Tanning bed use by teens is in the news again, as 18 states consider following California’s lead in restricting their use among those younger than 21. Back in January, the Inquirer took an in-depth look at how the incidence of malignant melanoma – a deadly skin cancer – has risen every year for the last 12 years in young women, keeping pace with growth of the tanning-salon industry.
Currently, 14- to 18-year-olds in New Jersey and Delaware are supposed to have parental permission for indoor tanning, according to the National Conference of State Legislatures. Pennsylvania has no restrictions, according to the National Tanning Training Institute’s state-by-state list. As winter turns to springtime, more teens may be considering indoor tanning as they get ready for prom season. I asked adolescent medicine specialist Rima Himelstein, M.D., a Crozer-Keystone Health System pediatrician and adolescent medicine specialist, about tanning and teens. Here’s what she told me:
Q: What’s the health issue with indoor tanning and teens?
A: Tanning beds use UVA radiation, one of the three types of ultraviolet radiation (UVA, UVB, and UVC) that the sun emits. Ultraviolet raiation is considered to be a carcinogen like tobacco. The levels of UVA radiation from tanning beds is believed to cause deeper skin damage than even the levels from the sun. Indoor tanning devices can lead to 15 times more UVA levels than sunlight. The American Academy of Pediatrics, the World Health Organization, the American Medical Association, the American Academy of Dermatology as well as other professional organizations have recommended that laws ban minors from going to tanning parlors. 
Q: Why is there so much concern about girls and tanning salons?
A: Of the one million people who tan in tanning salons on an average day in the United States, almost 70 percent are teenage girls and young women. This disparity becomes especially alarming when it is coupled with the fact that the rates of skin cancers in young people have increased dramatically. Melanoma, which is the most aggressive form of skin cancer, is now the second most common cancer in 15 to 29 years old. 
Q: What should parents tell teens who want to tan?
A: My advice to parents is to not allow their teenagers to go to tanning salons. Parents need to take the time and effort to explain in detail to their children the risks of skin cancer. Although, in general, scare tactics are not usually effective at promoting change in teens, the effect may be different in skin cancer where truly "a picture is worth a thousand words".  Such a picture can be obtained by searching "skin cancer" images online. (Find some grisly examples here.)  
Q: Are spray tans a good alternative?
A: If teenagers like the look of bronzed skin or if they feel good when they are tanned, we are not going to be able to change their feelings by the prom. A safe alternative is an artificial tanner that contains dihydroxyacetone. Parents should offer this to their children as a safe alternative to tanning beds.  Dihydroxyacetone reacts with amino acids in the skin's outer layer to form brown-black deposits in the skin.  Dihydroxyacetone is approved by the Food and Drug Administration for use as a tanning agent and has not been linked to cancer in animal studies.  
What about you? Any stories to share about your teens and the desparate need to look tan?