More than 5 out of 6 indoor tanning businesses report having clients who patronize the salon as a less-expensive alternative to sunbed phototherapy in a dermatology office, according to a SmartTan.com poll conducted in August.

According to the poll, 86 percent of salons say they know they have clients who patronize the salon mainly because a $5 sunbed session is much less expensive than the insurance copayment of a $100 sunbed phototherapy session in a dermatology office. Only 14 percent said they didn’t know of clients whose main reason for tanning was to avoid dermatology fees — which doesn’t mean those salons don’t also have clients tanning for that reason, just that the salons didn’t know.

Many dermatology offices use sunbeds virtually identical to those used in indoor tanning businesses to treat purely cosmetic skin conditions — primarily psoriasis. Some dermatologists even refer patients to tanning salons in lieu of more-expensive phototherapy in their offices.

An International Smart Tan Network survey of 6,881 indoor tanning clients conducted in January 2010 showed that an estimated 1.5 million American utilized sunbed salons to informally treat psoriasis in lieu of phototherapy in a dermatologist’s office. Phototherapy procedures use the same equipment found in tanning salons. In fact, the Mayo Clinic cites UV light therapy as the standard of care for treating these ailments. According to the 2010 Smart Tan survey, 11 percent of tanning clients say a doctor referred them to a tanning salon for therapeutic reasons and that 28 percent of those referring physicians were dermatologists.

Dermatology’s usage of phototherapy sunbeds is defended as “safe” by dermatology leaders who simultaneously attack indoor tanning. Ironically, phototherapy protocol often involves higher dosages of UV light than are administered in tanning salons. Dermatologists using phototherapy often intentionally induce a mild sunburn to treat the cosmetic skin condition, according to the Journal of the American Academy of Dermatology. Tanning salons, in contrast, always deliver dosages designed to be non-burning based on a client’s skin type.

In 1993 dermatologists administered 873,000 visits for phototherapy sessions. By 1998, that number dropped by 94 percent according to the Journal of the American Academy of Dermatology, which in 2002 described phototherapy sessions as “a safe and effective treatment for psoriasis.” Patients figured out that indoor tanning was often just as effective, used the same equipment and was 20 times less expensive.

“If any UV exposure were as dangerous dermatology lobbyists contend, then dermatologists would be guilty of violating their Hippocratic oath for using UV in what they describe as burning dosages to treat purely cosmetic skin conditions,” said Smart Tan Vice President Joseph Levy. “Professional tanning facilities are trained to deliver non-burning dosages of UV light to create a cosmetic tan, but a side effect is that people are treating all sorts of conditions informally and effectively. What we’re really seeing is dermatology’s anger for the loss of billions of dollars in phototherapy treatments in their offices, as consumers choose a more economical and convenient method of self-care.”

Professional indoor tanning facilities promote a balanced message about UV exposure — acknowledging the risks of overexposure. In contrast, AAD continues to mislead the public by suggesting in its statements that any UV exposure causes melanoma, which completely misrepresents the science. “This has never been a health care debate,” said Levy. “This is the cosmetic dermatology industry attacking indoor tanning for strictly financial gain.”

The AAD has come under fire from within its ranks for its position on melanoma. In 2008, Dr. Bernard Ackerman — a pioneer in dermatology pathology recognized as a Master Dermatologist by AAD — backed up Smart Tan’s position about the complex relationship between UV and melanoma in the Dermatology Times stating, “There is no compelling evidence that sun tan parlors have induced a single melanoma,” and that any regulation of the tanning market “…should be predicated on evidence and not on accusation.”

In fact, AAD spokesperson Dr. James Spencer admitted in a May 2008 article in Dermatology Times that, “We don’t have direct experimental evidence,” referring to the fact that research has not shown a causative mechanism between indoor tanning and melanoma. The studies the AAD has referred to do not show causation — only weak correlations that are confounded by study design.

The organization continues to omit refuting evidence and studies and the fact that most studies don’t show a correlation.

Further, while AAD is lobbying to restrict indoor tanning, its lobbying efforts have always called for phototherapy treatment in dermatology offices to be exempted from further restriction.

“It’s time that researchers and the media start asking tough questions about why dermatologists refuse to talk about these issues and their real motivations around their attacks on indoor tanning,” Levy said.