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Imagine you've just finished your 45-minute Spinning class. In the room next door, you lift a few weights, feeling pleased with your slowly improving strength. Then you're ready for a quick nutritious snack and a shower. Next up: the tanning bed, to get that "healthy" glow. However, it's not that healthy.
Women who indoor-tan once a month or more have a 55 percent higher risk of developing melanoma than non-tanners, according to the Journal of the National Cancer Institute. And doing it before age 35 ups your chances by 75 percent, reports the International Journal of Cancer. (Indoor tanners are also 2.5 times more likely to develop squamous cell carcinoma, which causes about 2,500 deaths in the U.S. annually, and 1.5 times more likely to get basal cell carcinoma.) Part of the reason: High-pressure sunlamps emit doses of UV radiation that can be as much as 12 times stronger than the sun."Essentially, 20 minutes in a tanning bed can do as much damage as five hours of natural sunlight," says Ohio dermatologist Louis Barich, MD
But tanning salons know their market: a woman who wants to feel her best -- and they're hoping you think tanning is a quick, easy beauty boost. In the past five years, an increasing number of fitness clubs have added tanning beds to their facilities, according to John Overstreet, the executive director of the Indoor Tanning Association. Large national franchises such as Anytime Fitness and Snap Fitness (both based in Minnesota, with more than 600 locations each) offer tanning in about 80 percent of their clubs. Planet Beach, a tanning franchise, shares space with chains like Gold's Gym and Fitness 19, which offer brand-name bronzing just steps from workout equipment.
It's shocking to know that as skin cancer rates rise, indoor tanning just seems to get more convenient. FITNESS found 8 tanning facilities within 10 blocks of a popular Manhattan gym, 45 within 5 miles of a Los Angeles gym, and 19 within 5 miles of a Cherry Hill, New Jersey, health club. "It's not surprising," says Todd Beckman, president and CEO of the Tan Company, a Missouri-based chain of 70-plus salons. "Both businesses cater to body-conscious women who want to look good." Mark Daly, spokesperson for Anytime Fitness, corroborates that notion, saying, "about 75 percent of our tanners are female."
Consider Randee Braham, 29. She works out consistently, eats well, doesn't smoke -- and then tans weekly at a salon down the street from her gym. "I realize the dangers, but I choose to look the other way," says the Brooklyn resident. "Tanning shows off my hard work at the gym."
Braham is not alone in her willingness to risk damaging her body. Cari Goodrich, 26, from Fremont, California, is also a health-conscious gym-goer -- she's even a vegetarian. But she visits the tanning salon up to four times a week in the warmer months. "I tell myself that having a mild tan for three-quarters of the year is better than the massive burn I'd get if I spent one day outside -- though I know that's not true," Goodrich says. She started tanning six years ago while working at the front desk of her health club, which offered the service.
With all the evidence against indoor tanning, why do it? "Many women in their 20s and 30s who exercise regularly think they're so far removed from having health problems that they're not concerned about the long-term ramifications," says Arielle Kauvar, MD, a clinical associate professor of dermatology at New York University School of Medicine. Plus, 61 percent of women believe a tan makes them look more attractive, finds an American Academy of Dermatology (AAD) survey. "The irony is women go to the gym to look good, but tanning eventually destroys some of that hard work," says dermatologist Sandra Read, MD, a spokesperson for the AAD. (UV exposure is the primary culprit behind wrinkles, age spots, and leathery skin.)
"The rates of melanoma -- the deadliest form of skin cancer -- are increasing much faster in women than in men, thanks in part to the fact that women are more likely to use tanning beds," says Dr. Read.
The tanning industry's strategy appears to be to put beds in places people see as "healthy." "Gym members are more likely to use tanning facilities in a health club than elsewhere," says Thijs Fabels, president of UltraSun USA, Inc., an international tanning-bed supplier. "They already feel comfortable there and they don't have to invest the time finding a separate tanning studio." Tanner Cari Goodrich agrees. "I never indoor-tanned before, but it was so convenient at the gym that I got hooked."
"Hooked" is the key word here. Numerous studies support the finding that UV light causes a feel-good endorphin rush, like a runner's high. Intentionally or not, placing tanning beds inside or next to gyms is a perfect way to attract those in search of that boost -- like Kelli Pedroia, 24, of Chandler, Arizona. "It's pathetic to admit," she says, "but I felt a million times better after I tanned. It was a high." Three years into her UV habit, she was diagnosed with melanoma, but even then, she didn't quit. "I was embarrassed by what I was doing, but it didn't stop me," she says. It's not surprising if you consider a 2007 University of California at San Francisco study, which found that 18 percent of indoor tanners exhibit addictive behaviors toward the activity, such as feeling guilt. It took two more cancer scares for Pedroia to get the wake-up call.
But unlike with other addictive substances, "the government doesn't require the same kind of vigilance on indoor tanning beds as it does on cigarettes -- despite the fact that the Department of Health and Human Services has declared ultraviolet radiation a carcinogen," says Dr. Kauvar. However, in September 2007, President Bush signed the Tanning Accountability and Notification Act, which asked the FDA to consider requiring new warning labels on tanning equipment to make the dangers more apparent. (Many feel the current warnings are not strong enough.)
With or without new regulations, the public is misinformed. When Consumer Reports contacted 296 tanning facilities in 12 cities for a 2005 report, nearly 35 percent denied that indoor tanning can cause skin cancer and/or claimed it doesn't prematurely age the skin. And when FITNESS reviewed 12 tanning salons' Web sites, each stated that indoor tanning was in some way healthy. For example, Great Tans, a chain in San Marcos, Texas, claimed "calling a tan damage to your skin is like calling exercise damage to your muscles." And while Arizona franchise Energy Tanning did state that tanning can cause some kinds of skin cancer, it also affirmed: "Moderate tanning can help keep you healthy and fit. Sunlight or tanning salons can improve muscle tone and cardiovascular fitness while helping prevent cancer and osteoporosis." When we contacted the salons for comment, representatives said they'd get back to us. By press time, they had not.
"Two of the most popular myths propagated by the tanning industry," says Dr. Read, "are that tanning is the best way to get enough vitamin D and that tanning beds emit only safe ultraviolet light." According to Stephen Smith, CEO of Planet Beach, "numerous studies have shown that responsible and moderate exposure to UV light is important to well-being, natural vitamin D production, and disease prevention. We [are helping] customers maintain healthy skin for life."
Dr. Kauvar could not disagree more. "You can get plenty of vitamin D by eating enriched foods or being outside for 5 to 10 minutes a day. And there's no such thing as safe UV rays." So what's with the pro-tanning studies these companies cite? "The tanning industry often funds studies that find tanning is healthy," says Dr. Read. "It's a clear conflict of interest."
Health clubs that house tanning salons usually get a flat fee or a percentage of the tanning profits from this $5-billion-plus-a-year industry. "Gyms really only need a small percentage of their clients to take advantage of the tanning beds for them to be cost-effective," says UltraSun USA president Fabels.
How can fitness centers -- the very image of good health -- feel comfortable with such a partnership? Although the American Council on Exercise doesn't have an official stance, its chief science officer, Cedric Bryant, PhD, says the organization will likely address it in the future, asking its members to "think twice about whether partnering with tanning salons is a safe or healthy practice." Representatives of the International Health, Racquet and Sportsclub Association, an organization for health and fitness professionals, declined to comment.
Many of those we interviewed, such as Peter Taunton, CEO of Snap Fitness, put the onus on the customer to make healthy decisions: "We hope club members will choose to tan in moderation, at a level that makes them feel more healthful." Only one of the gyms we spoke to denounced the gym/tanning alliance. Cassie Findley, director of continuing education and research for Curves, said, "It's irresponsible for any gym to present tanning in a positive light. To imply tanning is as good for you as working out is grievously misleading."
Above all, gyms that offer tanning say they're giving people what they want. "Providing everything under one roof simplifies women's lives," says Planet Beach CEO Smith. "Partnering with gyms creates an opportunity for an individual to incorporate total wellness into their weekly regimen." But Dr. Barich points out, "Gyms don't offer tanning to help make people healthy; they do it for money." Which puts the power to condone or condemn gym tanning in the lap of consumers. If it were in your health club, what would you do?
UPDATE: The American Academy of Dermatology wants you to know about the dangers of indoor tanning. Research shows an increase in melanoma, a deadly form of skin cancer, in females 15-29 years old, who make up 70 percent of indoor tanners. UV radiation from the sun and artificial sources like tanning beds is a known carcinogen, as declared by the U.S. Department of Health and Human Services.
Approximately one in five Americans will develop skin cancer in their lifetime, yet on a given day, more than one million Americans use indoor tanning salons. The AAD wants to reduce the incidence and mortality from skin cancer and has launched public service advertisements to send this important message about your health.
Originally published in FITNESS magazine, May 2008.