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Liverpool has some of the highest rates of skin cancer in the country. It is also a city where sunbed use is much higher than the UK average.

Tanning salons are licensed in Wales, Scotland and London, but elsewhere councils are struggling to ensure operators are using safe equipment and are not offering sunbed sessions to those under the age of 18.

Now Liverpool council wants licensing powers to try to cut the number of young people in the city being diagnosed with skin cancer.

At Broughton Hall High School in Liverpool, a group of Year 9 pupils are being shown the grisly reality of skin cancer.

It includes some fairly graphic images of the most serious form of skin cancer, a malignant melanoma.

There is also a discussion of the risks posed by the use of sunbeds, which Cancer Research UK says raises the chance of developing a melanoma by nearly 60% in first-time users under the age of 35.

Sunbed dangers

In Liverpool the campaign is particularly relevant, especially as council research found more than 80% of people were unaware of the dangers.

This session certainly had an impact on the Broughton Hall pupils.

"It's too serious to be risking it when there are other options like false tan, spray tans and make-up you could use instead and they give the same effect," said pupil Emma Howard.

Image copyright Science Photo Library Image caption Malignant melanomas are the most dangerous type of skin cancer

Classmate Molly Madigan said it had changed her perceptions of the risks associated with sunbeds.

"I know now not to go anywhere near them and I know I can tell people not to go near them because it's not worth it."

Devastating diagnosis

At the city's Broadgreen Hospital, Alisha Lawler knows just how devastating a skin cancer diagnosis can be.

While still in her early teens, she was using a sunbed several times a week, but with fair skin, would burn on a regular basis.

Media playback is unsupported on your device Media caption Alisha Lawler says she is "scarred for life" from sunbed use

Alisha is now in her 30s and mum to a five-year-old daughter, but last year she spotted an unusual mole on her arm.

It turned out to be a melanoma.

Now a livid scar several inches long marks where the tumour was removed.

"Why would you want to expose your skin to the dangers of something and go through the pain that I've been through and be scarred for life like I have?

"I've had to hide my arms for like the last year or so.

"And people ask, 'What have you done, what is it?' And how do you say to someone, 'It was skin cancer'?"

Liverpool's sunbed culture

Liverpool seems to have a deep-rooted culture of sunbed use, but it is hard to define exactly why.

Some link it to the popularity of perma-tanned celebrities or to the notion that, in a city with significant levels of poverty, a tan displays success and wealth.

And children - young teenagers - are not immune to that culture.

Despite it being illegal to allow an under-18 to use a sunbed, there is evidence that plenty do.

But the city council, trying to police sunbed salons, faces a problem. It doesn't know where they all are.

Licensing dilemma

Some may be obvious high street operations, well-run and using equipment that has been properly tested.

It is a life-long problem that these young girls have - unfortunately they don't appreciate it at the time Linda Mullen , Nurse Consultant

But as councillor Roy Gladden explains, others may be coin-operated booths in the back of a local nail salon or hairdressers, unregulated and open to abuse.

"If you don't know where they are we can't check them.

"So they could be breaking health and safety regulations and basically giving people an over-powering of radiation poisoning.

"But we don't know where they are because they don't have to register and the government won't allow us to have the powers to do so."

Back at Broadgreen Hospital, consultant nurse Linda Mullen, a specialist in skin cancer, says something needs to be done to stem the tide of young patients walking through her doors.

"UV light damages skin cells.

"That stays with the skin for many, many years, it is a life-long problem that these young girls have.

"Unfortunately they don't appreciate it at the time - they want a tan and it's a quick fix to get a tan."

A cross party group of MPs is also backing a call for a ban on coin-operated booths.

Unprotected exposure to strong sun can also cause skin cancer.

But since 2000, the council says the number of cases among women in Liverpool has risen by 129%, more than double the UK average.

It seems the city's sunbed culture is exacting a high price.