Scientific developments in indoor tanning and melanoma.

CI: confidence interval OR: odds ratio UV: ultraviolet I n this month’s Journal of the American Academy of Dermatology online, Lim et al summarize a large body of evidence that relates to the regulation of indoor ultraviolet (UV) tanning. From a public health perspective, the most important aspect of this issue is the association of indoor tanning with melanoma, the leading cause of death among skin conditions. It is therefore particularly important for dermatologists to appreciate recent changes in the scientific documentation and strengthening of the evidence for this association. More than a decade ago we knew that UV radiation from the sun was a cause of melanoma, and on this basis the dermatology community counseled sun protection and advocated avoidance of indoor UV tanning. However, systematic review of the empirical verification that indoor UV exposure increased melanoma risk was quite weak, because of a variety of factors. Nevertheless, even in 1998 the concern was raised that indoor UV tanning could function as a ‘‘radiation multiplier,’’ resulting not only in damage from the artificial UV exposure in the tanning booth, but also from further damage from increased sun exposure subsequently as a result of the perceived protection from the tan obtained indoors. Hence, this results in a potentially substantial increased risk of melanoma.