"A SUNTAN generally is an indication of damage to the skin. It is a sign of skin damage, not of health."
So argues Dr Gillian Murphy, a consultant dermatologist, who takes a firm stand against excess exposure to the sun, but an absolutist position against the use of sunbeds. "Avoid the risks of sun exposure and don't use sunbeds at all because they are totally unnecessary. Use fake tan if you need to be brown."
The recent death of a man who was burned after using a sunbed to treat his psoriasis has again raised safety concerns about tanning equipment. Far from being a safer way to tan the skin, sunbed exposure causes the same skin damage as ordinary sunlight. It also adds to a person's cumulative lifetime exposure to ultraviolet (UV) radiation, the rays which cause the skin to go brown.
"It is the cumulative affect of ultraviolet on the skin that ultimately causes cancer," Dr Murphy explains. "The more you get the greater the risk."
She is strongly opposed to the use of sunbeds for psoriasis patients. Psoriasis is a common chronic skin disease which causes itchy, scaly, red patches.
"Generally I would not be in favour of a psoriasis patient using a sunbed at all. As a dermatologist I would never say to any of my patients to go on a sunbed.
Sunbeds can cause sun allergies, a type of itchy rash which in turn can encourage the spread of the psoriasis. Inflammation of the skin is possible because of the warmth, but a natural photosensitivity may also be exposed by these treatments, she said.
About one in eight psoriasis patients reacts badly to the UV, worsening their condition." "I have had people covered from head to foot with psoriasis after being on a sunbed," Dr Murphy said.
Far more serious, however, is the potential for skin cancers arising from UV exposure. "Ninety per cent of all skin cancers are caused by the sun," she says.
Tanning is the body's natural defence against the damage caused by UV. The UV rays cause two responses as the skin tries to limit the impact on sensitive deeper tissues. One is to stimulate cells called melanocytes which produce a dark pigment we recognise as a tan. The rays also cause the skin to thicken, increasing the protection against damage.
Despite these responses, damage still occurs in the deeper tissue layers and over time the damage can result in various types of skin cancer. Sunbed tanning is therefore part of the problem, not part of the solution to UV exposure.
Dr Murphy believes that those offering sunbed treatments should be "obliged by the authorities" to give customers information about the hidden risks for some individuals.
"Those on medication of any kind should not use sunbeds," Dr Murphy says. The drugs can interact at the skin's surface with the UV causing problems. The natural chemicals in many essential oils and perfumes can also react with UV rays, causing burns and skin damage.