THE BRIGHT SIDE OF INDOOR TANNING PROJECT

This SAE information, compiled by SAE National Board of Directors under the direction of Carol Goodall, SAE National Board Leader for Image Management and Joe Schuster, SAE National Board Leader for Media Relations, presents the facts of indoor tanning and answers the most common questions people have about the indoor tanning option. It is the intention of SAE and its salon operator members that once you know the facts, you will then be able to make an informed decision on whether or not to tan indoors, and if you do choose to tan indoors, that you will do so responsibly and in moderation.

Contributors to the information are: California Suncare Inc., Cosmedico Light Inc., Eye Pro Inc., Kelsun Distributors Inc., Light Sources, Inc., MOST Products, Sun Ergoline, (formerly Sun Industries Inc.) Ultrabronz USA, Ultraviolet Resources International and Wolff System Technology Corporation.

COPYRIGHT 1996, SAE. ALL RIGHTS RESERVED UNDER INTERNATIONAL COPYRIGHT CONVENTIONS. NO PART OF THIS PUBLICATION MAY BE REPRODUCED IN ANY FORM OR BY ANY MEANS, ELECTRONIC OR MECHANICAL (INCLUDING PHOTOCOPYING) WITHOUT PERMISSION IN WRITING FROM SAE.
WHY TAN?
Light is essential to all life on earth. There are various reasons, physiological and psychological, why exposure to light is desirable. There exists a growing body of scientific evidence indicating that some people actually require more light exposure in order to function effectively. Exposure to bright light, such as generated by the mid-day summer sun, causes the brain to suppress the release of the hormone melatonin that acts as a depressant in the body if generated during the daytime. When affected individuals are exposed to longer hours of bright light, they feel happier and are able to enjoy life.
You may know that there are various health benefits associated with the exposure to sunlight, such as the production of Vitamin D3 in the prevention of bone diseases (such as osteoporosis) and in the improvement of symptoms of psoriasis.


Due to FDA regulations, those in the indoor tanning industry may not make any medical representations or claims related to indoor tanning exposure. They can only refer to its cosmetic effect: the tan.
On the unscientific "lifestyle" side of "why tan?", there is the belief that a great tan looks good, conveying a "feeling great" attitude, adding to personal confidence and attractiveness.

COMPARISON OF INDOOR (Controlled) AND
OUTDOOR (Uncontrolled) TANNING
Indoor tanning technology provides the most efficient choice for individuals to obtain a cosmetic tan in a controlled exposure environment as opposed to the uncontrolled exposure of the outside environment. Indoor tanning technology must include an exposure schedule (prominently displayed on each tanning unit) that factors in individual skin type and appropriate time exposure. Individuals choosing the indoor tanning option can do so at any time and are not limited to daylight hours and weather conditions. Outdoor sun exposure (uncontrolled environment-no one can control the sun) can vary in intensity depending on such factors as: altitude, cloud cover, air pollutants, reflective surfaces, times of day and proximity to the equator.

THE INDOOR  (CONTROLLED) TANNING PROCESS
The degree that individuals are able to tan is determined by their body's ability to produce and process melanin. Melanin is formed in melanocytes in the basal layer of the epidermis. When the melanocytes are stimulated by UVB, the forming pigment granules are then oxidized (browned) by UVA causing the skin to tan as well as to produce new pigment granules and the tanning process cycle. Within the controlled environment of indoor tanning the precise combination of UVA and UVB administered in measured doses by indoor tanning technology promotes the tanning process. The tanning process consists of two phases. The first phase (IPD) is the Immediate Pigment Darkening, coloring which begins immediately and fades within minutes. This is simply the oxidation of existing melanin which was present in a chemically reduced form and heat reaction. The second phase, Delayed Tanning, may be visible after 24 hours and becomes obvious in 3-5 days. Delayed Tanning is the reason that visible results might take from 2-4 sessions. As your indoor tanning sessions continue according to the exposure schedule of the tanning unit used, a continuous cycle of IPD and Delayed Tanning generates a steady migration to the skin surface of newly formed pigment granules and together with the continued oxidation (browning) of existing melanin allows one to maintain a tan with just two sessions per week (dependent on skin type and indoor tanning unit used).

THE ABC'S OF INDOOR TANNING TECHNOLOGY
Basically, there are two types of indoor tanning equipment: low pressure and high pressure. Low pressure equipment is the type found in most salons in the U.S. Low pressure units are typically beds, on which you recline, or booths, in which you stand while tanning. The lamps used in low pressure emit both UVA and UVB at a low energy level. These units may have anywhere from 24 to 50+ lamps with the maximum time for a single session from 10 to 30 minutes. The maximum per session time is determined by the manufacturer based on the FDA specifications for number of tanning lamps, type of lamps and reflector system, electrical configuration and acrylic protective shielding.


High pressure equipment  utilizes metal halide lamps that generate UVC, UVB and UVA rays, but by means of a sophisticated filtering system, only UVA is emitted during a tanning session. Low and high pressure combination equipment incorporates one or more high pressure facial units, along with low pressure lamps. The user has the option of activating the facial units or not. High pressure differs from low pressure in that you tan one side at a time and it takes fewer high pressure sessions to produce a base tan and to maintain one. MPORTANT TO FOLLOW THE  EXPOSURE SCHDULE SPECIFIC TO THE INDOOR TANNING UNIT BEING USED?
The exposure schedule on the specific indoor tanning unit represents the appropriate length of exposure for each individual skin type as determined in accordance with the FDA regulations for gradual  and appropriate exposure in developing and maintaining a tan.
Your first exposure may be as brief as 2-3 minutes. As your skin slowly becomes conditioned to ultraviolet light, the length of your tanning sessions are gradually increased to the maximum exposure time for the specific tanning technology and your skin type. Abusing the exposure schedule, that is, tanning for periods longer than recommended for your skin type, may result in damage to your skin such as blistering, peeling, dry skin and other adverse long term effects. By following the exposure schedule times for your skin type, your tan will develop gradually and without the adverse effects of overexposure.

SAE teaches and advocates tanning responsibly and in moderation and ALWAYS IN ACCORDANCE WITH THE RECOMMENDED EXPOSURE SCHEDULE FOR YOUR SKIN TYPE.
HAT IS PHOTOSENSITIVITY AND WHAT SUBSTANCES AFFECT  IT?
Photosensitivity  comes from the Latin words "photo," which means "light" and "sensitivus," which means "feeling". It is a condition in which skin reacts abnormally to light, especially UV rays or sunlight,  due to the pre-sence of medications, hormones, or heavy metals in the human body. Thus, when we identify a substance or a "photosensitizer" that, in combination with light, will cause a sensitivity reaction, we can take appropriate steps to ensure  responsible tanning. Medications such as psoralen, diuretics, birth control pills, high blood pressure medicine, and antibiotics may also affect  photosensitivity. Certain foods such as citrus fruits and celery and cosmetics and soaps can also increase one's level of photosensitivity. Please review the list of photosensitizers prominently displayed by your indoor tanning operator. Photoallergy is an immunilogical reaction produced by the interaction of light rays and certain chemicals. It is a form of contact allergic reaction where light is necessary to cause the sensitivity reaction. Some examples of photocontact allergens are: hexochlorophene, sunscreen agents, topical antihistamines and certain cleaning agents. A phototoxic reaction is a harmful reaction produced by light energy (sunburn is a phototoxic response). In case of doubt please consult your physician and or pharmacist for the photosensitivity of the drugs you are taking. A PERSON CANNOT TAN IN THE SUN, WILL HE/SHE TAN INDOORS?
Normally, a person tans indoors only as well as he/she is able to tan outdoors. Yet, it is possible for fair skinned people, who generally cannot tolerate the direct uncontrolled rays of the sun, to achieve some color when tanning indoors, according to the exposure schedule and their skin type. The reason for this is the specific spectral output of indoor tanning technology as well as the carefully timed exposure sessions in a controlled tanning environment. Skin type and individual photosensitivities determine who will have relative tanning success tanning indoors.

WHAT IS ULTRAVIOLET (UV) LIGHT?
Of the total solar radiation (the sun's energy given off as light, heat, radio waves, x rays) that reaches the earth, invisible UV light makes up only 3%, while visible and infrared make up the rest. UV light is further divided into three parts: UVC, UVB and UVA and is measured in units of nanometers nm.
UVC (200-280nm) - is considered to be potentially more capable of burning the skin and is almost completely absorbed by the atmospheric ozone layer
UVB (280-320nm) - stimulates melanin (pigment) production; overexposure causes sunburn; is emitted in small amounts in low pressure tanning equipment
UVA (320-400nm) - is more intense than UVB; can penetrate deeply into the skin to  potentially  cause  damage  to underlying tissue; its longer wavelengh reduces UVA's ability to cause sunburn by a factor of up to 1000. UVA is emitted by all indoor tanning equipment and is considered to be the primary  cause of long-term  skin damage from the sun (photoaging).
UVB and UVA rays can affect the skin in a positive or negative  way, depending on the dosage and scheduling of exposure.

WHAT ARE SKIN TYPES?
Tanning works differently for different skin types. These differences can be considerable, are hereditary and cannot be changed by outside influences. People with a very sensitive skin will burn easily and will tan only with difficulty while the more dark skinned individuals (skin type III & IV)  will have few problems with sunburn and will tan easily. The individual's natural ability to produce melanin (pigmentation) determines their skin type. Skin type is classified into the following skin groups:

TYPE I:  always burns easily and severely, then peels -  never tans, very fair skin, red or blond hair & freckles (unexposed skin is white)
TYPE IIburns easily, tans minimally or lightly and peels, usually fair skinned (unexposed skin is white)
TYPE III: burns moderately, tans eventually (unexposed skin is white)
TYPE IV: burns minimally, always tans well (unexposed skin is white)
TYPE V: rarely burns, always tans readily (unexposed skin is brown)
TYPE VI: never burns, tans profusely (unexposed skin is black)eanhat while tnning may make your skin appear darker, it does not and cannot change your original skin type. If your skin type is Type III, it will remain Type III no matter if or how much you tan. Individuals with skin Type I are not good candies for tanning, indoors or outdoors.

THE SUN & THE SKIN & THE RISK: SKIN CANCER
Scientific data confirms that excessive exposure to the sun without the proper precautions can cause harm i.e. that exposure to the sun includes risk. Any choice we make that includes risk also includes specific ways to minimize such risk. The same holds true for UV exposure, whether from the direct sun or from indoor tanning technology. Sun overexposure can be harmful. An immediate result of overexposure to the sun's UV rays is sunburn. Another result of too much sun is prematurely aged skin. The sun weakens the skin's elasticity and can also cause dark patches and scaly gray growths, keratoses, which are often precancerous.  Almost all of the more than 500,000 cases of skin cancer developed annually  in the U.S. are considered by the American Cancer Society to be sun-related. Fortunately, if treated in time, the two most common forms of skin cancer, basal and squamous cell cancers, are curable. CLUSIVE EVIDENCE THAT THE BROWNING OF THE SKIN WITHOUT CAUSING BURNING IS HARMFUL.

The risk factors for skin cancer:
-- heredity and excessive exposure (overexposure) to UV radiation
-- an adult who has had one severe sunburn as a child or adolescent
--most skin damage is accumulated in the first 18 years of life
-- has double the chance of developing melanoma)
-- fair skinned, skin type one, notably persons with red or blond hair, are at highest risk
-- occupational exposure to coal tar, pitch, creosote, arsenic compounds, or radium.

The signs of skin cancer:
- a skin growth that increases in size and appears pearly, translucent, tan, brown, black or multicolored
- a mole, birthmark or beauty mark that: changes color, increases in size or thickness, changes in texture and is irregular in outline.
- a spot or growth that continues to itch, hurt, crust, scab, erode or bleed
- an open sore or wound on the skin that does not heal or persists for more than four weeks, or heals and then reopens.

If you think that you have any of the above symptoms, see your physician.
The ABCDs of skin cancer detection (self examination of moles, freckles and beauty marks):
  A-Asymmetry: common moles are round and symmetrical; early malignant melanomas are asymmetrical (a line drawn through the middle will not create matching halves).
  B-Border: common moles have smooth, even borders; early malignant melanomas often have scalloped or notched (irregular) borders.
  C-Color: common moles usually have a single shade of brown; different shades of brown or black are often the first sign of a malignant melanoma.
  D-Diameter: common moles are usually the size of a pencil eraser (1/4") or smaller; early melanomas tend to be larger.

Melanoma, which makes up only 5% of all skin cancers, can be fatal. There is no evidence, to date, which unequivocally substantiates that melanoma is caused by gradual, moderate UV exposure. Those who are predisposed to contract melanoma due to hereditary factors may develop melanoma if it is triggered. While some studies have suggested a link between severe sunburn and malignant melanoma, there are other studies available that show that gradually increasing moderate amounts of exposure to UV light may be beneficial.

CAN TANNING INDOORS CAUSE SKIN CANCER?
Continuous excessive overexposure to UV light from any source (indoor tanning technology or the outside sun) can cause skin cancer. Squamous and basal cell carcinomas seem to take 15-30 years to develop. Melanoma now appears in some cases in teenagers and may require less time than basal and squamous cell carcinomas to develop. An induction period of 3-30 years would be a more reasonable time for melanoma, given the existing studies and the incidence in teenagers. Therefore, it is very difficult to isolate that indoor tanning is directly linked to the reported increase of skin cancer. SAE recommends that all UV exposure be moderate from any source. If a person is predisposed to skin cancer tanning indoors or outdoors should be avoided. Everyone should avoid sunburn, always.
AN I TAN THROUGHOUT THE YEAR WITHOUT HARMING MY SKIN?
Depending on your skin type, SAE recommends moderate and responsible tanning practices such as following the recommended exposure schedule based on your skin type. Skin damage, including skin cancer, could occur if  a person overexposes the skin to UV.
IS EYE PROTECTION REQUIRED FOR INDOOR TANNING?
YES. Strict federal laws require that eye protection be worn by every indoor tanner. IT'S A MUST THAT EACH INDOOR TANNER WEAR PROTECTIVE EYEWEAR THAT MEETS THE MINIMUM FDA STANDARD. YE PROTECTION IS REQUIRED BY FEDERAL LAW WHEN TANNING INDOORS?
Indoor tanning eye protection product must block 99% of UVA and 99.9% of UVB to be in compliance with federal law. The protective eyewear must also "enable the user to see clearly enough to reset the timer." In other words, the user must be able to shut off the unit in case of emergency without removing the protective eyewear thus protecting him/her from exposing the eyes to harmful UV rays. If the eyewear product comes with an elastic strap, the strap must be used by the wearer for the product to be compliant and a worn out strap must be replaced.

WHY IS EYE PROTECTION FROM UV LIGHT MANDATORY?
Eye damage from UV light is cumulative and has many ramifications such as corneal burns and brunescent cataracts. Generally, UVB can cause short term injury (a corneal burn (snow- blindness) that can be treated and can be repaired. Long term effect of overexposure to UVB and the eyes is not yet known. Prolonged unprotected exposure to UVA is cumulative and permanent. There is scientific speculation that damage from this type of short wavelength visible light can cause macular degeneration. Although blindness does not result, the condition is disabling and frustrating since the ability to read or to use the eyes for other kinds of detailed perception is lost. Again, the use of indoor tanning technology requires wearing FDA compliant protective eyewear.CAN UV RAYS PASS THROUGH THE PRTECTIVE LAYERS OF THE SKIN AND AFFECT INTERNAL ORGANS?
UV light rays from indoor tanning units have the ability to penetrate the dermis and the epidermis skin layers, down to the skin's sub-cutaneous layer. Because UV light does not penetrate further, internal organs cannot be affected.

WHY DOES A TAN "DISAPPEAR"?
The cosmetic tan. or pigmentation process, occurs in the top layer of the skin. The skin cells in this top layer (epidermis) are replaced every 28-30 days. A tan can be maintained only by repeated exposure to UV light.
WHAT IS THE SUN PROTECTION FACTOR (SPF)?
The Sun Protection Factor (SPF) is the ratio between the amount of exposure to UVB rays required to cause skin redness when a chemical sunscreen is applied compared to when it is not. WHAT IS THE DIFFERENCE BETWEEN A SUNBLOCK AND A SUNSCREEN?
Sunblocks (physical sunscreens) are opaque formulations which absorb, reflect and scatter up to 99% of both UV and visible light. Because they are messy and may stain clothing, sunblocks are often used on such sun-sensitive areas as the nose, lips, ears and shoulders. Examples of ingredients in sunblocks are zinc oxide and titanium dioxide.
Sunscreens (chemical sunscreens) absorb specific wavelengths (range of 200-400 nm) and are classified as drugs by the FDA because they are "...intended to protect the structure and function of the human integument against actinic damage." Sunscreens are considered more cosmetically refined due to their pleasing consistency and are, therefore, typically used over a prolonged time for effective photoprotection.

INTRODUCTION TO SAE

The Suntanning Association for Education (SAE) is the only non-profit trade association for the indoor tanning industry with the mission to organize, unite, and serve its members by providing programs, services and products to advance the individual professional development of each member and the collective professionalism  and growth of the indoor tanning industry. SAE  educates individuals about responsible indoor tanning practices and advocates the individual choice to tan indoors, responsibly and in moderation. SAE provides positive and accurate facts about indoor tanning to the national media balancing the often distorted image of indoor tanning presented by the media.

THE PROFESSIONAL EDGE: THE SAE Basic Associate National Curriculum (BANC TRAINING PROGRAM) & THE CERTIFICATE of COMPLETION

When you notice the individual accomplishment of the salon operator represented by the BANC Certificate of Completion you can be confident that this individual has attended a one day training seminar and passed the written examination covering all FDA regulations, specific state indoor tanning regulation and information such as: the biological effects of ultraviolet light, photosensitivity, ultraviolet light and eye protection, tanning center management practices and equipment maintenance and operation. This indoor tanning professional is then qualified to recommend a tanning program suited to your individual needs.

WHAT ARE THE PROFESSIONAL PRACTICES & SERVICES OFFERED BY SAE MEMBER SALONS?

THE PROFESSIONALLY TRAINED STAFF WILL:

·provide you with a thorough orientation to indoor tanning and risks prior to your use of any indoor tanning technology orienting you with such topics  as: skin typing, photosensitivity, the importance of following the unit's exposure schedule and instruction on wearing protective eyewear and do so in a courteous, friendly and accountable manner AND
·provide you with the necessary consent forms for your review and  signature
·refuse to allow individuals longer exposure than recommended by the unit
        manufacturer's exposure schedule
·refuse to tan individuals that will not use protective eye wear
·display all required warnings signage
·display of a chart of photosensitizing agents
·use FDA compliant lamps in FDA compliant equipment
·use appropriate sanitizing agents to maintain a clean tanning environment





THE BRIGHT SIDE OF INDOOR TANNING
Suntanning Association for Education