Indoor tanning
Indoor tanning involves using a device that emits ultraviolet radiation to produce a cosmetic tan. Typically found in tanning salons, gyms, spas, hotels, and sporting facilities, and less often in private residences, the most common device is a horizontal tanning bed, also known as a sunbed or solarium. Vertical devices are known as tanning booths or stand-up sunbeds.
Indoor tanning became widespread in the Western world in the late 1970s. The practice finds a cultural parallel in skin whitening in Asian countries, and both support multibillion-dollar industries. Most indoor tanners are women, 16–25 years old, who want to improve their appearance or mood, acquire a pre-holiday tan, or treat a skin condition.
Indoor tanning can increase the risk of developing skin cancer. As such, the number and usage of tanning facilities have declined, and many countries have either banned the practice outright or banned it for use by people under 18 years of age.
Background
Ultraviolet radiation
Ultraviolet radiation is part of the electromagnetic spectrum, just beyond visible light. Ultraviolet wavelengths are 100 to 400 nanometres and are divided into three bands: A, B and C. UVA wavelengths are the longest, 315 to 400 nm; UVB are 280 to 315 nm, and UVC wavelengths are the shortest, 100 to 280 nm.About 95% of the UVR that reaches the earth from the sun is UVA and 5% UVB; no appreciable UVC reaches the earth. While tanning systems before the 1970s produced some UVC, modern tanning devices produce no UVC, a small amount of UVB and mostly UVA. Classified by the WHO as a group 1 carcinogen, UV radiation has "complex and mixed effects on human health". While it causes skin cancer and other damage, including skin aging or creases such as wrinkles, it also triggers the synthesis of vitamin D and endorphins in the skin.
History
In 1890 the Danish physician Niels Ryberg Finsen developed a carbon arc lamp that produced ultraviolet radiation for use in skin therapy, including to treat lupus vulgaris. He won the 1903 Nobel Prize in Physiology or Medicine for his work.Until the 20th century in Europe and the United States, pale skin was a symbol of high social class among white people. Victorian women would carry parasols and wear wide-brimmed hats and gloves; their homes featured heavy curtains that kept out the sun. But as the working classes moved from country work to city factories, and to crowded, dark, unsanitary homes, pale skin became increasingly associated with poverty and ill health. In 1923 Coco Chanel returned from a holiday in Cannes with a tan, later telling Vogue magazine: "A golden tan is the index of chic!" Tanned skin had become a fashion accessory.
In parallel physicians began advising their patients on the benefits of the "sun cure", citing its antiseptic properties. Sunshine was promoted as a treatment for depression, diabetes, constipation, pneumonia, high and low blood pressure, and many other ailments. Home-tanning equipment was introduced in the 1920s in the form of "sunlamps" or "health lamps", UV lamps that emitted a large percentage of UVB, leading to burns.
Friedrich Wolff, a German scientist and hailed as the "father of indoor tanning", began using UV light on athletes, and developed beds that emitted 95% UVA and 5% UVB, which reduced the likelihood of burning. In 1975, Wolff invented the sunbed. A tanning salon was opened two years later in Berlin, followed by tanning salons in Europe and North America in the late 1970s. In 1978, Wolff's devices began selling in the United States, and the indoor tanning industry was born.
Devices
Lamps
Tanning lamps, also known as tanning bulbs or tanning tubes, produce the ultraviolet light in tanning devices. The performance varies widely between brands and styles. Most are low-pressure fluorescent tubes, but high-pressure bulbs also exist. The electronics systems and number of lamps affect performance, but to a lesser degree than the lamp itself. Tanning lamps are regulated separately from tanning beds in most countries, as they are the consumable portion of the system.Beds
Most tanning beds are horizontal enclosures with a bench and canopy that house long, low-pressure fluorescent bulbs under an acrylic surface. The tanner is surrounded by bulbs when the canopy is closed. Modern tanning beds emit mostly UVA. One review of studies found that the UVB irradiance of beds was on average lower than the summer sun at latitudes 37°S to 35°N, but that UVA irradiance was on average much higher.The user sets a timer, lies on the bed and pulls down the canopy. The maximum exposure time for most low-pressure beds is 15–20 minutes. In the US, maximum times are set by the manufacturer according to how long it takes to produce four "minimal erythema doses", an upper limit laid down by the FDA. An MED is the amount of UV radiation that will produce erythema within a few hours of exposure.
High-pressure beds use smaller, higher-wattage quartz bulbs and emit a higher percentage of UVA. They may emit 10–15 times more UVA than the midday sun, and have a shorter maximum exposure time. UVA gives an immediate, short-term tan by bronzing melanin in the skin, but no new melanin is formed. UVB has no immediate bronzing effect, but with a delay of 72 hours makes the skin produce new melanin, leading to tans of longer duration. UVA is less likely to cause burning or dry skin than UVB but is associated with wrinkling and loss of elasticity because it penetrates deeper.
Commercial tanning beds cost $6,000 to $30,000 as of 2006, with high-pressure beds at the high end.
Booths
Tanning booths are vertical enclosures; the tanner stands during exposure, hanging onto straps or handrails, and is surrounded by tanning bulbs. In most models, the tanner closes a door, but there are open designs too. Some booths use the same electronics and lamps as tanning beds, but most have more lamps and are likely to use 100–160 watt lamps. They often have a maximum session of 7–15 minutes. There are other technical differences, or degrees of intensity, but for all practical intents, their function and safety are the same as a horizontal bed. Booths have a smaller footprint, which some commercial operators find useful. Some tanners prefer booths out of concern for hygiene, since the only shared surface is the floor.Eye protection
Eye protection for indoor tanning, either in the form of goggles, or disposable eye protection must be worn to avoid eye damage. In one 2004 study, tanners said they avoided using indoor tanning eye protection at times to prevent leaving the appearance of pale skin around the eyes.Prevalence
Tanning-device use
Indoor tanning is most popular with white females, 16–25 years old, with low-to-moderate skin sensitivity, who know other tanners. Studies seeking to link indoor tanning to education level and income have returned inconsistent results. Prevalence was highest in one German study among those with a moderate level of education.The late teens to early–mid 20s is the highest-prevalence age group. In a national survey of white teenagers in 2003 in the US, 24% had used a tanning facility. Indoor-tanning prevalence figures in the US vary from 30 million each year to just under 10 million.
The figures in the US are in decline: according to the Centers for Disease Control and Prevention, usage in the 18–29 age group fell from 11.3 percent in 2010 to 8.6 percent in 2013, perhaps attributable in part to a 10% "tanning tax" introduced in 2010. Attitudes toward tanning vary across states; in one study, doctors in the Northeast and Midwest of the country were more likely than those in the South or West to recommend tanning beds to treat vitamin D deficiency and depression.
Tanning bed use is more prevalent in northern countries. In Sweden in 2001, 44% said they had used one. Their use increased in Denmark between 1994 and 2002 from 35% to 50%. In Germany, between 29% and 47% had used one, and one survey found that 21% had done so in the previous year. In France, 15% of adults in 1994–1995 had tanned indoors; the practice was more common in the north of France. In 2006, 12% of grade 9–10 students in Canada had used a tanning bed in the last year. In 2004, 7% of 8–11-year-olds in Scotland said they had used one. The North East of England has been described as the “sunbed capital of the UK” with 43% of adults reporting they have used sunbeds at least once, the highest rate in the country, followed by Scotland at 38%, according to a survey by the charity Melanoma Focus. Sunbed use in the United Kingdom varies by region, with the lowest levels reported in Northern Ireland, followed by the South East, East Midlands, and West Midlands.
Density of facilities
Tanning facilities are ubiquitous in the US, although the figures are in decline. In a study in the US published in 2002, there was a higher density in colder areas with a lower median income and higher proportion of whites. A study in 1997 found an average of 50.3 indoor-tanning facilities in 20 US cities ; the highest was 134 in Minneapolis, MN, and the lowest four in Honolulu, Hawaii. In 2006 a study of 116 cities in the US found 41.8 facilities on average, a higher density than either Starbucks or McDonald's. Of the country's 125 top colleges and universities in 2014, 12% had indoor-tanning facilities on campus and 42.4% in off-campus housing, 96% of the latter free of charge to the tenants.There are fewer professional salons than tanning facilities; the latter includes tanning beds in gyms, spas and similar. According to the FDA, citing the Indoor Tanning Association, there were 25,000 tanning salons in 2010 in the US. Mailing-list data suggest there were 18,200 in September 2008 and 12,200 in September 2015, a decline of 30 percent. According to Chris Sternberg of the American Suntanning Association, the figures are 18,000 in 2009 and 9,500 in 2016.
The South West Public Health Observatory found 5,350 tanning salons in the UK in 2009: 4,492 in England, 484 in Scotland, 203 in Wales and 171 in Northern Ireland.