lamps have less UVA and will produce a sunburn quicker, but many Americans seem to like them because a short session produces a "reddening", or instant gratification. These lamps actually produce a slower deep tan (but a faster base tan) that fades faster, but are simply marketed as "hotter", although technically they have about the same amount of UV but with different ratios of UVA and UVB.
While the primary reason for both Americans and Europeans to use a tanning bed is cosmetic, there are many other reasons why they are used. It is common for people to tan simply because it makes them feel good. Also, most tanning beds generate a large amount of heat, including infrared, which has deep penetrating action that can relieve minor muscle aches. People who use tanning beds for these reasons will often tan all year long, typically once or twice a week.
Most salon patrons visit the tanning bed every 1 to 3 days. A typical scenario is for a tanner to begin with 3 to 5 minute exposures, working toward the full 20 minute session (for most beds) over a period of 3 to 4 weeks. Many states require a minimum of 48 hours between tanning sessions, although this is almost impossible to enforce due to a lack of manpower in the regulatory agencies. Most states do require that the timing mechanism is located outside the room where the tanning bed is located, to prevent the customer from adding minutes, and unintentionally overexposing themselves. This is recommended even in states that do not require it, as it protects the customer and removes a potential liability to the salon.
The tan produced by a tanning bed is not as deep as a tan produced in the sun. This is due to the fact that tanning beds have higher overall levels of UV than the sun on a typical day, so the exposure times are shorter than the average session spent in the sun to achieve the same amount of tan. This can cause someone with a dark indoor tan to go outside and get a bad sunburn quickly because the deeper levels of their skin have not been exposed previously, and have no natural protection above what white skin would have. It is strongly recommended that a person does NOT tan indoor and outdoors on the same day, due to the likely chance that they will get overexposed. Because overexposure actually destroys melanin, getting a sunburn will result in LESS tanning. The popular wisdom that you "need to burn to tan" or that a sunburn will turn into a tan is simply wrong, and greatly increases your chances for skin cancer later in life.
Technical Information
Main articles: Tanning lamps
In many ways, tanning beds are simply light fixtures that you lie down on to tan. Most tanning beds use choke ballasts, a technology that has been around for about 100 years, consisting of a simple limiter device that permits a limited amount of current to pass through, thus regulating the power to each lamp. New systems include magnetic ballasts, electronic ballasts and more recently high frequency ballasts that induce tanning and other fluorescent lamps to work using less current, but at frequencies exceeding 100,000 hertz. In general, newer ballast designs produce less heat and are more energy efficient. All choke ballasts require 230V only because no one has found a need for 120V choke ballasts in tanning manufacturing.
The ballasts regulate the power that is sent to the lamps, so that if you install a 160W lamp in a tanning bed that has 100W ballasts, only 100W will be delivered to the lamp. The lamp will still ignite and offers no benefits over a 100W lamp, and may actually create less UV since it is designed for higher current. It will not damage the system, although installing 100W lamps with a 100W ballast will result in very short lamp life, as the 160W lamps are designed to run at a much higher temperature and use higher grade cathode/anode sets. The lamp starter part of the bed (small tan cylinder) is used only on beds with choke ballasts and is a simple plasma starting switch. It has no bearing on how powerful the bed is. Either it works (the lamp lights) or doesn't. They are installed one per lamp on beds that use them, and are generally replaced every couple of years in salons or every 6 to 10 years for home systems.
Like all fluorescent lamps (and other plasma devices such as neon lamps), low pressure tanning lamps work when the ballast directs enough energy to the lamp that a plasma is generated inside the lamp. The lamps are coated on the inside with special phosphors and contain a small amount of mercury (20mg typical). Unlike high pressure lamps, the glass that is used in low pressure lamps automatically filters out all UVC. Once the plasma is fully flowing (less than one second), the plasma literally strips away the outer electrons from the mercury, sending them into the phosphor, which produces photons in the proper spectrum for tanning. The electrons, now in a lower energy state, will jump back into place onto the first mercury atom they find with an electron missing.
The clear shields on a tanning bed are called acrylics because they are made from a 100% acrylic compound. It is a common mistake to call them plexiglass, which is a very different plastic that will block the majority of UV rays, while pure acrylic transmit the majority of UV in all frequencies. These shields break down over time as they are exposed to UV and oxygen and must be reconditioned every few years. Failure to do so will reduce the transparency of the acrylic to UV rays, although to the eye it will still appear perfectly clear. The reconditioning is most commonly done with a compound called Novus #2, which is a slighly gritty cleaning compound that removes a microlayer of the acrylic, restoring to near new condition and is used in many other industries.
Most mainstream tanning beds built today use similar electronics, with the primary differences being in the design and quality of the frame and shell of the bed, and the number and type of lamps used. The newer high frequency electronics are very promising because of their lower power usage and cooler running temperature, but their high cost has limited adoption. Newer 120V electronics can add $300 to the cost of the a similar 230V system using choke ballasts.
Risks - Skin Cancer, Reduced Immunity, and Aging of the Skin
Ultraviolet (UV) radiation in is the most prominent and universal cancer causing agent in our environment.[1] The US Department of Health and Human Services, Public Health Service, National Toxicology Program Report on Carcinogens (cancer causing agents) states that UV solar radation, and use of sun lamps and sun beds are "known to be a human carcinogen." [2] Further research has revealed the implications for tanning beds. Some scientists have suggested recently that there may be an association between UVA radiation (the type of radiation that makes up most of the radiation in tanning beds) and malignant melanoma, the most dangerous form of skin cancer.[3] There is persuasive evidence that each of the three main types of skin cancer, basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and melanoma, is caused by sun exposure.[4]Women who visited a tanning parlor at least once a month were 55% more likely to later develop melanoma than women who didn't artificially suntan. Those who used sun lamps to tan while in their 20s had the greatest later risk, about 150% higher than similarly aged women who shunned tanning beds. [5]
Exposure to ultraviolet radiation induces two of the most common DNA mutations known in cellular biology. Those include cyclobutane–pyrimidine dimers (CPDs) and 6–4 photoproducts (6–4PPs) and their Dewar valence isomers.[6]. Cells have developed a number of repair mechanisms to counteract the DNA damage caused by ultraviolet radation and other toxins. In human cells, a repair process is initiated after DNA damage is detected in which the damaged DNA is removed before it is replicated. As humans age, their cellular repair mechanisms make more errors because they have accumulated years of oxidative stress from daily life.[7]. Over time, it is more difficult for the cell to find and destroy aberrant DNA. The replication of damaged DNA leads to cancer, and exposure to UV radiation sets a process in motion that can take decades to ultimately cause skin cancer[8]. Similarly, most people who smoke cigarettes do not get lung cancer until decades of use have passed. Most critically, if a mutation occurs within a gene that regulates cell division, the cell becomes prone to malignancy. For example, squamous cell carcinoma (a type of skin cancer) is caused by a UVB induced mutation in the p53 gene.[9]
Exposure to UV radiation has a detrimental effect on the immune system. Exposure causes changes in antigen presentation by Langerhans cells and macrophages. Also, the activities of natural killer cells and T cells is reduced. Last, cytokine regulation is disrupted by UV exposure. [10] Ultraviolet radiation exposure may facilitate the growth of skin neoplasms and the spreading of skin-associated infections due to stimulation of suppressor T cells.[11]
While the dangers of UVB are widely recognized[12][13][14], it has been convenient to regard UVA as 'safe'. UVA is less likely to burn the skin, and it has been called the "bronzing light." However, it is clearly associated with inducing aging changes in the skin and in promoting the development of skin cancer. This is because UVA penetrates the skin more deeply than UVB, and therefore causes damage on a deeper level. Most aging of skin is due to UVA rays destroying collagen and connective tissue beneath the superficial layer of the skin. UVB rays do not reach as far below the skin. Excessive exposure to UVA radiation will cause premature aging, including wrinkles, sunspots, and loss of skin elasticity.[15]
Awareness of the risks of tanning beds does not influence tanning behavior among college students.[16]
Tanning Beds vs. Natural Sunlight
Tanning beds have a different ratio of UVA to UVB radiation than sunlight does. Furthermore, the radiation levels are more intense, requiring individuals to limit their exposure to very brief periods. One unanswered question is: what is the effect on the human body when it is forced to absorb such a large amount of UVA radiation in such a short amount of time? For example, one study found that the amount of UVA radiation, which penetrates deeper into the skin, was anywhere from about 3-8 times greater in the tanning beds than in the light from the sun. [17]
While there appears to be a link between indoor tanning beds and cancer[3][19][20], the connection is not possible to indisputably prove because people who tan indoors also tan outdoors. Furthermore, cancer shows up decades after exposure. Last, there is a genetic component to skin cancer. None of this changes the fact that there are risks associated with exposure to UVA and UVB for anyone who is exposed for any length of time, regardless of whether or not they burn (see above for the description of the process by which ultraviolet light damages DNA).
Last, while living in a constantly sunny climate may confer some benefits, intermittent exposure to strong sunlight may be more important in the etiology of melanoma than chronic long-term exposure. Therefore the "weekend" or "vacation" tanner is at greater risk due to the intermittent nature of such exposure.[21]
Hygiene Concerns
Some have found that tanning beds can be a vector for infections of pubic lice, also known as crabs.[22] If the surface of the bed is not properly cleaned or if towels provided by the salon are not washed in hot water, crab lice can survive for several days on these surfaces. Crab lice are difficult to see on the acrylic of a dimly lit tanning bed, and they are not killed by anti-bacterial or anti-viral cleaning agents used in salons. They can only be killed by physical removal or by the use of insecticides such as pyrethrin.
Benefits
Exposure to UVB[23] light (regardless of source) leads to production of vitamin D in the skin. Vitamin D is necessary for many cellular functions such as calcium absorption.
Tanning makes most people feel good. To understand how this happens, researchers set out to determine if endorphin levels were increased after tanning. They concluded that there were no significant differences in the mean plasma levels of β-endorphin between people who were exposed to tanning beds and those who were not[24] The positive psychological benefits of tanning may be due to factors other than endorphins.
It is believed that indoor tanning beds are useful for the treatment of SAD (Seasonal Affective Disorder)[25][26] though this is disputed at present[27]. It is plausible that the benefit that many SAD patients experiece are more due to tanning causing them to feel good in general, rather than treat the SAD itself.
While a tan that is developed in a tanning bed does offer some protection from overexposure to the natural sun, it is more cosmetic than a natural tan. A tan provides a natural SPF of between 2 and 4. Depending on the intensity of the sun outside, it may be advisable to use additional lotion with SPF even if a base tan is present.
A more controversial benefit of tanning indoors rather than tanning outside is the amount of control the tanner has. If a person decides to get a suntan and wants to minimize the risk of getting a sunburn, a tanning bed offers an environment that delivers virtually the same amount of UV in a given period of time, day after day. In contrast, the amount of UV that reaches the ground can vary from minute to minute and the longer tanning times results in deeper exposure. This doesn't make the tan in a tanning bed safer per se, but it can reduce the chance of a sunburn.
One of the most commonly mentioned benefits of tanning in a tanning bed is time savings. Most tanning beds offer a maximum session time of 20 minutes. After a desired level of tan has been achieved, a person can maintain that level of color with typically 1 to 2 sessions per week, which can often be accomplished in a lunch hour. For individuals living in urban areas, or who work extended hours, a tanning bed may be the only opportunity for tanning or UV exposure of any kind.
Compared to tanning outside, other benefits include comfort, available of tanning even if it is cloudy or late at night, tanning inside is cooler than in the hot sun, you don't get tan lines if you decide to tan nude, and socialization. In many communities (particularly smaller towns), the tanning salon is a social place, like a hair salon (and sometimes both are the same place) and offers stay-at-home parents an opportunity to get out of the house and socialize.
Medical Use
Some people with psoriasis or eczema are treated with UV light therapy (known as PUVA, for Psoralens and UVA radiation) to lessen the symptoms[28]. In some extreme circumstances the purchase of home tanning beds have even been prescribed by doctors and is covered by many insurance policies .
Tanning may temporarily help some forms of acne by drying out the skin, but it is not a solution that lasts for very long.[29][30][31]. Further, most prescription or over the counter acne medications (e.g. Accutane, Benzoyl Peroxide, Retin-A) should not be used in combination with tanning beds or the user may experience negative side effects from burning to delayed healing.
Addiction
Addiction to tanning, unofficially termed "tanorexia," may be due to several underlying psychological issues. Symptoms include a false and persistent belief that he or she is too pale, and will therefore exceed normally accepted limits of UV exposure. The individual will seek out this exposure indoors or outdoors, with the fruitless goal of obtaining a tan that is dark enough for his or her tastes. This condition is likely to be comorbid with body dysmorphic disorder.[32]. Neither tanning addiction nor tanorexia are covered under the latest edition of the DSM-IV, though they are most likely versions of similar problems already on record. To that end, a 2005 article in The Archives of Dermatology presents a case for UV light tanning addiction to be viewed as a type of substance abuse disorder. [33]
History
Although tanning beds were initially brought to America by Friedrich Wolff in 1978, he soon patented his particular blend of phosphors (since expired) and began licensing the technology to other companies. Wolff Systems has since devoted all their resources into lamp technology and development. Some of the early adopters of the Wolff technology include ETS, Inc., SCA, Sun Industries, Inc., Montego Bay, Sunal. Later, Friedrich sold Wolff Systems to his brother Jorg Wolff, who was the founder of Cosmedico, Ltd., another pioneer in the tanning industry.
Initially, tanning beds were virtually unregulated in the US, but in 1988 (and later updated in 1999) the primary source of regulation at the federal level was 21 CFR 1040.20. This law was designed primarily to ensure that all tanning beds sold or used in salons adhered to a general set of safety rules, with the primary focus on tanning bed and lamp manufacturers in regards to maximum exposure times and product equivalence. It is left up to each individual state to determine the regulations for salons themselves, and as such, many states are still not regulated beyond these basic federal rules.
Several companies continue to license the Wolff name and use their lamps because of the name recognition, although this has steadily diminished over the years as other lamp builders have created lamps that are arguably as good as or better. Licensing is not required to use Wolff lamps, but it is required to call a tanning bed a "Wolff System" and use the Wolff System logo, a yellow circle with horizonal bars and the name "Wolff Systems" in black. Tanning beds that use Wolff products but do not pay royalties can use only the term "Powered by Wolff," which is unique in the industry.
Most modern tanning beds have not changed much from the original systems. The lamp technology and electronics have evolved over the years, but the basic "low pressure" tanning bed has not evolved. The original electronics used in the first tanning beds, both "European choke" and magnetic, are still in use today although there are now many other choices including electronic and high frequency. The lamps are still fluorescent type, using special phosphors that create a spectum in the UVA and UVB range although there has been a great deal of advancement over the years to make the light spectrum they emit more "sun-like".
The first original tanning lamps were discovered by accident in 1903 by a German company called Heraeus who were developing lighting systems for the home and for industrial usage. These lamps were of the high-pressue metal halide variety. They discovered that the light that was developed for visible light purposes also emitted ultra-violet light. In the 1920s and 1930's they (Heraeus) first started to market and sell single lamp, self standing tanning/wellness devices. The first high-pressure tanning beds incorporating more than a single high-pressure lamp were manufactured in the mid to late seventies by companies such as Ultrabronz and JK Ergoline and in the 1980s the first high-pressure units were exported to the United States.
These units require special filter glass to remove the UVC and the majority of the UVB that is emitted and are difficult to manufacture because the alignment of the lamps is more critical than in traditional low-pressure tanning beds. They are generally large units, with a padded area to lie on or an acrylic and 6 to 36 lamps in a canopy or canopy and bench configuration, the tanning effect is much deeper and requries only a maintenance exposure of about 2-3 times per month compared to every 48 hours for regular tanning beds. They are much more expensive to operate, thus more expensive for the user. Retail prices in the $20,000 to $35,000 range are common with individual sessions costing $20 to $45, depending on the market.
Current Trends
A growing trend is the home tanning bed. Many people are now opting to own their own tanning system instead of going to the salon. The primary reasons are sanitation concerns and convenience. The average home system has 16 to 24 lamps, and costs $2000 to $3000, making it price competitive (over a number of years) for tanners who frequent salons regularly. This has led to an explosion of retailers that feature smaller, home style tanning beds both on the internet and in traditional retail stores.
Another trend is spray on tanning (a form of sunless tanning), using either special booths or a hand held setup similar to an airbrush. Many people who try spray on tanning often still go to the tanning salon, and use the spray on as a way to jump start the appearance of a tan, while others use it as a way to look tan while avoiding UV exposure of any kind. This is also demonstrated by the large number of indoor tanning lotions that have "bronzers" included, which is similar to the chemicals used for spray on tans, DHA.
See also
★ Sunless tanning
★ Tanning lamp
★ Tanning booth
★ Tanorexia
★ Buck-boost transformer
External links
★ TanningBeds.org Q & A blog for owners of older tanning beds
★ Title 12 CFR 1040.20 US FDA regulations that cover tanning lamps and devices
★ WHO - Artificial tanning sunbeds: risk and guidance
★ How Stuff Works - Sunless Tanning
★ Health Politics: The Trouble with Tanning Beds
★ ITA - Indoor Tanning Association
★ BBC NEWS: "Doctors' call to regulate sunbeds"
★ Danger of Ultraviolet Radiation
★ The Case Against Indoor Tanning
References
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2. http://ntp.niehs.nih.gov/index.cfm?objectid=72016262-BDB7-CEBA-FA60E922B18C2540
3. http://www.fda.gov/cdrh/consumer/tanning.html
4. http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=11684447&dopt=Citation
5. Veierod, M. The Journal of the National Cancer Institute, Oct. 15, 2003; vol 95: pp 1530-1538 cited from http://www.webmd.com/melanoma-skin-cancer/news/20031016/tanning-salons-boost-skin-cancer-risk
6. http://www.rsc.org/publishing/journals/PP/article.asp?doi=b201230h
7. http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=11525876&dopt=Abstract
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13. http://www.nature.com/jid/journal/v95/n5/abs/5612809a.html
14. http://carcin.oxfordjournals.org/cgi/content/abstract/19/5/723
15. http://content.nejm.org/cgi/content/abstract/337/20/1419
16. http://archderm.ama-assn.org/cgi/content/abstract/138/10/1311
17. Woollons, A., Clingen, P.H., Price, M.L., Arlett, C.F., Green, M.H.L. (1997). Induction of mutagenic DNA damage in human fibroblasts after exposure to artificial tanning lamps. British Journal of Dermatology 1997; 137: 687-692.
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http://www.healthguidance.org/entry/1659/1/Seasonal-Affective-Disorder-and-Tanning-Salons.html
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33. http://archderm.ama-assn.org/cgi/content/abstract/141/8/963
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