With prom season just around the corner, many high school students are starting to think about dresses, tuxes, and dinner arrangements. Some may even be planning indoor tanning sessions to get the perfect bronze for those memorable prom pictures.

While visiting an indoor tanning salon sounds innocent, a new study has dermatologists and psychiatrists raising a red flag and urging parents to ask a few questions.

According to a study published recently in JAMA Dermatology and led by Gery Guy Jr., Ph.D., of the Centers for Disease Control and Prevention (CDC), teens who use indoor tanning facilities are more likely to engage in other risky health behaviors.

The study suggests that indoor tanning was associated with binge drinking and unhealthy weight-control practices. For females, indoor tanning is also linked to illegal drug use and having sexual intercourse with four or more partners. In addition, for teenage boys, it was connected to steroid use and daily cigarette smoking. Attempted suicides were also noted for boys.

The study evaluated the Youth Risk Behavior Survey from 2009 and 2011 conducted by the CDC that involved 31,000 students nationally.

"Indoor tanning has long been questioned due to its association with skin cancer," says Bruce A. MacLeod, MD, president of the Pennsylvania Medical Society. "Now research tells us that it may also be a signal for other problems. That should be a red flag for parents."

"It's amazing how many of our young adults have developed melanoma after even moderate use of indoor tanning," says Bruce Brod, MD, Political Advocacy Committee chairman of the Pennsylvania Academy of Dermatology and Dermatologic Surgery and a practicing physician in Lancaster. "That in itself worries dermatologists, but now research is telling us that there's an association between tanning and other unhealthy behaviors."

advertisement

Kathleen Dougherty, MD, president of the Pennsylvania Psychiatric Society, believes this research could have value in helping identify those more likely to put themselves at risk through other activities.

"Only a small fraction of teenagers who decide to use indoor tanning facilities may also partake in other potentially addictive behaviors such as misuse of controlled substances, alcohol use, and other unhealthy behaviors," she says. "However, this study opens the door for the initiation of a dialogue between parents, children, and health care professionals to further discuss potential risky behaviors before they occur."

Dr. Dougherty suggests all parents of teens, regardless of whether or not they use indoor tanning facilities, should ask a few more questions not just around the prom season, but at the advent of the school year.

"Parents should feel comfortable speaking with their children about the physical effects of tanning, along with the reasons that the teen wants to tan in the first place," she says. "Is there a body image concern? There may be an unrealistic view that tanning will make the teen more desirable or repair some imagined flaw."

"Negative body image can be associated with several conditions such as eating disorders or, depression, and other self-damaging behaviors may be present without parental knowledge," Dr. Dougherty continues. "This dialogue can assist parents in determining if there is a need for additional intervention by a child and adolescent psychiatrist."

Circling back to the issue of indoor tanning, Dr. Brod says it's something that should be avoided as it is dangerous and has no medical benefit. According to Dr. Brod, studies show the rate for melanoma is 59 percent higher for those who have ever used tanning beds and is double for those who indoor tan more than 10 times in a lifetime.

advertisement

According to the Skin Cancer Foundation, every year nearly 2.3 million American teenagers visit tanning salons. In addition, a study published in the International Journal of Cancer in May 2011 determined that for young people diagnosed with melanoma between the ages of 18 and 29 years old, 76 percent were attributable to indoor tanning bed use.

Justin Vujevich, MD, president of the Pennsylvania Academy of Dermatology and Dermatologic Surgery, practices in Pittsburgh, which has the second highest number of indoor tanning facilities per capita of any major U.S. city.

"Our region's climate won't win any awards for its sunny weather. So patients, particularly females in their teens and 20s, frequent indoor tanning parlors to obtain that 'healthy' glow," Dr. Vujevich says.

"My older patients didn't know about the risks of tanning, and wish they would have changed their behaviors when they were younger," Dr. Vujevich continues. "Now we know that ultraviolet radiation from the sun or indoor tanning is a cancer-causing carcinogen. But my younger patients, even after being diagnosed with a melanoma, ask me, 'Can I still go tanning?' It's like an addiction."

Dr. Brod, whose organization along with the Pennsylvania Medical Society have lobbied in recent years for tighter regulations on tanning beds in the Keystone State, says there are safer options for teens looking to get the perfect bronze for upcoming prom pictures. His organization along with the Pennsylvania Medical Society suggests

1. Sunless tanning lotions

2. Spray tans (airbrushing)

3. Tanning towels

4. Cosmetics