If you perform an internet search of tanning sites and look for tanning myths you will get several thousand hits. The publication, and refutation, of tanning rumors is a significant part of the tanning business. It is very common to see a section of the website set aside for any tanning salon which reports on this subject. What is less clear is whether or not the claimed refutation of myths is credible or a myth in itself. The comments of a salon/business owner will obviously be intended to reduce client apprehension concerning whether or not they should tan. The salon earns its’ revenue by attracting customers, not scaring them away. As a result there will always be a vested interest in refuting anything that presents tanning as less than desirable. That does not automatically mean the salon is wrong, it just means the claims must be viewed in the context of their vested interest in shaping your perception. This will always be true of any other source of information as well, such as rumors from well intended friends, physicians, politicians, and even regulatory agencies. All must necessarily have an agenda and honest sources of information will reveal their sources and their biases when reporting claims. Also, every single one of us will necessarily view the world from the position of our own personal life experiences and education. This means that every single one of us will view the world, including tanning, with some predetermined bias. It’s unavoidable, and anyone who claims to present objective, unbiased information should be viewed with skepticism on the basis of just that claim alone.

The average consumer may not be skilled in analyzing claims to determine whether or not they are likely to be true. The U.S. Federal Trade Commission has regulations regarding what may or may not be claimed regarding advertising of indoor tanning services. The salon owner must comply with the regulations, but there are methods of circumventing them for those inclined to do so. There are also federal regulations under the U.S. Food and Drug Administration. These are found in 21 CFR 1040.20, and elsewhere. State regulations are usually the most specific and restrictive, yet many states still do not regulate the tanning industry. The bottom line is that in order for the average consumer to evaluate information presented as being a “myth” related to indoor tanning, it will require a certain amount of investigative work.

What are some of the most popular “myths” listed by tanning salons, their refutations, as well as a reasoned evaluation of both? Below are some common examples.

1. CLAIM: I’ve heard that indoor tanning is more harmful than tanning outdoors because the UV light exposure is more intense.
   
   • INDUSTRY RESPONSE: People tanning indoors are exposed to a scientifically calibrated amount of UV light. When used according to the U.S. Food and Drug Administration’s exposure guidelines (posted on each machine), tanning beds are designed to maximize tanning and minimize burning. Conversely, tanning outdoors is an unregulated environment. There are many factors that have to be considered when you tan outdoors: geography, time of day, weather conditions, the seasons, latitude, and the ozone layer.

   • REASONED CONSIDERATION: People who tan either indoors or outdoors are affected by several variables including:
     • Skin type which is really a genetically determined sensitivity to ultraviolet exposure.
     • Tanning history. If you have not been tanning regularly your tolerance to exposure will be lower.
     • Medications, cosmetics and foods used by the individual which may increase their sensitivity to ultraviolet radiation exposure.
     • Pre-existing disease which affects sensitivity to ultraviolet and may make it inadvisable to tan at all.
     • Use of tan enhancers.

     Outdoor tanning is subject to additional variables which include:

     • Season of the year
     • Time of day
     • Local Weather conditions, cloud cover
     • Ozone layer
     • Sunscreen use
     • Latitude*
     • Altitude*
     
     A serious tanner might approach these variables from a quasi-scientific perspective using calibrated meters, shadow screens, and other devices to more accurately measure and control the exposure. This would be extremely unusual, but in any event the amount of time spent in the sun, especially early in the season, can and should be carefully monitored.

     Note, especially, the last two items on the list; latitude and altitude. It is true that solar energy in general is different in intensity and spectral distribution at different latitudes and altitudes. It is also different in different countries, different depths under water, outer space, and etc. However, If you live in Phoenix, work in Phoenix, play in Phoenix and tan in Phoenix what difference does it make that the sunlight is different in Anchorage, Alaska or Mexico City? What difference does it make if the solar radiation in Leadville, Colorado (elevation 10,000') or on top of Mt. McKinley (20,320') is different than Phoenix? In other words, these two aspects of sunlight differences are generally irrelevant characteristics of scientific interest only. As a practical they do not relate to a meaningful comparison of outdoor tanning and indoor tanning unless you are both traveling and tanning a lot.

     Indoor tanning is also subject to several additional variables which include:

     • Timer accuracy
     • Condition of acrylic
     • Age of tanning bed lamps
     • Type of tanning bed lamps, especially if mixed in type
     • Functional status of ballast and starter
     • Distance from the source
     • Lamp compatibility

     The claim that an indoor tanning device is a scientifically calibrated source of ultraviolet light exposure is a mis-representation . When used according to the U.S. Food and Drug Administration’s exposure guidelines (posted on each machine) and in a business environment, tanning beds still are variable sources of ultraviolet exposure. The manufacturing of equipment and initial testing is performed in accordance with scientific principles, just as automobiles are manufactured and tested in accordance with scientific principles. However, in operation conditions are continually changing and unless the owner is trained in scientific investigation methods and uses properly calibrated meters to carefully measure output prior to and during each tanning session it is not applied scientifically. At current prices for a tanning session it would be prohibitive to conduct a truly scientifically controlled environment and there would be no customers. A business is not required or expected to achieve that level of performance, and it is incorrect to claim that it does. To my knowledge the only laboratory in the U.S. conducting that level of indoor tanning device testing on a routine basis is the Non-Ionizing Radiation Research Institute (NIRRI) in Arizona. Lamp manufacturers control only part of the equation. Timer manufacturers control another. Salon owners have control over other factors, to the extent that they do exert that control. Just as automobiles have numerous safety features built into a highly scientifically designed apparatus, it is how it is actually used (or mis-used) that results in over three million injuries and 40,000 deaths each year (according to the National Safety Council).

   Now, notice that in the initial response which directed attention to the idea that an indoor source is scientifically calibrated the fundamental point of the question was never actually answered. There were two points in the original question.. is indoor tanning more harmful than tanning outdoors? ....and if so is it because the UV light exposure is more intense?

   Indoor tanning may be more or less harmful for reasons that have little to do with the intensity of the ultraviolet radiation produced. Frequently we see in literature and on the net that indoor tanning is not "artificial ultraviolet", it is the same as sunlight. Also, claims are made that the intensity of the tanning lamps is twenty times (or ten times, or some other number) that of natural sunlight. Yet we see above that both outdoor and indoor tanning involves many variables. Some of the those variables skew the spectrum of the radiation that ultimately reaches our body, so that sunlight at different times or altitudes may have different components of UVA and UVB. The same is true of a tanning lamp that changes its emission spectrum as it ages, and the condition of the acrylics can alter the quality of the emission. An indoor tanning device is designed specifically to produce ultraviolet radiation at an intensity that will result in tanning within a relatively short time, so the intensity is obviously not negligible. But instensity is one component of output, and therefore any claim that a tanning lamp emits radiation that is ten, or twenty times as intense as sunlight is meaningless unless you know which lamp and which sunlight conditions are being compared. Tanning lamp emissions are intense, but are they more intense than sunlight on a clear day at high noon in Phoenix on July 4th? Maybe. It is certainly more intense than sunlight on that same day in Barrow, Alaska. And when we say they are more intense do we mean in terms of total energy output at a certain point from the source, or does this refer to only a comparison of the UVA and UVB of a new, non-reflective low pressure tanning lamp manufactured by Comedico? In other words, such an assertion is sloppy science, which is to say it is not a scientific response at all. It is an example of why we cannot claim indoor tanning is scientifically calibrated when we are not applying the scientific method to its use. There are aspects of indoor tanning that should be a concern for any customer, such as facility hygiene, equipment maintenance, and adequate instruction by the operator including screening for skin type, tanning history, eyewear, and UV sensitizing agents. Thus, depending on the operator of the salon indoor tanning at a particular salon may be more dangerous than outdoor tanning. Or it may not. There is no simple, unqualified answer of "yes" or "no" to the question.

   As already mentioned there are other important factors to consider besides the intensity of the ultraviolet radiation. Therefore, even if a particular facility is found to be operated in an unsafe manner it may or may not have anything to do with the intensity of the ultraviolet emissions. Simple, catchy, sound bites do not capture unbiased facts in a way that the customer can rely on. And they certainly do not represent a scientific calibration of the process.