Examining Dermatologist Use and Opinions of Ultraviolet Radiation for Cosmetic and Medical Purposes

Abstract

BACKGROUND: The commercial tanning industry has opposed efforts to educate the public on the risks of tanning as well as attempts to restrict minors' access to tanning services. Despite a paucity of supporting literature, statements from the tanning industry claiming that dermatologists routinely use in-office phototherapy for cosmetic treatments and refer patients to tanning salons have successfully derailed and defeated legislation in many states. OBJECTIVE: This study aims to evaluate dermatologist referrals for ultraviolet radiation for cosmetic and medical purposes via tanning beds or phototherapy, as well as their opinions on tanning, legislation, and ultraviolet radiation counseling practices. DESIGN: The study was conducted using a 10-question anonymous survey. SETTING: The participants were surveyed during meetings of three regional dermatologic societies. PARTICIPANTS: One hundred and fifty-two dermatologists attending society meetings participated in the study. MEASURES: The authors measured physician referrals, opinions, and recommendations regarding ultraviolet exposure. RESULTS: Zero physicians (0/152) recommended tanning salons for cosmetic reasons. These 152 dermatologists referred 458 (417 adult, 41 pediatric) out of an estimated 809,369 patients (0.057%) to tanning salons for medical treatment. Of these physicians, 76 out of 152 and 15 out of 152 reported referring at least one adult or one pediatric patient, respectively, within the last year. All respondents supported ultraviolet tanning legislation and discouraged cosmetic tanning. CONCLUSION: These findings directly contradict the assertion that dermatologists use ultraviolet radiation for cosmetic purposes or routinely refer patients to tanning salons. This study underscores the complex nature of ultraviolet radiation, as dermatologists infrequently utilize ultraviolet radiation for medical purposes and unanimously support restrictive legislation. In addition, these dermatologists counsel against cosmetic tanning and list tanning bed use among their highest concerns with regard to the health of pediatric patients.

Keywords: Dermatologist referrals; UV; UV counseling practices; UV exposure; legislation; pediatric dermatology; phototherapy; public health policy; tanning; tanning bed; tanning regimen; tanning salon; ultraviolet radiation.

FIGURE 1.

Recommended tanning regimens. Complete regimens recommended to either adults or minors for medical treatment in tanning beds, including: 1) minutes per session (y-axis), 2) sessions per week (x=3, Δ=2.5, □=2, ◆=1), and 3) weeks of treatment (x-axis)

FIGURE 2.

Physician concern for pediatric patients: Comparison of the average level of concern providers have for pediatric patients’ wellbeing with regards several health-related issues. Data presented as mean with error bars representing standard error

APPENDIX 1.

Survey used for study