Can a tan be healthy?

Some people think that tanning gives them a healthy glow. But tanning, either outdoors or indoors with a tanning bed, is not healthy at all. It exposes you to harmful rays and puts you at risk for health problems such as melanoma and other skin cancers.

What are UV rays, and how do they affect the skin?

Sunlight travels to earth as a mixture of both visible and invisible rays. Some of the rays are harmless to people. But one kind, ultraviolet (UV) rays, can cause problems. They are a form of radiation. UV rays do help your body make vitamin D, but too much exposure damages your skin. Most people can get the vitamin D that they need with only about 5 to 15 minutes of sun exposure two to three times a week.

There are three types of UV rays. Two of them, UVA and UVB, can reach the earth's surface and affect your skin. Using a tanning bed also exposes you to UVA and UVB.

UVB rays can cause sunburn. UVA rays can travel more deeply into the skin than UVB rays. When your skin is exposed to UVA, it tries to protect itself from further damage. It does this by making more melanin, which is the skin pigment that makes your skin darker. That's what gives you a tan. This means that your tan is a sign of skin damage.

What are the health risks of tanning?

Since tanning means overexposure to UV rays, it can damage your skin and cause health problems such as

• Premature skin aging, which can cause your skin to become thickened, leathery, and wrinkled. You may also have dark spots on your skin. These happen because long-term exposure to UV rays makes your skin less elastic. The more sun exposure you have, the earlier your skin ages.
• Skin cancers, including melanoma. This can happen because the UV light damages the DNA of your skin cells and interferes with your body's ability to fight the cancer.
• Actinic keratosis, a thick, scaly patch of skin that usually forms on areas exposed to the sun, such as the face, scalp, back of the hands, or chest. It can eventually become cancerous.
• Eye damage, including cataracts and photokeratitis (snow blindness)
• A weakened immune system, which can increase your sensitivity to sunlight, decrease the effects of immunizations, and cause you to have reactions to certain medicines.

What should I do to protect my skin from UV rays?

• Limit sun exposure. Try to stay out of the sun between 10 a.m. and 4 p.m., when its rays are strongest. But remember that you still get sun exposure when you are outside on cloudy days or are in the shade.
• Use sunscreen with sun protective factor (SPF) 15 or higher. It should also be a broad spectrum sunscreen, which means that it gives you both UVA and UVB protection. If you have very light skin, use SPF 30 or higher. Apply sunscreen 20-30 minutes before going outside, and reapply it at least every 2 hours.
• Wear sunglasses that block both UVA and UVB rays. Wrap-around sunglasses work best because they block UV rays from sneaking in from the side.
• Wear a hat. You can get the best protection with a wide-brimmed hat that is made out of a tightly woven fabric, such as canvas.
• Wear protective clothing such as long-sleeved shirts and long pants and skirts. Clothes made from tightly woven fabric offer the best protection.

It is also important to check your skin once a month. If you do see any new or changing spots or moles, go see your health care provider.

Isn't indoor tanning safer than tanning in the sun?

Indoor tanning is not better than tanning in the sun; it also exposes you to UV rays and damages your skin. Tanning beds use UVA light, so they expose you to a higher concentration of UVA rays than you would get by tanning in the sun. Tanning lights also expose you to some UVB rays.

Some people think that getting a "base tan" in a tanning salon can protect you when you go in the sun. But a "base tan" causes damage to your skin and will not prevent you from getting sunburn when you go outside.

Indoor tanning is particularly dangerous for younger people. You have a higher risk of melanoma if you started doing indoor tanning while you were a teen or young adult.

Some research shows that frequent tanning may even be addictive. This can be dangerous because the more often you tan, the more damage you do to your skin.

Are there safer ways to look tan?

There are other ways to look tan, but they are not all safe:

• Tanning pills have a color additive that turns your skin orange after you take them. But they can be dangerous and are not approved by the Food and Drug Administration (FDA).
• Sunless tanners have no known risk for skin cancer, but you do have to be careful. Most spray tans, lotions, and gels use DHA, a color additive that makes your skin look tan. DHA is considered safe for use on the outside of your body by the FDA. You need to make sure it doesn't get into your nose, eyes, or mouth. If you use a spray tan, be careful not to breathe in the spray. Also, remember that these "tans" do not protect you from UV rays when you go outside.

Factors such as age, health, and skin type all determine how an individual will be affected by UV exposure.

People over the age of 50 and under the age of 5 are generally more sensitive to the harmful effects of UV. Those with immune deficiencies and chronic diseases also tend to be more susceptible to the side-effects of UV exposure.

In general, people with medium to dark complexions are less sensitive to UV exposure. Although people with darker complexions are less likely to get skin cancer than people with lighter complexions, they can still develop malignancies and suffer all forms of UV damage.

Dermatologists divide human skin into six types. Type I is the most sensitive and type VI is the least sensitive. People with skin type I are at a particularly high risk and should try to avoid exposure to UV.

People who need to be especially careful in the sun are those who have:

• Pale skin
• Blonde, red, or light brown hair
• Been treated for skin cancer
• A family member who’s had skin cancer

Certain oral and topical medicines, such as antibiotics, birth control pills, and benzoyl peroxide products, as well as some cosmetics, may increase skin and eye sensitivity to UV in all skin types. Check the label and ask your doctor for more information.

What it is:

Sunburn, also called erythema, is one of the most obvious signs of UV exposure and skin damage. Often marked by redness and peeling (usually after a few days), sunburn is a form of short-term skin damage.

Why it happens:

When UV rays reach your skin, they damage cells in the epidermis. In response, your immune system increases blood flow to the affected areas. The increased blood flow is what gives sunburn its characteristic redness and makes the skin feel warm to the touch. At the same time, the damaged skin cells release chemicals that send messages through the body until they are translated as a painful burning sensation by the brain.

White blood cells, which help protect you from infection and disease, attack and remove the damaged skin cells. It is this process of removing damaged cells that can cause sunburned skin to itch and peel.

Symptoms:

The earliest signs of sunburn are skin that looks flushed, is tender or painful, or gives off more heat than normal. Unfortunately, if your skin tone is medium to dark you may not notice any obvious physical signs until several hours later. It can take 6 - 48 hours for the full effects of sunburn to appear.

Treatment:

The American Academy of Dermatology (AAD) recommends treating mild sunburn with cool baths, over-the-counter hydrocortisone creams, and aspirin to ease pain and swelling.

Severe sunburn should be treated as a medical emergency and examined by a doctor right away. Severe sunburn is often characterized by a large area of red, blistered skin with a headache, fever, or chills.

The Bottom Line:

Sunburn can be a very painful effect of UV exposure. Studies have shown a link between severe sunburn and melanoma, the deadliest form of skin cancer. Pay careful attention to protecting yourself from UV rays.

What it is:

There is no such thing as a safe tan. The increase in skin pigment, called melanin, which causes the tan color change in your skin is a sign of damage.

Why it happens:

Once skin is exposed to UV radiation, it increases the production of melanin in an attempt to protect the skin from further damage. Melanin is the same pigment that colors your hair, eyes, and skin. The increase in melanin may cause your skin tone to darken over the next 48 hours.

Symptoms:

Skin tones that are capable of developing a tan, typically skin types II through V, will probably darken in tone within two days.

The Bottom Line:

Evidence suggests that tanning greatly increases your risk of developing skin cancer. And, contrary to popular belief, getting a tan will not protect your skin from sunburn or other skin damage. The extra melanin in tanned skin provides a Sun Protection Factor (SPF) of about 2 to 4; far below the minimum recommended SPF of 15.

What it is:

Sometimes referred to as “photoaging,” premature aging is the result of unprotected UV exposure. It takes the form of leathery, wrinkled skin, and dark spots.

Why it happens:

Although the causes of premature aging are not always clear, unprotected exposure to harmful UV rays break down the collagen and elastin fibers in healthy young skin, and cause wrinkles and loosened folds. Frequent sunburns or hours spent tanning can result in a permanent darkening of the skin, dark spots, and a leathery texture.

Symptoms:

• Wrinkles
• Dark spots
• Leathery skin

Treatment:

A dermatologist or plastic surgeon can develop a treatment plan based on your needs. Treatments can include chemical peels, dermabrasion, and skin fillers.

The Bottom Line:

Premature aging is a long-term side effect of UV exposure, meaning it may not show on your skin until many years after you have had a sunburn or suntan. Avoiding UV exposure is essential to maintaining healthy skin.

What it is:

There are two main types of skin cancer:

• Melanoma
• Non-melanoma

Melanoma is the less common, but more dangerous form of skin cancer, and accounts for most of the deaths due to skin cancer each year. Melanoma is cancer that begins in the epidermal cells that produce melanin (melanocytes). According to the American Cancer Society (ACS) melanoma is almost always curable when detected in its early stages.

Non-melanomas (basal cell and squamous cell carcinomas) occur in the basal or squamous cells located at the base of the epidermis, both inside and outside the body. Non-melanomas often develop in sun-exposed areas of the body, including the face, ears, neck, lips, and the backs of the hands.

Why it happens:

Predisposition to skin cancer can be hereditary, meaning it is passed through the generations of a family through genes. There is also strong evidence suggesting that exposure to UV rays, both UVA and UVB, can cause skin cancer.

UV radiation may promote skin cancer in two different ways:

• By damaging the DNA in skin cells, causing the skin to grow abnormally and develop benign or malignant growths.
• By weakening the immune system and compromising the body’s natural defenses against aggressive cancer cells.

Symptoms:

Performing regular self skin cancer exams is a good way to protect yourself against skin cancer. The following are possible signs of skin cancer, and should be checked by a doctor.

• Any changes on the skin, especially in the size or color of a mole, birthmark, or other dark pigmentation
• Unexplained scaliness, oozing, or bleeding on the skin's surface
• A spot on the skin that suddenly feels itchy, tender, or painful

Treatment:

Skin cancer treatment varies depending on the type and severity of the cancer. Your doctor will develop a treatment plan based on your needs.

The Bottom Line:

According to the American Cancer Society, most of the more than one million skin cancers diagnosed each year in the U.S. are considered sun-related. Skin cancer occurs in people of all skin tones, though it is less common in those with darker skin tones. Assessing your risk with the help of your doctor, protecting your skin, and performing regular skin cancer checks are the best methods of prevention.

What it is:

A fourth type of growth, actinic or solar keratoses, is a concern because it can progress into cancer. Actinic keratoses are considered the earliest stage in the development of skin cancer, and are caused by long-term exposure to sunlight. They are the most common pre-malignant skin condition, occurring in more than 5 million Americans each year.

Symptoms:

Actinic or solar keratoses share some of the symptoms of skin cancer. Look for raised, rough-textured, or scaly bumps that occur in areas that have been sunburned or tanned.

Treatment:

Most cases of actinic keratoses are easily treated in a dermatologist’s office by removing them with liquid nitrogen or chemical peels.

The Bottom Line:

Actinic or solar keratoses are the most common pre-malignant skin condition. Check with your doctor if you find any suspicious-looking bumps.

What it is:

Photokeratitis can be thought of as a sunburn of the cornea. It is caused by intense UVC/UVB exposure of the eye. Photokeratitis is also called “snow blindness” because many people develop this condition at high altitudes in a snowy environment where the reflections of UVB are high. This condition can also be produced by exposure to intense artificial sources of UVC/UVB, like broken mercury vapor lamps, or certain types of tanning lamps.

Symptoms:

• Tearing
• Pain
• Swollen eyelids
• A feeling of sand in the eye
• Hazy or decreased vision

Treatment:

Consult your doctor if you have any of these symptoms. Your doctor can prescribe a topical solution which will aid your cornea in healing. Since the cornea usually heals in 24 to 48 hours, the symptoms are not long-lasting.

What it is:

Cataracts are one form of eye damage that research has shown may increase with UV exposure. Clouding of the natural lens of the eye causing decreased vision and possible blindness are all effects of cataracts.

Other types of eye damage include cancer around the eyes, macular degeneration, and irregular tissue growth that can block vision (pterygium).

Symptoms:

Consult your doctor if you experience any of the following symptoms.

• Clouded or spotty vision
• Pain or soreness in and around the eyes

Treatment:

Cataracts can be surgically removed.

The Bottom Line:

Wearing sun protection gear such as a wide-brimmed hat and sunglasses with 100% UV protection can help decrease the risks of eye damage.

According to the World Health Organization (WHO), all people, regardless of skin color, are vulnerable to the effects of immune suppression. Overexposure to UV radiation may suppress proper functioning of the body’s immune system and the skin’s natural defenses, increasing sensitivity to sunlight, diminishing the effects of immunizations or causing reactions to certain medications.

In people who have been treated for an infection of the Herpes simplex virus, sun exposure can weaken the immune system so that it can no longer keep the virus under control. This results in reactivation of the infection and recurring cold sores.

Sun safety is always in season. It’s important to protect your skin from sun damage throughout the year, no matter the weather. Why? Sun exposure can cause sunburn, skin aging (such as skin spots, wrinkles, or “leathery skin”), eye damage, and skin cancer, the most common form of cancer in the U.S.

Skin cancer is on the rise in the U.S. The National Cancer Institute estimates there will be 99,780 new cases of skin melanomas and 7,650 related deaths in 2022. In 2019, there were an estimated 1.3 million people living with melanoma of the skin in the U.S. About 4.3 million people are treated for basal cell carcinoma and squamous cell carcinoma, two of the most common types of skin cancer, in the U.S. every year, according to published data from the Centers for Disease Control and Prevention.

The U.S. Food and Drug Administration continues to evaluate sunscreen products to ensure that they are safe and effective. Sunscreens help protect people from sunburn and, for broad spectrum products with sun protection factor (SPF) values of at least 15, from skin cancer and early skin aging caused by the sun when used as directed with other sun protection measures.

As you may have recently heard, certain spray sunscreens have been recalled because of benzene contamination. The FDA recommends that consumers not use recalled sunscreens. Find out here if your sunscreen has been recalled. The FDA continues to monitor the quality of drugs and, when appropriate, encourages retailers to remove products from store shelves and online marketplaces when issues arise. Consumers should continue to use sunscreen, along with other sun protection measures, to reduce risks from sun exposure.

Lower Your Risk for Sunburn, Skin Cancer, and Early Skin Aging

Sun damage to the body is caused by invisible ultraviolet (UV) radiation. Sunburn is a type of skin damage caused by the sun. Tanning is also a sign of the skin reacting to potentially damaging UV radiation by producing additional pigmentation that provides it with some, but often not enough, protection against sunburn.

Spending time in the sun increases your risk of skin cancer and early skin aging. People of all skin colors are at risk for this damage. You can reduce your risk by:

• Limiting your time in the sun, especially between 10 a.m. and 2 p.m., when the sun’s rays are most intense.
• Wearing clothing to cover skin exposed to the sun, such as long-sleeve shirts, pants, sunglasses, and broad-brim hats. Sun-protective clothing is now available. (The FDA regulates these products only if they are intended to be used for medical purposes.)
• Using broad spectrum sunscreens with an SPF value of 15 or higher regularly and as directed. (Broad spectrum sunscreens offer protection against both UVA and UVB rays, two types of the sun’s ultraviolet radiation.)
• Reading the label to ensure you use your sunscreen correctly.
• Consulting a health care professional before applying sunscreen to infants younger than 6 months.

In general, the FDA recommends that you use broad spectrum sunscreen with an SPF of 15 or higher, even on cloudy days. In addition:

• Apply sunscreen liberally to all uncovered skin, especially your nose, ears, neck, hands, feet, and lips (but avoid putting it inside your mouth and eyes).
• Reapply at least every two hours. Apply more often if you’re swimming or sweating. (Read the label for your specific sunscreen. An average-size adult or child needs at least one ounce of sunscreen, about the amount it takes to fill a shot glass, to evenly cover the body.)
• If you don’t have much hair, apply sunscreen to the top of your head or wear a hat.
• No sunscreen completely blocks UV radiation. So other protections are needed, such as protective clothing, sunglasses, and staying in the shade.
• No sunscreen is waterproof.

Currently, only sunscreens in lotion, cream, stick, gel, oil, butter, paste, spray, and powder dosage forms can be legally marketed. Sunscreen in all other dosage forms, including wipes, towelettes, body washes, and shampoos, cannot be legally marketed without further FDA action.

Read Sunscreen Labels

Although UVB rays are the primary cause of sunburn, both UVA and UVB rays contribute to skin cancer. All sunscreens help protect against sunburn. But only those that are broad spectrum and have an SPF of at least 15 have been shown to also reduce the risk of skin cancer and early skin aging caused by the sun when used as directed with other sun protection measures.

Current requirements applicable to sunscreens marketed without approved applications state:

• Only products that pass the FDA’s broad spectrum requirements can be labeled “broad spectrum.”
• Sunscreens that are not broad spectrum or that lack an SPF of at least 15 must carry a warning: “Skin Cancer/Skin Aging Alert: Spending time in the sun increases your risk of skin cancer and early skin aging. This product has been shown only to help prevent sunburn, not skin cancer or early skin aging.”
• Water resistance claims, for 40 or 80 minutes, tell you how much time you can expect to get the labeled SPF-level of protection while swimming or sweating.
• Manufacturers may not make claims that their sunscreens are “waterproof” or “sweat proof.”
• Products may not be identified as “sunblocks” or claim instant protection or protection for more than two hours without reapplying.

Risk Factors for Harmful Effects of UV Radiation

People of all skin colors are potentially at risk for sunburn and other harmful effects of UV radiation, so always protect yourself. Be especially careful if you have:

• pale skin
• blond, red, or light brown hair
• been treated for skin cancer
• a family member who has had skin cancer

If you take medications, ask your health care professional about sun-care precautions. Some medications may increase sun sensitivity. Even on an overcast day, up to 80 percent of the sun’s UV rays can get through the clouds. Stay in the shade as much as possible.

The FDA is committed to ensuring that safe and effective sunscreen products are available for consumer use. Because the body of scientific evidence linking UVA exposure to skin cancers and other harms has grown significantly in recent years, the FDA has proposed a new requirement that all sunscreen products with SPF values of 15 and above must be broad spectrum, and that as the SPF of these products increases, broad spectrum protection increases as well. The FDA also proposed changes to the labeling of SPF values to make it easier for consumers to compare and choose sunscreen, and to raising the maximum proposed SPF value from SPF 50+ to SPF 60+. These and FDA’s other sunscreen-related proposals are described in detail in the 2021 Proposed Order, Amending Over-the-Counter (OTC) Monograph M020: Sunscreen Drug Products for OTC Human Use.

Protect Your Eyes With Sunglasses

Sunlight reflecting off sand, water, or even snow further increases exposure to UV radiation and increases your risk of developing eye problems. Certain sunglasses can help protect your eyes.

When using sunglasses:

• Choose sunglasses with a UV400 rating or “100% UV protection” on the label. These sunglasses block more than 99% of UVA and UVB radiation and provide the most protection against UV rays.
• Do not mistake dark-tinted sunglasses as having UV protection. The darkness of the lens does not indicate its ability to shield your eyes from UV rays. Many sunglasses with light-colored tints – such as green, amber, red, and gray – can offer the same UV protection as very dark lenses.
• Check to see if your tinted glasses have UV protection. If you are unsure, your eye care professional may be able to check for you. When you wear tinted glasses, your pupils dilate and can increase exposure of your retinas to UV light. Without UV protection, you are putting yourself at risk to harmful effects associated with solar radiation.
• Be aware that children should wear sunglasses that indicate the UV protection level. Toy sunglasses may not have UV protection; so be sure to look for the UV protection label.
• Consider large, wraparound-style frames, which may provide more UV protection because they cover the entire eye socket.
• Know that pricier sunglasses don’t ensure greater UV protection.
• Even if you wear UV absorbing contact lenses, wear quality sunglasses that offer UV protection.
• Even when you wear sunglasses, wearing a wide-brim hat and sunscreen can help further protect you from sun exposure.