Tanning Addiction 101

Tanning addiction isn’t well-understood or well-studied. The latest figures — which date to 2005 — found that approximately 30 million Americans each year use sunlamps, tanning booths and/or sunbeds to achieve an indoor tan. Most are driven by a simple desire to improve their appearance, and most will leave the salon a little browner and at a slightly higher risk for skin cancer, but otherwise unaffected.

An unfortunate few, however, will return over and over. Many researchers believe that compulsive tanning is driven by a need to re-experience the relaxing sensation of the chemicals that are released by the brain in response to  the UV light. Researchers have also found that individuals struggling with certain mental illnesses, most notably obsessive-compulsive disorder (OCD) or body dysmorphic disorder (BDD), are more prone to developing a tanning addiction than the general population. OCD is characterized by obsessive, repetitive thoughts and behaviors, and BDD involves an extreme preoccupation with small or nonexistent flaws in one’s appearance.

You should know:

  • The International Agency for Research on Cancer in 2009 placed tanning beds in its highest cancer risk category based on an analysis of 20 studies showing that use of a tanning bed before age 30 increases risk of melanoma by 75%. The agency describes tanning beds as “carcinogenic to humans,” meaning they are cancer-causing. And the World Health Organization recommends that no one under age 18 use a tanning bed.
  • Learning about the risks of tanning may not be enough to decrease the use of a tanning bed. A study of nearly 500 college students at a large public university in the Midwest found that nearly half had used a tanning lamp in the prior year, even though the vast majority were aware of the dangers of indoor tanning.
  • Tanning beds do have medical uses. For example, they’re sometimes used for the treatment of certain skin diseases, including psoriasis and dermatitis.

Causes

There’s very little research on why one person might become addicted to tanning while another does not. Researchers, for example, haven’t determined if experiences in early childhood might influence susceptibility to tanning addiction. Here’s what we know: It may be caused by an addiction to UV light. Research suggests that the craving to hit the tanning bed (or tan outside, though even less research has been done on outdoor tanners) appears to be driven by an addiction to the mood-altering effects of the UV light itself. In a randomized controlled trial, investigators at Wake Forest University in Winston-Salem, North Carolina, recruited 14 young adults who regularly used tanning beds and had them alternate between tanning beds that were identical except that one emitted UV light and the other non-UV light. Although the tanners weren’t told that the beds were different, after six weeks, when given an opportunity to tan for an extra day, 12  of the 14 opted for the extra exposure. Of the 12, all but one chose the bed with UV light. The tanners reported feeling more relaxed after UV exposure compared to non-UV exposure, which led the researchers to theorize that frequent tanners may be chasing not only the cosmetic effects of tanning but the chemical effects as well.

Brain imaging technology shows that during regular tanning sessions areas of the brain that have been implicated in addiction will light up. And when the UV light is filtered out, those same areas show less activity. A 2006 study in the Journal of the American Academy of Dermatology found that frequent tanners exhibited nausea and jitteriness similar to withdrawal symptoms when given medication prior to tanning that blocks the effects of endorphins. Among infrequent tanners, the drug had no effect.

Tanning addiction may be caused by a psychiatric disorder. Excessive tanning has been linked to some psychiatric disorders, including OCD and BDD. In fact, researchers from Brown University Medical School found that among 200 individuals with BDD, 25% reported tanning in response to BDD-related anxieties about their bodies. In addition, some compulsive indoor tanners may be driven by an underlying anxiety or mood disorder. Compulsive tanners have twice the rate of moderate-to-severe anxiety and depression of infrequent indoor tanners. Research also suggests that compulsive tanners might be more prone to seasonal affective disorder.

Symptoms of Tanning Addiction

If you feel a strong urge to go to indoor tanning facilities, relax under the UV light and leave darker than when you arrived, you may be a compulsive tanner. (You may have similar urges related to tanning outside as well.) As with other types of addiction, you might feel that you should cut back on tanning, but thinking about doing so makes you feel anxious.

In looking for signs that someone is at risk for tanning addiction, some researchers use a variation of the CAGE questionnaire, which was designed to screen for alcohol abuse. An adapted version for compulsive tanning would include some version of the questions below. Answering “yes” to two of the four questions would suggest that you or someone you love might have a problem with tanning:

  • Have you ever felt you should cut down on your tanning?
  • Have people annoyed you by criticizing your tanning?
  • Have you ever felt bad or guilty about your tanning?
  • Have you ever felt a need to tan first thing in the morning?

Other danger signs include:

  • Tanning three or four times a week or year-round
  • Missing out on important work, family or social events to tan
  • Becoming anxious when asked not to tan
  • Tanning to get the skin a certain color
  • Feeling concerned that you don’t appear tan when you are
  • Spending a lot of money on tanning and creams to maintain the tan
  • Becoming defensive when told you’re too tan or your skin looks wrinkled
  • Being diagnosed with skin cancer, yet still continuing to tan
  • Constantly thinking about and planning around tanning
  • Tanning more than necessary to maintain a tan

Risk Factors

Researchers aren’t certain what characteristics might raise someone’s risk for developing a tanning addiction. Some studies suggest that women may be more prone to develop the disorder, but the evidence is conflicting. Here’s what we know:

  • Early start. Those who begin tanning at age 13 or younger have more difficulty quitting than those who start at an older age.
  • Having another mental health issue. Compulsive tanners have higher-than-expected rates of depression, anxiety, eating disorders and substance use disorders. They’re also more likely to have OCD or BDD and are likelier to use and abuse marijuana and alcohol.
  • Smoking. It’s not clear why, but smokers have a greater likelihood of developing a tanning addiction than do non-smokers.
  • Normal weight. Obese people (meaning a body mass index, or BMI, equal to or greater than 30) are less likely to develop a tanning addiction than those who are underweight or normal weight.

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