Sunless Tanners: Is An Orange Glow The Only Risk?

Source: Photo by Magic Tan

Tan skin is all the rage, but maybe you would prefer to skip the rays and go straight for the spray.

After all, UV radiation is dangerous, whether it be from the sun or a tanning bed. It seems like everyone knows someone who has been diagnosed with skin cancer. So what do you do? Do you give up on getting the “jersey shore” look, or do you fake it? If you choose to fake it, whether by a spray or a pill, there are a few safety risks you should know about using sunless tanners.

Topical sunless tanners can come in many forms including lotions, gels, mousses, sprays, wipes, creams, and powders. But the main active ingredient most sunless tanning products share is dihydroxyacetone, or DHA. The FDA has approved DHA for topical use but warns against inhalation or exposure “to areas covered by mucous membranes including the lips, nose, and areas in and around the eye” (FDA, 2018).

The chemical process through which DHA’s darkens the skin is called the Maillard reaction. During this reaction, researchers observed a link between DHA and free radical injury to the skin. Sounds radical, right? Wrong. Free radicals are unstable atoms with unpaired electrons that can destabilize cell components such as DNA, even causing breaks in DNA strands, and have been associated with genetic degenerative diseases such as Parkinson’s disease and Alzheimer’s disease. Topical DHA levels of 5% or greater have been demonstrated to increase susceptibility to free radical damage when also exposed to sunlight for 24 hours after application (Jung, Seifert, Herrling, and Fuchs 2008).

Source: Photo by Compound Interest

A 2004 study on mouse cells also found that DHA induces DNA damage on living cells (Petersen, Wulf, Gniadecki, & Gajkowska, 2004). Another byproduct of the Maillard reaction, glycotoxins known as advanced glycation end products (AGEs) are formed through DHA application. In excess, AGEs in the body can become pathogenic, and have been associated with chronic degenerative disorders such as Alzheimer’s disease, cardiovascular disease, and diabetes (Uribarri et al., 2010).

A 2009 study looking at the interaction of DHA and UVB radiation found that using a 9% DHA spray lowered the body’s vitamin D production (Armas, Fusaro, Sayre, Huerter & Heaney, 2009). This is problematic as Vitamin D is considered to provide a wide range of benefits, including playing a role in cancer risk-reduction (Grant, 2012). To play the part of devil’s advocate, there was one study that suggested a possible benefit of DHA exposure. A 2018 in vitro study examined DHA’s role in apoptotic cell death in melanoma cells. The researchers found that human melanoma cells were sensitive to DHA and within an hour of exposure “displayed a transient burst of reactive oxygen species within 1 hour of exposure” ((Smith, Granberry, Tan, Daniel & Gassman, 2017). More research is necessary to understand the role DHA plays in attacking cancer cells. We’ll call it 3 to 1 on the risks to benefits. Here is a recap of the DHA potential risks:

DHA Potential Risks

  • Free radical introduction
  • Advanced glycation end products linked to Alzheimer’s disease, diabetes, and more
  • Lowered Vitamin D production

Say you avoid those convenient spray tan booths (that are not FDA approved by the way), are you protected from the nasty side effects of DHA? Not quite. Even with skin-focused application of sunless tanners, DHA can cause health risks beneath the skin. Although DHA was previously thought to only affect the dead outer layer of the skin, the FDA reported around “11 percent of applied DHA penetrates into the living cells of the epidermis and dermis” (Garone, Howard, & Fabrikant, 2015).

Current market offerings for “mist” tanning booths are not FDA approved and can cause accidental inhalation. Source: Mystic Tan

More research will have to be done to say just how much of a risk DHA poses but the current research links it to some serious health consequences.

Unfortunately, there are other chemicals to be wary of before faking your way to that “healthy” glow. The chemical Erythrulose in sunless tanners functions very similar to DHA. When applied on its own, Erythrulose takes longer to produce a tan than DHA, “and the resulting tan fades quicker”. But sunless tanning product formulas typically include both chemicals, as together they reportedly create longer lasting tans with a more “attractive tone” Garone, Howard & Fabrikant, 2015). But like DHA, Erythrulose is also linked to increased production of free radicals (Jung, Seifert, Herrling & Fuchs, 2008).

There’s still one more “black olive” in the sunless tanner chemical “cocktail”. Since the Maillard reaction caused by DHA creates a highly unpleasant smell (typically associated with tanning products), many products attempt to mask this smell with a custom-engineered fragrance called an “aromaguard”. The formulas for these fragrances are patented and the companies that developed them have not released what chemicals are used. Further study will provide a more complete understanding of the toxicity of fragrances in sunless tanning products.

“But wait,” you say. “My friend takes tanning pills, and I only ever used a tanning lotion. Those don’t contain DHA or Erythrulose.”

Tanning pills and tanning lotions containing the amino acid Tyrosine are part of a class of tanning products labeled “tanning accelerators”. These products are often marketed as a way to stimulate the body’s “natural” tanning process. The FDA has not approved these drugs and their use is likely to increase risk of developing a rash or acne (Herrmann, Cunningham, Cantor, Elewski & Elmets, 2015). Worse, the color additive canthaxanthin included in some tanning pills can cause hives, liver damage, and “an eye disorder called canthaxanthin retinopathy, in which yellow deposits form in the retinas” (FDA, 2018).

While posing less of a health risk than UVR tanning, topical sunless tanning products are not without safety concerns of their own. As most research concerning DHA and Erythrulose has been performed on animals and cells, further research is necessary to determine safe levels of their use, how they affect humans over extended periods of exposure, and whether or not they can be linked to other nefarious consequences such as birth defects in pregnant women. The FDA recommends sunless tanners only be applied externally, and to avoid inhalation or contact with the eyes, lips or any other body surface “covered by mucous membrane”. Misting applicators, such as misting from tanning booths, have not been approved (FDA, 2018). As the process of tanning is one of skin damage, the healthiest choice in regards to skin care is to limit exposure to potentially harmful chemicals and UV radiation.

References

Armas, L., Fusaro, R., Sayre, R., Huerter, C., & Heaney, R. (2009). Do Melanoidins Induced by Topical 9% Dihydroxyacetone Sunless Tanning Spray Inhibit Vitamin D Production? A Pilot Study. Photochemistry And Photobiology, 85(5), 1265–1266. doi: 10.1111/j.1751–1097.2009.00574.x

B. Grant, W. (2012). Update on Evidence that Support a Role of Solar Ultraviolet-B Irradiance in Reducing Cancer Risk. Anti-Cancer Agents In Medicinal Chemistry, 13(1), 140–146. doi: 10.2174/1871520611307010140

FDA. (2018). Retrieved from https://www.fda.gov/radiation-emittingproducts/radiationemittingproductsandprocedures/tanning/ucm116434.htm

Fisher, G., Kang, S., Varani, J., Bata-Csorgo, Z., Wan, Y., Datta, S., & Voorhees, J. (2002). Mechanisms of Photoaging and Chronological Skin Aging. Archives Of Dermatology, 138(11). doi: 10.1001/archderm.138.11.1462

Garone, M., Howard, J., & Fabrikant, J. (2015). A Review of Common Tanning Methods. The Journal Of Clinical And Aesthetic Dermatology, 8(2), 43–47. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4345932/

Herrmann, J., Cunningham, R., Cantor, A., Elewski, B., & Elmets, C. (2015). Tanning accelerators: Prevalence, predictors of use, and adverse effects. Journal Of The American Academy Of Dermatology, 72(1), 99–104. doi: 10.1016/j.jaad.2014.10.020

Jung, K., Seifert, M., Herrling, T., & Fuchs, J. (2008). UV-generated free radicals (FR) in skin: Their prevention by sunscreens and their induction by self-tanning agents. Spectrochimica Acta Part A: Molecular And Biomolecular Spectroscopy, 69(5), 1423–1428. doi: 10.1016/j.saa.2007.09.029

Petersen, A., Wulf, H., Gniadecki, R., & Gajkowska, B. (2004). Dihydroxyacetone, the active browning ingredient in sunless tanning lotions, induces DNA damage, cell-cycle block and apoptosis in cultured HaCaT keratinocytes. Mutation Research/Genetic Toxicology And Environmental Mutagenesis, 560(2), 173–186. doi: 10.1016/j.mrgentox.2004.03.002

Smith, K., Granberry, M., Tan, M., Daniel, C., & Gassman, N. (2017). Dihydroxyacetone induces G2/M arrest and apoptotic cell death in A375P melanoma cells. Environmental Toxicology, 33(3), 333–342. doi: 10.1002/tox.22520

Uribarri, J., Woodruff, S., Goodman, S., Cai, W., Chen, X., & Pyzik, R. et al. (2010). Advanced Glycation End Products in Foods and a Practical Guide to Their Reduction in the Diet. Journal Of The American Dietetic Association, 110(6), 911–916.e12. doi: 10.1016/j.jada.2010.03.018