Basal Cell Carcinoma at a Young Age: Another Consequence of Tanning Beds

Tanning bed users younger than 40 developed early-onset BCCs significantly more often than nonusers.

Over the past 4 decades, the incidence of basal cell carcinoma (BCC) has increased markedly, particularly in women under the age of 40. This increase coincides with the more frequent use by the public of tanning beds for cosmetic purposes. Estimates suggest as many as one third of teenagers in the U.S. have used tanning beds at least once, and 40% regularly use this means of tanning. Although good epidemiological evidence associates tanning bed use with cutaneous squamous cell carcinomas (SCCs) and melanomas, the effect on BCCs has been less certain. Investigators examined the development of BCCs in young tanning bed users.

The researchers compared interview responses by 376 patients with prior history of biopsy-proven BCC and 390 patients with other dermatological conditions (age, <40 in both groups). Men and women who had used indoor tanning beds at least once were significantly more likely than never-users to have early-onset BCC (BCC that develops before age 40; odds ratio, 1.69). The association between tanning bed use and early-onset BCC was greater in women than in men and greater in patients with multiple BCCs than in those with single BCCs. In multivariate analysis, this association grew stronger with increasing years of use. Researchers also identified a strong association between early-onset BCC and having had a tanning bed–induced burn. Compared with nonusers, tanning bed users were nearly four times more likely to have BCCs on the extremities and more than twice as likely to have BCCs on the trunk. Tanning bed users had no observable increase in BCCs on the head and neck, areas subject to considerably more ambient sun exposure. The authors estimated the percentages of early-onset BCCs that could have been prevented by tanning bed avoidance at 27% overall and 43% among women alone.

Comment: Few studies have evaluated the association between tanning bed exposure and basal cell carcinoma, and the results of existing studies are inconclusive because most included older individuals in the study population. This well-designed study was limited to assessment of the under-40 population that is most likely to use tanning beds. The observation that tanning bed use was associated with BCCs of the trunk and extremities highlights the importance of complete examinations of frequent tanning bed users, not only for BCCs but also for melanomas and squamous cell carcinomas of the skin.

 Craig A. Elmets, MD

Published in Journal Watch Dermatology February 3, 2012


Ferrucci LM et al. Indoor tanning and risk of early-onset basal cell carcinoma. J Am Acad Dermatol2011 Dec 8; [e-pub ahead of print]. (


  1. #1 by Hein Vandenbergh on February 4, 2012 - 5:30 am

    Interesting comments in that study, esp the comment that there is good epidemiological evidence of increased incidence of SCC and melanoma with tanning [beds].

    My understanding has alway been that incidence of BCC and melanoma ran in parallel lines – the latter with decreased incidence – associated with the same solar exposure factors, esp blistering sunburn in childhood. I thought SCC ran its own merry race, associated with regular intensive solar exposure such as seen in e.g. farmers.

    One wonders here whether those who used tanning beds had, in fact, increased solar exposure to sunlight during N hemisphere summers and used tanning beds ‘to maintain that healthy look’ during those long, dark northern winters. I think there is more to it than just tanning bed exposure.

    What kind of UV light predominates in tanning salons?

    Still, BCC being the commonest cancer in the world, and the commonest skin cancer [allowing for all those 6% pa risk of SCC AKs being cryoed b4 they ‘go off’!], it’s going to take a mighty big study to draw conclusions, certainly requiring more than questionnaires of 766 pts. I think this is indicative of a deeper sun-exposure malaise amongst sun-bed users, for which the study does not adjust [would be hard to assess in any case]. Add into that the fact this is an observational study, and one is left with an interesting read, but nothing to really hang one’s hat on.

    Thanks Ian, food for thought.


Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: