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Teen tanning bed bans keep patients from phototherapy.

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.

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.

cnellist@mdedge.com

BY CATHERINE COOPER NELLIST

FROM CLINICS IN DERMATOLOGY

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

COMMENTARY BY DR. SIDBURY

EVEN WELL-INTENDED public health initiatives can have unintended consequences. Many states have taken steps to limit the use of tanning beds by underage patients in an effort to prevent skin cancer.

Investigators at the University of Texas MD Anderson Cancer Center, Houston, remind us that phototherapy for conditions such as psoriasis, vitiligo, and even cutaneous T-cell lymphoma do not always occur in doctor's offices. Although commercial tanning beds are less regulated and more chromatically constrained (tanning beds emit very little UVB radiation), they are, for most, cheaper and more accessible. A typical phototherapy schedule requires treatments two to three times weekly for months, so this is not a trivial concern. As more states rightly consider how to sensibly protect children from a known carcinogen, ultraviolet light, they would do well to consider therapeutic exceptions.

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Author:Nellist, Catherine Cooper
Publication:Dermatology News
Date:Jun 1, 2018
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