Young women were more likely to stay away from indoor tanning if they were warned that the practice could increase their risk of getting leathery, wrinkled skin, than being warned about risk of melanoma, the deadliest form of skin cancer, a study found.
The study found a 75 percent reduction in indoor tanning visits if girls were warned of skin deterioration and turning unattractive.
"They're not worried about skin cancer, but they are worried about getting wrinkled and being unattractive," said June Robinson, a professor of dermatology at Northwestern University Feinberg School of Medicine and senior author of the study.
The study examined the best strategy to wean college-age women who are considered addicted or pathological tanners from tanning salons.
"The fear of looking horrible trumped everything else. It was the most persuasive intervention, regardless of why they were going to tan," said Robinson.
The research showed warning them about the effects on their appearance caused a 35 percent drop in their indoor tanning visits, which were measured at intervals up to six months after the intervention.
Joel Hillhouse, lead author of the paper, noted that some women in the study eventually stopped tanning.
"It was a progressive kind of thing. At first the women said they tried sunless tanning as an alternative, but over time they gave up tanning altogether," he said.
Between 25 to 40 percent of older adolescent girls visit tanning salons, according to the study's authors.
The study included 435 college women, ages 18 to 22, who visited tanning salons.
Within this population, researchers focused on women who visited salons up to four times a week - more than what is needed to maintain a tan - and who tanned for psychological reasons, not just for a special event.
These tanners included one group who strongly disliked the natural colour of their skin, which was related to a psychological condition called body dysmorphia.
"They thought their skin was disgusting when it was pale," said Hillhouse.
The other group, who said tanning made them feel happier and more relaxed, showed symptoms of seasonal affective disorder (SAD) on a diagnostic psychological test.
"They were self medicating their own depression," said Robinson, noting that lying in a tanning bed produces internal opioids.
The women received a 25-page booklet, authored by Hillhouse, that discussed the effect of tanning on appearance and explained how ultraviolet rays destroy collagen in the skin.
The booklet also offered many alternatives to meet the women's needs for tanning, such as taking an exercise class for socializing and relaxation or getting a spray-on tan or self-tanning cream application at a spa.
After reading the booklet, the women reported their attitudes and behaviours twice a week in diaries.
The study results surprised researchers.
"The hypothesis was because this was an appearance intervention, it would have less of an effect on the people tanning for mood problems. We found the opposite. The intervention worked just as well for people with seasonal affective disorder as for people who didn't like their skin color. That means it's a really good intervention for everyone," said Hillhouse.
Robinson stressed it was also important to offer women alternatives to tanning salons. The study has been published in Archives of Dermatology.