Both genetic and psychiatric factors may play a part in tanning "addiction," according to a recent study from Georgetown Lombardi Comprehensive Cancer Center.
“In our research we found that people with certain genotypes in DRD2 dopamine receptor genes are at higher risk of indoor tanning addiction, and those with elevated depressive symptoms are, too,” lead author and associate professor of oncology Darren Mays, PhD, told Healthline.
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“We also found some evidence of an ‘interaction’ between these two factors, meaning those with certain genotypes in DRD2 genes and elevated depressive symptoms may be at an even greater risk,” he said.
Mays and colleagues analyzed survey responses from almost 300 non-Hispanic white women in the Washington, D.C. area, who were ages 18 to 30 and who used indoor tanning beds, sunlamps, or sun booths.
The participants responded to questions about values and behaviors that might predispose a person to a tanning addiction, as well as questions to determine if they had symptoms of depression.
“Some of the self-report questions we used do measure factors that put people at risk of other addictions. For example, psychiatric comorbidities such as depression and addiction often co-occur. However, we did not measure other addictions, such as to drugs or alcohol, formally in our study,” Mays said.
The researchers also collected saliva samples from respondents to obtain DNA. In the samples, they looked for 34 single nucleotide polymorphisms (SNPs) in five different genes.
SNPs are changes in one of the base molecules on a strand of DNA. The specific SNPs that researchers looked at were in genes known to be related to pathways that reward addictive behavior.
Mays said the data collected from DNA indicates that variation in DRD2 dopamine receptor genes are associated with indoor tanning addiction.
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“In other words, in our data people with certain genotypes had a greater likelihood of meeting our criteria for tanning addiction. Replication of these findings in future studies will be important to confirm what we’ve found, too,” he said.
A problem worth studying
Most skin cancers are caused by exposure to ultraviolet (UV) rays in sunlight.
The most common forms of skin cancer — basal cell and squamous cell — tend to be found on body parts that are most exposed to the sun, such as the face.
The risk of melanoma is also related to sun exposure. The American Academy of Dermatology reports that “it is estimated that 192,310 new cases of melanoma, 95,830 noninvasive (in situ), and 96,480 invasive, will be diagnosed in the U.S. in 2019.”
Skin cancer has also been linked to exposure to some artificial sources of UV rays, such as those from indoor tanning. In fact, researchers estimate that indoor tanning may cause upwards of 400,000 cases of skin cancer in the United States each year.
Mays said the prevalence of skin cancer as it relates to indoor tanning makes the context of his research important.
“The link between indoor tanning and an increased risk of skin cancer is well-established, and it is especially important in young people because it increases the risk of a skin cancer (particularly melanoma) diagnosis early in life,” Mays said.
“By gaining a better understanding of indoor tanning addiction and developing interventions to help people quit, we can make progress to prevent and reduce skin cancer in this population,” he added.
How to treat tanning addiction
Mays is building on his study results and working to develop and test interventions and resources designed to help young women who may be addicted to indoor tanning quit.
He’s currently studying a mobile text messaging program that delivers information about the risks of indoor tanning combined with behaviorally-motivating content.
“The idea we are pursuing is whether interventions that have evidence of efficacy for other addictive behaviors such as cigarette smoking can be adapted and applied to indoor tanning addiction,” said Mays.
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Jenifer Cullen, PhD, a clinical psychologist in Belmont, Massachusetts, said in order to best treat someone who excessively tans, she has to first understand why they tan.
“If their reason is, ‘I’m going to the tanning bed because they make me feel good and it takes my mind off things, and when I leave there, I’m in a better mood,’ then that would be tied to possibly depression,” Cullen told Healthline.
In addition to medications, Cullen said cognitive behavioral therapy (CBT), which is talk therapy that helps you become aware of inaccurate or negative thinking, is often used to treat depression.
“CBT gets people into contact with the things in their life that are meaningful and important to them like religion and community, and has them access those things because people who are depressed typically isolate themselves, and the more they isolate, the more they become more and more depressed,” said Cullen.
In reference to tanning, the goal of CBT would be to eliminate the desire to mood enhance with tanning.
Cullen also points out that extreme tanning could be caused by body dysmorphic disorder (BDD), a condition in which a person obsessively focuses on a perceived flaw in their appearance.
“Someone with BDD who excessively tans may say, ‘I’m not happy with the color of my skin. It’s too pale, too white. I need to look dark.’ And they will do all sorts of compulsive behaviors in an effort to perfect their skin,” Cullen explained.
The go-to treatment for BDD is exposure and response prevention (ERP), a type of therapy that exposes a person to their thoughts, images, objects, and situations that make them anxious or trigger their obsessions.
“As far as tanning, if the person wants the color of their skin to be dark, we would have them go outside wearing a high SPF, and tell them they have to wear a high SPF every time they go outside, so that eventually the color of their skin will return to the natural,” Cullen said.
By doing the opposite of what their disorder tells them to do, she says over time they learn to change the relationship with their appearance.
“Anyone with BDD is trying to perfect the ‘defect’ they perceive,” Cullen said. “Through ERP, the goal isn’t to get them to like their skin color, it’s to accept their appearance as is without trying to change it.”
Cullen notes that BDD is not an addiction.
“I don’t think the person with BDD is addicted to the tanning. They’re more addicted to the effect because their [journey is to] perfect their appearance, and the tanning just becomes a compulsion to try to achieve the results,” she said.
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Still, she says tanning addiction isn’t something to take lightly.
“If a person feels like both they couldn’t stop tanning, but also it is interfering in their life in some way, then they need to seek professional help,” she said.
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