Sunlamps and cancer

ROC STATUS: Known human carcinogen since 2000

ALSO KNOWN AS: Ultraviolet (UV) radiation, ultraviolet A (UVA), ultraviolet B (UVB), artificial ultraviolet radiation, nonsolar ultraviolet radiation

RELATED CANCERS: Skin cancer, squamous cell carcinomas, basal cell carcinoma, melanomas

DEFINITION: Sunlamps are lamps that produce ultraviolet radiation.

Exposure routes: Through skin

Where found: Sunlamps, sunbeds, tanning salons, tanning booths, home tanning lamps

At risk: People who use artificial sources of ultraviolet radiation such as sunlamps or tanning salons

ETIOLOGY AND SYMPTOMS OF ASSOCIATED CANCERS: Sunlamps or other artificial sources of ultraviolet radiation are used primarily for cosmetic reasons, such as to obtain a suntan and for treatment of certain medical conditions. Teenagers and young adults use sunlamps most often.

Epidemiological studies report that exposure to sunlamps increases the risk of skin cancer. A person’s risk of skin cancer is related to lifetime exposure to ultraviolet (UV) radiation, with greater incidence observed with increasing duration of exposure, especially in those using sunlamps before the age of thirty and in those who sunburn easily. UV radiation from sunlamps can affect all skin types, but people with fair skin that freckles or burns easily, a skin type generally associated with red or blond hair and light-colored eyes, are at greater risk.

Sunlamps increase the risk of skin cancer because they involve exposure to UV radiation. Although ultraviolet radiation emissions vary substantially according to the device, the radiation exposure can be similar to or greater than that from natural sunlight. Depending on the frequency of use, commonly used sunlamps deliver several times the annual UVA dose; some units may emit UVA and UVB radiation at levels as much as fifteen times greater than sun exposure. UV radiation damages deoxyribonucleic acid (DNA) in skin cells, which can lead to skin cancer.

Skin cancers that have been associated with sunlamp use include basal and squamous cell carcinomas, as well as melanoma. Most basal cell and squamous cell skin cancers can be cured if found and treated early. Both basal and squamous cell skin cancers occur on parts of the skin frequently exposed to the sun, such as the face. Basal cell carcinomas grow slowly and rarely spread to other parts of the body. Squamous cell carcinomas are more aggressive and sometimes spread to lymph nodes and organs inside the body.

Although much less prevalent than other types of skin cancer, melanoma is the most serious. Melanoma occurs in pigment cells in the skin called melanocytes. When melanoma becomes cancerous, it can become invasive and spread to other parts of the body. When melanoma starts in the skin, it is called cutaneous melanoma. Melanoma may also occur in the eye and is then called ocular melanoma or intraocular melanoma.

Not all skin cancers look the same, but a change on the skin is the most common sign of skin cancer. Some skin changes that may occur include a new growth, a sore that does not heal, a change in an existing growth, or red or brown spots that are rough, dry, and scaly. Melanoma usually begins in a mole, with the first symptom typically a change in size, shape, or color of an existing mole or the appearance of a new mole. Melanomas vary in their appearance, but most melanomas have a black or blue-black area and usually appear abnormal. Patients should monitor their moles using the ABCDE classification system. In this system, the patient should look for asymmetry, observe the borders and color of their moles, be cognizant of their diameter, and monitor all their moles for evolving changes over time. Any changes in these conditions warrants a trip to a primary care physician or dermatologist.

History: Sunlamps have been used for many years to treat a range of skin conditions, vitamin D deficiency, seasonal depression, acne, and neonatal jaundice. Sunlamps have also been used increasingly for cosmetic tanning in commercial salons or at home. The typical UV emissions from artificial tanning devices have changed over time; before the mid-1970s, sunlamps mostly emitted UVB with a small amount of UVC, but with the rise of commercial tanning salons in the early 1980s sunlamps using ultraviolet A were developed. Sunlamps in use in the twenty-first century emit mostly UVA radiation and some UVB radiation, although the type of UV radiation emitted depends on the type of bulb used in the sunlamp.

The US Food and Drug Administration (FDA) Center for Devices and Radiological Health developed regulations concerning ultraviolet lamps in sunlamps that specify requirements for performance, protective eyewear, and labeling, and require tanning salons to post warnings about the dangers associated with exposure to artificial UV radiation. The American Medical Association, the American Academy of Dermatologists, and the Centers for Disease Control and Prevention have all issued statements discouraging the use of sunlamps for nonmedical purposes. Still, in the mid-2020s, over 10 percent of adults and 6 percent of adolescents throughout the world reported using a sunlamp or sunbed.

Bibliography

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“Sunlamps and Sunlamp Products (Tanning Beds/Booths).” FDA, 28 Sept. 2020, www.fda.gov/radiation-emitting-products/home-business-and-entertainment-products/sunlamps-and-sunlamp-products-tanning-bedsbooths. Accessed 21 June 2024.

Swerdlow, A. J., et al. “Fluorescent Lights, Ultraviolet Lamps, and Risk of Cutaneous Melanoma.” British Medical Journal, vol. 297.6,649, 1988, pp. 647–50.

“Will a SAD Sun Lamp Actually Make You Happy?” Cleveland Clinic Health Essentials, 17 Sept. 2020, health.clevelandclinic.org/are-sun-lamps-best-to-improve-your-winter-mood. Accessed 21 June 2024.