From the Journals

Teen tanning bed bans keep patients from phototherapy


 

FROM CLINICS IN DERMATOLOGY

Bans keeping minors from using commercial tanning beds may be depriving dermatology patients of an alternative way to access phototherapy, said Daniel J. Lewis and Madeleine Duvic, MD, of the University of Texas MD Anderson Cancer Center, Houston.

To prevent skin cancer, many states and the District of Columbia have set in place age restrictions on the use of commercial tanning beds and banned minors from indoor tanning; another 12 states put in place bans at younger ages. The Food and Drug Administration proposed a policy in 2015 that would keep all minors from indoor tanning, according to Mr. Lewis and Dr. Duvic.

Phototherapy is known to be an effective treatment for psoriasis, mycosis fungoides, and vitiligo. Phototherapy usually is given in physician offices and administered in ultraviolet B for treatment of psoriasis, but studies have found that tanning beds, which emit primarily ultraviolet A, can produce a clinical response in 80% of psoriasis patients, and 53% of patients report using tanning beds for psoriasis treatment, Mr. Lewis and Dr. Duvic said in a letter to the editor in Clinics in Dermatology.

The demanding schedule of visiting a physician’s office three times a week for phototherapy can be hard for some patients, especially children attending school during regular office hours and patients in rural areas. High copayments also can limit access, the authors said.

Girl lying on tanning bed ©Vidmantas Goldbergas/iStockphoto.com
“Conveniently located and less expensive, tanning beds represent an alternative means of access to phototherapy. Although concerns remain regarding their use as treatment – variable spectral targeting, the absence of a supervising health care professional, and an increased risk of skin cancer – all therapies have limitations and adverse events” Mr. Lewis and Dr. Duvic said.

Despite the risks, making tanning beds “uniformly illegal for minors would be a disservice to patients with limited access to phototherapy. A more effective approach might be to collaborate with the tanning industry to achieve reasonable limits on age and exposure as opposed to an outright ban. At the very least, patients who receive a prescription from a dermatologist should be exempted from a universal ban,” they concluded.

SOURCE: Lewis, DJ and Duvic, M. Clin Dermatol. 2018 Jan-Feb;36(1):104-5

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