Monetary Motives:

The real story behind dermatology's "safe" sun beds

When it comes to discussing the potential risk and benefits of UV light and sun beds, new evidence suggests the profit-minded dermatology industry is talking out of both side of it's mouth and that the dollar sign matters more to it's biggest lobbying groups that any true scientific discussion.

The reason: Dermatology groups still market "safe" uv sun bed sessions in their own offices to treat purely cosmetic skin conditions while simultaneously telling the world that any UV exposure not received in their offices is dangerous

In other words, they are not acting as scientific guardians, protecting the public from indoor tanning UV exposure. They are acting as a competitor, promoting UV sun beds of their own.

It's an incredible contradiction. And here's how it breaks sown; When dermatology's lobbying groups talk about a sun bed in a tanning salon, they find no reason to be objective by acknowledging the full body of research pointing to a balanced benefit-risk portfolio. They put that sun bed in the same risk category as arsenic and tobacco- call it a carcinogen or a killer that has no benefits, should be avoided at all costs and should probably be banned

But when they're talking about a sun bed in a dermatologists's office- a nearly identical piece of equipment used to treat purely cosmetic skin disorders like psoriasis - it's "one of the oldest and safest treatments for psoriasis" according to the National Psoriasis Foundations, and legislation should be introduced to make it less expensive and more accessible to the 7.5 million Americans with the cosmetic disease.

It's the same sun bed and the same UV light. But when the dollars flow into dermatology's pockets , the spin about the safety of their UV gets dizzying.

Vitamin D Scientist Dr. Michael Holick hints that judicious daily UV exposures might be safe. However, I believe that every photon hitting the skin could produce a photo-mutation leading to skin cancer," says Dr. Mark vV. Dahl, past president of the American Academy of Dermatology. Those were his words from an AAD press release that urged people to stop tanning.

But that begs the question: If every photon of UV light could cause cancer, then why does dermatology continue to UV exposure as a safe procedure to treat purely cosmetic skin conditions like psoriasis. Isn't that a violation of medicine's Hippocratic Oath to do no harm?

The ADD has publicly called it's own usage of sun beds safe as a treatment for psoriasis, and many dermatology clinics use the word on web pages describing photo therapy procedures. Their argument is that a doctor monitors UV treatment in a photo therapy clinic. But does that really make the treatments safer that a salon sun bed?


1. Dermatology phototherapy softer involves intentional sunburn in up to 39 photo therapy sessions over 13 weeks in a single course of treatment.

2. Some photo therapy units are significantly more intense that standard indoor tanning salon sun beds.

3. "Blistering sunburn" (a second-degree burn0 is listed as a potential side affect of phototherapy in a dermatologist's office.

4. PUVA phototherapy is considered a known human carcinogen, according to the U.S. Department of Health and Human Services, which sites some studies showing that PUVA increases skin cancer risk 5,000 percent.

5. In lobbying for tighter regulations on indoor tanning sun beds, senior dermatology leaders have denied any connection between phototherapy and skin cancer (despite the fact that the government sees it otherwise) while saying that indoor tanning sun beds are connected.

That's a lot like Coke lobbying the government, saying that Pepsi is dangerous and should be banned.

In reality, indoor tanning protocol is so much more conservative. Our government exposure schedules are calibrated to deliver just three-quarters of what would induce a sunburn in a fair-skinned person. the exposure schedules are designed to tan with a minimal risk of sunburn when used correctly.

That's one reason why so many psoriasis patients visit tanning salons today as a more assessable, less expensive and less invasive way to self-treat cosmetic skin conditions

A Smart Tan survey of 6,881 indoor tanning clients revealed that 11 percent of tanning clients say a doctor refereed them to a tanning salon for therapeutic reasons and that 28 percent of those referring physicians were dermatologists.

Based on the survey, dermatologists refer an estimated 900,000 people to sun beds in the United States every year, and Smart Tan estimates 1.5 million Americans utilize tanning salons to informally treat psoriasis in lieu of phototherapy in a dermatologists office.

The high cost and limited access ability of phototherapy in a dermatologists office is a driving factor in this

Many patients are referred to tanning salons instead of dermatologist's by physicians, as the cost of a tanning session is almost always less expensive than the health insurance co-payment of a dermatology-based phototherapy session.

Cost has been a huge factor in the decreasing number of phototherapy treatments by dermatologists. In 1993, dermatologists administered 873,000 visits for phototherapy sessions. According to the Journal of the American Academy of Dermatology, that number dropped by 94 percent to 53,000 in 1998

"If any UV exposure were as dangerous as a recent statement from the AAD claims, then dermatologists would be guilty of violating their Hippocratic oath for using UV in what they describe as burning doses treat purely cosmetic skin conditions, "Smart Tan wrote in a press statement in 2010. "professional tanning facilities are trained to deliver non-burning dosages of UV light to create a cosmetic tan, but a side effect is that people are treating all sorts of conditions informally and effectively. What we're really seeing is dermatology's anger for the loss of billions of dollars in phototherapy treatments in their offices, as consumers choose a more economical and convenient method of self care."

Professional indoor tanning facilities promote a balanced message about UV exposure - acknowledging the risks of overexposure. In contrast, the AAD continues to attack salon sun beds while embracing it's own use of phototherapy, Smart Tan be lives this has never been a health care debate. This is the cosmetic dermatology industry attacking indoor tanning for financial gain.

If it were a health care debate , they'd stop using sun beds themselves. Instead, not only aren't the putting that on the table, they're introducing legislation to make phototherapy more affordable to patients.

In 2011, the National psoriasis Foundation promoted legislation in the state of Illinois to mandate that insurance companies not charge a co-pay for dermatology phototherapy procedure, in essence bringing a patients out-of-pocket cost from about $50 a session down to zero. The insurance company would be forced to pay for the entire $100-150 session.

The bill did not make it out of committee, nut the National Psoriasis Foundation is convinced that 18 percent of the nations 7.5 million psoriasis victims (1.35 million) would use phototherapy in a doctors office if it were financially possible for them.

"For years , light therapy of phototherapy - one of the oldest and safest treatments for psoriasis- has teetered on the edge of decline because of rising costs shouldered by patients,"Dermatologists have relied on phototherapy for decades as an important and safe treatment modality; unfortunately, the rising costs to patients is ruling out the option for many."

So, while the AAD is lobbying to restrict indoor tanning, it's lobbying efforts have always called for phototherapy treatment in dermatology offices to be exempted from further restriction.

And while dermatology lobbies that teenagers should not use sun beds in salons at all, it also concludes that dermatology phototherapy can be delivered to children when a dermatologist decides such a treatment is necessary.

Bottom line: It's time that researchers and the media start asking tough questions about why dermatologists refuse to talk about these issues and their real motivations around their attacks on indoor tanning.

We're happy to engage in that kind of discussion.

This Article was in Smart Tan Magazine, Written by Joe Levy, Senior Vice President, Smart Tan.