Are you addicted to the sun?
On bright, sunny days, many people can't wait to slip into bathing suits and flock to beaches and pools, despite widespread warnings that spending hours at a time soaking up the sun can increase the risk of skin cancer. When the summer ends, countless people, especially young adults, bring their sun-worshipping habits indoors as they visit tanning salons. In an effort to understand what's behind this persistent desire to soak up the sun's rays, researchers have begun to study whether exposure to ultraviolet, or UV, radiation could be somewhat addictive – and there is some evidence that the answer is yes.
A 2016 study from Finland and a 2014 study from Massachusetts General Hospital both found that exposure to low-dose UV radiation causes the release of beta-endorphins (the body's natural painkillers) in the skin. It's a process that's linked to the same pathway involved in pigment synthesis in the skin – "beta endorphins are a byproduct of that," explains Dr. David Fisher, chairman of dermatology at Massachusetts General Hospital/Harvard Medical School. This production of beta-endorphins in the skin leads to elevated blood levels of endorphins, which can then travel to the brain where they target opiate receptors, stimulating the same reward pathway as morphine and related opioid drugs, Fisher adds. "There is a feel-good component to it."
Indeed, besides inhibiting "pain signaling, endorphins can lead to feelings of euphoria," explains Aaron Blashill, an assistant professor of psychology at San Diego State University. "People enjoy reducing pain and experiencing pleasure – the experience is highly reinforcing – so if UV exposure leads to endorphin release, a cycle of habitual tanning behaviors can set up shop."
Who's at Risk of Getting Hooked?
Women, especially those with lighter skin, tend to have a higher risk of developing tanning dependence than men do, researchers say. And "the younger you are when you start tanning, the more likely you are to later have a problem with it," says Dr. Bryon Adinoff, a professor of psychiatry at the UT Southwestern Medical Center in Dallas. There also may be a hereditary component: A 2014 study from the Yale School of Public Health and the Yale Cancer Center found that people who carry a particular variant in the PTCHD2 gene may be more likely to develop an addiction to tanning.
Psychological factors come into play, as well. In a 2016 study published in JAMA Dermatology, researchers surveyed 74 women between ages 19 and 63 who went for at least 10 indoor tanning sessions in the previous year to identify some of the psychological underpinnings of their habit. (Keep in mind: Indoor tanning involves a more concentrated level of UV exposure than the outdoor variety does.) It turns out that 39 percent of them screened positively for body dysmorphic disorder, or BDD, issues, 57 percent did for seasonal affective disorder and 30 percent for high levels of perceived stress.
For some, "indoor tanning is like self-medication – people may be using tanning salons as a way to resolve or cope with their symptoms," notes study co-author Sherry Pagoto, a psychologist and professor of medicine at the University of Massachusetts Medical School in Worcester. And in the case of BDD, "these individuals may be tanning because they are dissatisfied with their skin tone or complexion – skin concerns are some of the most commonly noted appearance concerns among people living with BDD," co-author Blashill adds.
Similarly, a 2014 study at the University of Michigan found that people with problematic tanning behaviors and tanning dependence had higher scores on measures of obsessive-compulsive disorder and body dysmorphic disorder. And a 2010 study published in JAMA Dermatology found that people who met the Diagnostic and Statistical Manual of Mental Disorders, known as the DSM-5, criteria for addiction to indoor tanning reported greater symptoms of anxiety and greater use of alcohol, marijuana and other substances.
How to Kick the Unhealthy Habit
The first step is to recognize that you may be hooked on tanning if you're frequently seduced by sunshine or often engage in indoor tanning. If you tend to experience symptoms of withdrawal (such as irritability or restlessness), if you often say you're going to stop tanning but you don't or if you've had skin cancer and you continue to tan, "acknowledge that this is a problem for you," Adinoff says.
Then, give yourself a reality check by focusing on the health risks. "The most common carcinogen in the whole world is UV radiation," Fisher says. In fact, the vast majority of melanoma (the deadliest form of skin cancer) cases are caused by sun exposure, according to the Skin Cancer Foundation. "We're seeing an increase in the rate of skin cancer, particularly among young women, and that has been linked to indoor tanning," Pagoto notes.
What's more, if you're trying to look good now by getting a tan, there's a good chance your appearance will pay a price later. "Repeated UV exposure of the sort that produces tanning also accelerates the process of aging of the skin, including the development of wrinkles, hyperpigmentation and other skin growths [that may be benign or malignant]," Fisher warns.
Meanwhile, it's important to try to figure out what the exact appeal of tanning is for you. "Ask yourself why you're tanning – is it related to physical appearance issues or body image, or how you feel or cope with negative moods?" Pagoto suggests. Once you understand why you're tanning, you can begin to look for healthier ways to get the same desired effect. "If you like the way a tan looks and don't want to let go of that, consider getting a professional spray tan," Pagoto advises. "Then, you can have your tan and not have to worry about damaging your skin."
If it's the endorphin release that seems to make you feel better, try getting the same feel-good results with exercise. (Remember the "opioid theory" behind the runner's high?) If tanning is a coping mechanism, you'd be better off developing better tools, perhaps by working with a therapist who specializes in cognitive behavioral therapy, Pagoto says.
If you suffer from SAD, talk to a therapist or your doctor about whether bright light therapy might help you. "There is evidence that it is effective in treating SAD," Pagoto says, "so it's a win on all fronts because it doesn't utilize UV rays."
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