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Glenda Fuster lies in a tanning booth at the Run to the Sun tanning salon in Anchorage, Alaska. ((Al Grillo/Associated Press))

While many of us are comfortable in our skin, there are those who pursue that golden glow that comes with a tan.

Maybe you're one of those people who like to get in a bit of pre-tanning before swapping the winter duds for the summer wardrobe or heading off for a southern holiday. Perhaps you're even considering taking up the local tanning salon on one of those introductory offers that keep arriving in the mail.

Beware — risk lurks behind closed doors. Health Canada says there is no safe way to tan. The World Health Organization (WHO) warns that the use of tanning beds and other forms of indoor tanning carries an increased risk of skin cancer, skin aging and eye damage. In a report released in 2003, the WHO noted that indoor tanning is a billion-dollar-a-year industry that has not shown "significant capacity to self-regulate effectively."

The report says "consequences of regular sunbed use could include pain and suffering, early death and disfigurement, as well as substantial costs to national health systems for screening, treating and monitoring skin cancer patients."

The WHO has called for the tanning bed industry to face stricter regulations. It has also called for a ban on the use of tanning beds by anyone under the age of 18.

'The younger you start and the longer you keep it up, the higher the risk.'

The International Agency for Research on Cancer (IARC), the arm of the WHO that co-ordinates and conducts research on the causes of human cancers, has moved tanning beds to its highest cancer-risk category. In a report published in the medical journal Lancet Oncology on July 29, 2009, the organization says tanning beds are carcinogenic to humans. The use of sunlamps and sunbeds was previously classified as "probably carcinogenic to humans."

The change in designation means that tanning beds are now in the same category as cigarettes, arsenic and plutonium.

The international agency's report says use of tanning beds can be especially problematic for young people. The risk of skin melanoma increases by 75 per cent when use of tanning devices starts before 30 years of age, the report says.

Regulations coming into effect

Regulations covering the indoor tanning industry have been few and far between, but some jurisdictions have been making moves in that direction.

Nova Scotia introduced legislation in 2010 that bans people under 19 from using commercial tanning beds. It came into effect in June 2011.

New Brunswick brought in voluntary guidelines in 2010. They include an age limit of 18, a ban on advertising any health benefits of artificial tanning and a limit of one tan every 48 hours.

In January 2011, the City of Victoria and surrounding municipalities barred people under the age of 18 from using commercial tanning beds.

In Prince Edward Island, the provincial government introduced voluntary guidelines in December 2011 for the tanning industry. Health Minister Doug Currie has said he expects the guidelines will be followed, but health critic James Aylward says they are toothless.

France bans people under the age of 18 from using tanning beds. Ireland has banned them for kids under the age of 16. In October 2011, California became the first state to ban anyone under 18 from using tanning beds. Texas has also banned them for children younger than 16.

The Canadian Cancer Society has called for legislation banning indoor tanning for Ontario teens.

In 2005, Health Canada released a set of voluntary guidelines for the tanning industry. They include:

  • Tanning salon operators should tell people who always burn and never tan not to use tanning beds.
  • Children under 16 should not use tanning beds.
  • Tanning salons should always have staff on hand who can inform customers about the safe use of tanning beds.

A U.S. study published on Sept. 1, 2008, found that just under 27 per cent of students surveyed at a Virginia university reported symptoms of tanning dependence — or "tanorexia."

Most of those who took part in the study got their tans the old-fashioned way, but the researchers say they were alarmed that 40 per cent made regular use of tanning salons — and that the mean age at which they started going indoors for their tans was 17.

A study released by the American Association for Cancer Research on May 27, 2010, found that the use of tanning beds doubles to quadruples the risk of melanoma — depending on what type of tanning bed is used and how long a person is exposed to the radiation the beds produce. The study also found that the risk is greater for those who use tanning beds over a longer period of time: the younger you start and the longer you keep it up, the higher the risk.

The U.S. Food and Drug Administration is considering whether to impose bolder warnings and stricter regulations on the industry, especially when it comes to minors and indoor tanning. On March 25, 2010, an FDA panel recommended that the agency should consider banning artificial tanning for anyone under the age of 18. It also recommended bolder warnings on tanning beds and changes in the way they are regulated. 

Currently, the machines are classified as low-risk devices, in the same group as bandages and tongue depressors. By changing their classification to Class II, the FDA could limit the levels of radiation the devices emit and require other changes to their design.

The FDA is not required to follow the advice of its expert panels though it often does.

In October 2008, the Canadian Cancer Society released a study that suggested that most of the tanning salon operators surveyed in Toronto weren't following significant parts of Health Canada's guidelines.

In March 2007, Fabutan — one of Canada's largest tanning salon chains — announced that it would shut down any franchisee who allowed kids younger than 18 to use tanning beds without their parents' consent. Customers under the age of 16 would have to be accompanied by a parent.

The move came a year after Fabutan paid a $62,500 fine as part of a settlement with the Competition Bureau over misleading advertising.

The agreement required the company and its president, Douglas McNabb, to "stop making representations to the public linking indoor tanning with the unproven benefits of vitamin D — reduced risk of certain cancers, heart and cardiovascular conditions and osteoporosis — and promoting tanning as useful in treating seasonal affective order or stimulating … metabolism."

The company must now include warnings on its website about the risks of indoor tanning.

If you are looking to get a head start on a tan by taking in some artificial rays, Health Canada recommends you protect yourself by:

  • Not exceeding the recommended time per tanning session for your skin type. 
  • Allowing at least 48 hours between tanning sessions to allow your skin to repair damage from UV radiation.
  • Wearing safety eyewear.
  • Reporting adverse reactions — like sunburn or itchiness — to the salon operator.

But even following those recommendations won't guarantee you trouble-free time in the sun. A tan — acquired from the sun's rays or a tanning lamp — only provides protection from a sunburn equivalent to a sunscreen with SPF rating of 2-4. Health Canada recommends that you use sunscreen with a minimum SPF rating of 15 when you're out in the sun.