Medical Experts: Spray Tanning Not Safe
Commentary by Ray Allard Tan Plus/ Essentials Of Life
Since the late 1990's Tan Plus, as well as most tanning salons worldwide, have
been solicited by spray tanning equipment and solution distributors to add
their "safe UV alternative" as a service at our salon. Due to our concerns
about the short and long term potential health affects of the chemical, DHA
(dihydroxyacetone) used as the coloring agent, we declined to offer spray
tanning. We would not apply this chemical to our own skin so we could not
justify doing this to our customers. Your skin is like a sponge. What you put
on it will eventually be absorbed into the blood stream. We have been openly
critical of dihydroxyacetone used in spray tanning as well as other chemicals
used in sunscreen and "tingle factor" lotions.
Needless to say, many tanning salons and even dermatologists jumped on the spray
tanning bandwagon as a way to boost revenues. Most disturbing to me was that
doctors took their authoritative position to persuade their patients, even
pregnant women, to spray tan while providing absolutely no evidence of the
safety of the chemical, dihydroxyacetone and without any concern of the
potential affects to the fetus.
After thorough review, six medical experts have concluded that the active
chemical used in spray tans, dihydroxyacetone (DHA), has the potential to cause
genetic alterations and DNA damage. The panel of medical experts reviewed 10 of
the most-current publicly available scientific studies on DHA for ABC News,
including a federal report ABC News obtained through the Freedom of Information
Are 'Spray-On' Tans Safe? Experts Raise Questions as Industry Puts Out Warnings
By Mark Greenblatt and Gitika Ahuja
Six medical experts in areas ranging across the fields of dermatology,
toxicology and pulmonary medicine said they "have concerns" after reviewing the
literature and reports about DHA, the main chemical in the popular "spray-on"
tan, which has conventionally been referred to as the "safe" alternative to
tanning under ultraviolet lights.
None of the reviewed studies tested on actual human subjects, but some found DHA
altered genes of multiple types of cells and organisms when tested in different
labs by different scientists after the chemical was approved for use in the
consumer market. "I have concerns," said Dr. Rey Panettieri, a toxicologist and
lung specialist at the University of Pennsylvania's Perelman School of
Medicine. "The reason I'm concerned is the deposition of the tanning agents
into the lungs could really facilitate or aid systemic absorption -- that is,
getting into the bloodstream." Panettieri, like all the experts ABC News
consulted with, said more studies should be done. He emphasized the available
scientific literature is limited. Still, he said, he has seen enough to say the
warning signs of serious health concerns exist.
"These compounds in some cells could actually promote the development of cancers
or malignancies," he said, "and if that's the case then we need to be wary of
The FDA originally approved DHA for "external" use back in 1977, when it was
popular in tanning lotions. Those lotions, previously famous for turning skin
orange, were never as popular as current products that produce better tans. In
recent years, the use of DHA has exploded in the newer "spray" application of
the product, which provides a more even tan for consumers.
The FDA told ABC News it never could have envisioned the chemical's use in spray
tan back in the 1970s, and says "DHA should not be inhaled or ingested" today.
It tells consumers on its website, "The use of DHA in 'tanning' booths as an
all-over spray has not been approved by the FDA, since safety data to support
this use has not been submitted to the agency for review and evaluation." The
agency advises consumers who spray tan they are "not protected from the
unapproved use of this color additive" if they are inhaling the mist or
allowing it to get inside their body. The agency recommends, "Consumers should
request measures to protect their eyes and mucous membranes and prevent
inhalation." However, ABC News found some tanning salons offering consumers
advice that directly conflicts with what the Food and Drug Administration has
ABC News sent undercover cameras into a dozen randomly selected tanning salons
in New York City ranging from a large corporate location to smaller mom-and-pop
salons. Every salon ABC News visited said spray tanning was completely "safe"
with or without protective gear. When asked, nine out of 12 salons did not have
any eye covers in stock. Similarly, nine out of 12 salons did not have nose
plugs in stock. Eleven out of 12 failed to have any protective gear for the
mouth available. However, even if salons had some of the gear in stock, every
salon ABC News visited discouraged using it. "You don't need it. You really
don't need it," one salon employee said. Another discouraged eye protection,
saying it would impact the appearance of the tan. "We wouldn't recommend for
you to wear them because when you spray your face that part is going to be not
tan," a salon employee said. A different salon said, "We also have goggles but
you don't need them." Yet another salon wrongly told undercover ABC News
producers that DHA is so safe, it is used to help treat diabetes and can be
injected into the body.
Spray Tans: False Sense of Security Given Online
DHA the FDA tells consumers not to inhale or ingest, also called
dihydroxyacetone, is the chemical that turns your skin brown. However, an omega
3 fatty acid called docosahexaenoic acid also shares the same abbreviation
ABC News also discovered many tanning salons across the nation wrongly telling
consumers on their websites that DHA is so safe that it is "food grade," and,
"approved for ingestion by the FDA." One potential source of the inaccurate
information was one of the largest manufacturers of spray tan product in
America, Norvell Skin Solutions, ABC News found. The company runs what it calls
"Norvell University," a detailed educational course designed for tanning salons
and technicians who wish to offer spray tans to clients. ABC News found Norvell
wrongly training salons online and in its course material by saying that "DHA
is a food grade product approved for ingestion by the FDA. In fact, the largest
user of DHA in the world is the health supplement industry."
The salons and Norvell may have been confusing two very different kinds of
"DHA," each with the same abbreviated name. The type of DHA the FDA tells
consumers not to inhale or ingest, also called dihydroxyacetone, is the
chemical that turns your skin brown. However, an omega 3 fatty acid called
docosahexaenoic acid also shares the same abbreviation "DHA." That type of DHA
can be found in salmon or milk. It is approved by the FDA to be eaten and is
thought to help reduce the risk of coronary disease. "We were absolutely in
error," said Rick Norvell, president of Norvell Skin Solutions, after ABC News
contacted him about the discrepancy.
DHA: 'A Potential Health Hazard'?
The FDA recently released a report to ABC News, following a Freedom of
Information Act request, in which agency scientists wrote, "New information
regarding the genotoxicity and carcinogenicity of DHA has become available
since the listing of DHA as a color additive."
In the report, dated 1999, agency scientists cited the "new information"
discovered by non-FDA researchers who had tested DHA in laboratory settings and
found it had the potential for what they called a "mutagenic" effect on genes.
The various studies, conducted mostly by university researchers, tested DHA's
effects on different types of cells and organisms, including bacteria,
salmonella, ecoli and mice skin cells grown in a lab. None of the tests done at
the time tested human cells or humans themselves. Still, the results were
enough to prompt the agency in the 1990s to attempt to determine how much DHA
might be seeping into the living areas of the body when applied to the skin to
tan. Prior to the FDA release this year of its 1999 report to ABC News, the
tanning industry and even many in the field of dermatology thought DHA only
interacted with proteins in the outer protective layers of human skin, also
called the stratum corneum, where the skin cells are already dead and where DHA
could pose no health risk. However, in the report released to ABC News, FDA
scientists concluded that DHA does not stop at the outer dead layers of skin.
They wrote: "The fate of DHA remaining in skin is an important issue, since
high DHA skin levels were found." They added that tests they performed revealed
that much of the DHA applied to skin actually ended up in the living layers of
skin. They concluded: "This leaves about 11 percent of the applied DHA dose
absorbed remaining in the [living] epidermis and dermis."
Four years after the report was issued, the FDA wrote a follow-up paper based on
the same data, concluding that "probably" only 0.5 percent of each application
of DHA becomes "systemically available," meaning distributed throughout the
body after reaching the bloodstream. The agency concluded that 0.5 percent of
an applied dose of DHA was poor absorption, and no further testing was done to
check for actual toxicological impacts on the human body. The thinking was that
because only a little bit of DHA entered the bloodstream, the health risk would
be very low. However, any absorption into the living areas of the skin could be
pose a potential risk, even if none of it made it into the bloodstream, said
Dr. Darrell Rigel, an NYU professor of dermatology. The fact that some does
potentially get into the bloodstream raised additional red flags for him that
he said needed to be further explored. Rigel was especially concerned for
repeated users of the product and those in higher-risk groups such as pregnant
women or young children.
Girls as young as 4 years old who compete in beauty pageants are known to be
spray tanned by their moms, who believe the tan to be a completely safe way to
give their children a darker glow. Rigel believes the FDA paper, combined with
other literature he reviewed, would surprise many of his colleagues in the
medical field. He said the papers were enough to make him change what he will
tell his patients about spray tanning. "What you showed me certainly leads me
to say I have to rethink what I'm doing and what I'm saying because there's ...
a real potential problem there," he said. "I feel that I must give my patients
the information that you've given to me, because I think it is valid."
Following receipt of the 1999 FDA report, ABC News located nine other studies
performed mostly by non-government university researchers on DHA. ABC News
asked Rigel and five other medical experts to review the papers and anything
else they could find on their own, and to offer their analysis about potential
health risks. Before he read all of the papers, Rigel said, he would "tell my
patients what every other dermatologist tells them: 'If you want to be tanned,
[tanning with DHA] is effective, it's not being absorbed and there's no
long-term problems.' After reading these papers, I'm not sure that's true
anymore." "A potential problem has been identified and for public safety, more
studies should be done," added Rigel, a former president of the three largest
dermatological groups in the nation: the American Academy of Dermatology, the
American Dermatological Association, and the American Society for Dermatologic
"The concern here is we never thought this was getting absorbed," he said. "We
thought it's binding to the surface of the skin and that's where the stain is. So this is ... news that, in fact, it is penetrating beyond that."
ABC News also presented the panel of experts with information about some studies
that found no carcinogenic or potential cancer-causing impacts of DHA, such as
when it was tested on mice. However, that same FDA report from the 1990s raised
questions about whether some of those tests came up negative simply because the
DHA never absorbed into the skin of the particular type of mice tested.
Dr. Lynn Goldman, the dean of the School of Public Health and Health Services at
George Washington University, reviewed the same group of papers and said that
DHA tested positive for mutating genes in far too many different types of
studies to reject concerns about its health implications. "The substance seems
to have a potential for what they call creating mutations or changing DNA in
living cells, which is a serious problem and needs to be further investigated,
yet hasn't been," she said.
"What we're concerned about is not so much that reaction that creates the
tanning, but reactions that may occur deeper down with living cells that might
then change DNA, causing a mutation and what the possible impacts of that might
be," she said. "I'd be very concerned for the potential of lung cancer."
Researchers should, however, not just be concerned about cancer, but other
health effects such as birth defects, especially if a woman who was pregnant
was spray tanning and allowing the mist to get inside her body, Goldman said.
One tanning salon employee ABC News visited undercover, the lead trainer for a
large corporate chain of salons in New York, told undercover television
producers that DHA is "super safe," and, "great for pregnant women," something
Goldman disagreed with. Goldman is a pediatrician appointed by President
Clinton and approved by the Senate to serve in a top position at the EPA
overseeing chemical safety. She has since left the position and gone back to
university work. Her experience in both public health science and government
gives her an unusual perspective which bridges both health and regulatory
issues. "I think a lot of people assume that because things are on the market
that it means somebody has very carefully evaluated them and that they're
safe," she said. She was concerned about DHA mainly on two fronts -- firstly,
because of the new information scientists have learned about DHA since it was
approved for use in the 1970s. She believed the information was strong enough
to warrant a full review of the product's safety that takes into account all
potential health implications. Secondly, she said, the explosion in DHA's use
in spray tanning means many more people will be exposed to it in a manner that
has never been subject to an FDA safety review. "The use is expanding and it
doesn't prompt a re-evaluation," she said, "and I think that's a serious