Position Statement on Indoor Tanning
Considered by the National Psoriasis Foundation Medical Board on February 28, 2013; edited and reconsidered on July 31, 2013; Approved by the Medical Board on July 31, 2013
National Psoriasis Foundation (NPF) supports the following policy statement to ensure patient safety:
Phototherapy (light therapy), performed under medical supervision is safe, effective, and cost-effective. The National Psoriasis Foundation does not support the use of indoor tanning beds as a substitute for phototherapy performed with a prescription and under the supervision of a physician. Only medical professionals should provide and advertise light therapy for the treatment of psoriasis.
Phototherapy or light therapy, involves exposing the skin to ultraviolet light on a regular basis under medical supervision. Treatments are done in a doctor's office or at home with a phototherapy unit monitored by a health care professional. All phototherapy treatments, including purchase of equipment for home use, require a prescription.
The beneficial effect of using light therapy for the treatment of psoriasis is attributed primarily to ultraviolet light B (UVB). Present in natural sunlight, UVB is an effective treatment for psoriasis approved by the U.S. Food and Drug Administration (FDA). UVB penetrates the skin and slows the growth of affected skin cells. Treatment involves exposing the skin to an artificial UVB light source for a set length of time on a regular schedule. UVB can be combined with other topical and/or systemic agents to enhance efficacy, but some of these may increase photosensitivity and burning, or shorten remission.
The spectra of light in tanning beds vary greatly and often include wavelengths of light that are carcinogenic and photo-damaging. Moreover, unlike physician-prescribed phototherapy units, UVA is relatively ineffective unless used with a light-sensitizing medication psoralen, which is administered topically or orally. This process, called PUVA, is approved by the FDA. Psoralens should not be used with tanning beds as it may result in severe sunburn. Psoriasis often affects previously injured skin and the damage caused by sunburn can worsen psoriasis. This reaction to disruption of the skin barrier is known as the Koebner phenomenon.
The excimer laser is the only other phototherapy treatment option approved by the FDA for the treatment of psoriasis.
The American Academy of Dermatology, the United States Department of Health and Human Services and the World Health Organization all discourage the use of tanning beds and sun lamps. The ultraviolet radiation from these devices can damage the skin, cause premature aging and increase the risk of skin cancer.