Why My Patient Will Not Stop Tanning
UV radiation (UVR) is a known carcinogen, yet many people seek out additional exposure and even pay for it. An economic utility model breaks down the decision to tan as a cost-benefit argument whereby the guaranteed benefit of relaxing today and having the desired tan tomorrow can outweigh the distant possible cost of developing skin cancer and photoaging. Additionally, some individuals actually may develop a substance-related disorder (SRD) on UVR that drives their need to tan. Modification of the CAGE (cut down, annoyed, guilty, eye-opener) questionnaire and Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision)(DSM-IV-TR) criteria for substance abuse finds that a number of patients meet criteria for a possible UVR SRD. Although the dependency may primarily be psychological, it also is possible that a physiological dependency develops with chronic exposure to UVR. Administration of naltrexone to select frequent tanners blunted their preference for UVR versus non-UVR light beds and even induced withdrawal-like symptoms in some individuals. By looking deeper into the reasons that people tan, it may be possible to develop a more effective prevention campaign.
