A legislative study commission is examining the issue of whether to ban older teenagers from tanning salons in an effort to help address skin cancer among youth.

North Carolina Child Fatality Task Force committee members met recently to learn more about doctors’ continued efforts to increase the age of children requiring a written prescription to use indoor tanning equipment from 13 to younger than 18.

The North Carolina Dermatology Association has supported expanding the state’s ban and maintains tanning beds lead to an increased risk of melanoma — the most serious form of skin cancer.

Indoor tanning advocates argue tanning beds offer a controlled environment compared with outdoor sun rays.

"We’re very sun-conscious and exposure-minded," David Welch, owner of Saule Tanning on Carolina Beach Road, said Tuesday, Jan. 24. "Everybody who comes in we talk to on an individual basis, whether it’s a 14-year-old person or a
50-year-old person."

Unintended consequences may occur from such a ban because it could remove layers of supervision, Indoor Tanning Association Executive Director John Overstreet said Jan. 24 from Washington, D.C.

"In Wilmington, they’re going to go straight over to the beach," Overstreet said. "They may be making the problem worse, the problem they’re trying to address, which is kids getting sunburned."

But Dr. Rosalyn George, a dermatologist at the Wilmington Dermatology Center near Wrightsville Beach, said teenagers could always go to multiple tanning salons.

"There’s no way for the tanning beds to claim that they’re monitoring how much sun exposure people get," George said.

George said she had visited tanning salons as a teen before going to medical school and understanding the risks.

She also has recommended some tanning for certain patients with skin conditions that include eczema or psoriasis.

"I’m not anti-tanning industry or small business," George added. "This is a known carcinogen with a severe impact in children under 18."

Doctors and indoor tanning representatives seemed to agree on several points:

• There are health benefits from vitamin D, which our bodies can produce from sun exposure.

• The incidence of melanoma has been a concern since the 1930s — before tanning beds.

• Tanning is not the only cause of melanoma; other risk factors include genetic conditions and chemical exposures.

Supporters of the tanning bed restrictions should broaden their scope, Fred Knopp, owner of Tropical Tans on Wrightsville Avenue, said Jan. 24.

"They have gotten so tunnel-visioned on sun and tanning beds that they’re ignoring the other external factors going on here that actually may be causing it," Knopp said.

"But UV radiation is by far the No. 1 risk factor," George said. "And tanning is individually associated with that."

George also argued there are other ways to get vitamin D besides tanning, including through a supplement, healthy diet and about 10 minutes of sunshine a day.

North Carolina currently requires parental permission for children ages 13 to 18 to visit tanning salons and is among at least 31 states to regulate tanning bed use among minors, according to the National Conference of State Legislatures’ website, which also reported that California forbids all minors from using tanning beds.

A bill requiring a doctor’s prescription for older teens was introduced in the North Carolina General Assembly last year but stayed in committee.

Indoor tanning advocates say most clients are younger women but older men are most at risk of melanoma, while doctors say there have been rapid increases of melanoma among young women.

The Skin Cancer Foundation has reported that most melanoma diagnoses occur in white men older than 50, citing information from a 2011 National Cancer Institute study.

But the foundation also reported that melanoma among young women has jumped 50 percent from 1980 to 2004, referencing a 2008 Journal of Investigative Dermatology article.

The North Carolina Dermatology Association’s presentation to the task force on Monday, Jan. 23, included a controlled study figure published in 2010 in the International Journal of Cancer that attributed 76 percent of melanomas in 18- to 29-year-olds to indoor tanning that included even one session.

"It’s clear to us in the scientific community that if we protect children from the tanning beds then I have to do less surgery, and I’m OK with that," Dr. David Ollila, a surgical oncologist and surgery professor with the University of North Carolina at Chapel Hill, said during an audio feed of the meeting. "There’s no doubt that the youth are being harmed."

Lee Feldman, chief scientific officer at the Institute for Scientific Policy Analysis in Washington, D.C., also spoke to the task force and argued that while there was consensus around the problem of melanoma there was less of a consensus as to the causes.

"We need to look at science, not advocacy," Feldman said.