By Carla Ximena Torres-Zegarra, MD, FAAD, FAAP 

Many young people are interested in tanning to achieve a certain appearance or to fit beauty trends promoted on social media. Recently, online movements such as “looksmaxxing” and “tanmaxxing” have encouraged teens to pursue darker skin tones through a variety of methods, some of which may be unsafe. While a tan is often perceived as healthy or attractive, it is actually a sign of skin damage caused by ultraviolet radiation (UV) radiation. 

Pediatricians can use conversations about tanning trends as an opportunity to discuss body image, media literacy, and healthy self-esteem. Helping teens recognize that many online beauty standards are unrealistic can reduce pressure to alter their appearance and promote healthier long-term behaviors. Encouraging adolescents to appreciate their natural skin tone and focus on positive habits rather than appearance-based trends can help foster a healthier relationship with their bodies. 

While sunlight can be damaging to the skin, artificial sunlight in tanning salons can be particularly dangerous. UV radiation from tanning salons increases a person's risk of developing skin cancer, including melanoma, the most dangerous type of skin cancer. Tanning beds are considered carcinogenic and are classified in the same category as cigarettes and asbestos. According to the American Academy of Dermatology, approximately 1 in 5 Americans will develop skin cancer during their lifetime. Indoor tanning before age 35 increases the risk of melanoma by approximately 59%, and the risk rises with more frequent use. 

The American Academy of Pediatrics supports legislation prohibiting access to tanning salons and artificial tanning devices for individuals under age 18. Despite strong recommendations from pediatric and dermatology organizations, regulations regarding indoor tanning vary by state. 

One alternative to tanning beds is the use of sunless tanners, more commonly known as spray tans. Sunless tanners use dihydroxyacetone (DHA), a chemical that reacts with amino acids in the outermost layer of skin to create a temporary darker appearance. DHA-containing tanning preparations may be applied in tanning booths or at home using lotions, foams, sprays, or tanning mitts. Bronzers are water-soluble dyes that temporarily stain the skin and are easily removed with soap and water. 

While spray tans are generally considered safer than tanning beds because they do not expose the skin to UV radiation, they do not improve skin health and should not be viewed as a substitute for sun protection. Because neither DHA nor the pigments it creates provide meaningful UV protection, teens should continue to use sunscreen and other sun-safe behaviors when outdoors. Additionally, any sunscreen incorporated into a sunless tanning product only provides protection during the initial application and must be reapplied according to product instructions. 

Another tanning method gaining popularity on social media involves nasal tanning sprays that contain laboratory-produced hormone analogues designed to stimulate melanin production. These products often require UV exposure to achieve the desired tanning effect, meaning users are still exposing their skin to harmful radiation. This may encourage teens and young adults to spend even more time in the sun without adequate sun protection. 

The U.S. Food and Drug Administration (FDA) does not approve these products, and their safety profile remains largely unknown. Because the ingredients and concentrations may vary widely, there is no guarantee that the contents match what is listed on the label. Reported side effects include acne, nausea, gastrointestinal symptoms, facial flushing, decreased appetite, and spontaneous erections. 

Although tanning bed use has declined over the past decade, social media trends and concerns about appearance continue to drive interest in tanning. Experimental and unregulated tanning methods may carry unknown long-term health risks. The safest tan is no tan. 

Instead of tanning indoors or outdoors, encourage teens to embrace their natural skin tone and focus on healthy skin habits. Daily use of a broad-spectrum sunscreen with SPF 30 or higher, seeking shade, wearing protective clothing, and avoiding indoor tanning can significantly reduce the risk of skin cancer and premature skin aging. If a tanned appearance is desired, sunless tanning products are a safer cosmetic alternative than UV exposure, but they should never replace sun protection. 

For more information, go to HealthyChildren.org.