The FDA has withdrawn a decade-old proposal that would have prohibited minors from using tanning beds, drawing the consternation of dermatologists and other physicians.

The agency’s withdrawal — published in the Federal Register — stated that “in light of the scientific and technical concerns raised in the comments,” including “concerns regarding possible unintended consequences,” it was withdrawing the original proposal — published in 2015. Comments closed in March 2016.

It is not clear why the rule was never made final or why the agency withdrew it now. When asked to comment by Medscape Medical News, an FDA spokesperson said the agency withdrew the proposal “to clarify to the public that this proposed action will not be finalized.”

Susan C. Taylor, MD, president of the American Academy of Dermatology, said in a statement that the organization was “disappointed.” She noted that in addition to barring individuals younger than 18 years from using sunlamps, the proposal would have required all prospective users to read and sign a risk acknowledgment before use.

Taylor said that exposure to ultraviolet (UV) radiation from indoor tanning is associated with an increased risk for melanoma and nonmelanoma skin cancers. “Using tanning beds before age 20 can increase the risk of developing melanoma by 47%, and the risk rises with each use,” she said, adding that adolescents who begin indoor tanning before age 18 are more likely to continue into adulthood.

“Restricting teens’ access to indoor tanning and informing the public about the dangers of indoor tanning are critical to preventing skin cancer,” said Taylor, a professor of dermatology at the University of Pennsylvania in Philadelphia.

A recently published study by Northwestern University dermatologists found that frequent tanning bed users may have up to an eight times greater risk for melanoma than people considered at high risk who don’t use tanning beds. The researchers also showed how tanning beds alter melanoma-linked DNA on the molecular level and damage areas of skin not usually exposed to the sun.

The rate of new melanoma cases in the US has been rising an average 1.2% per year from 2013 to 2022, according to National Cancer Institute data.

“Indoor tanning increases the risk of melanoma and other skin cancers, particularly when use begins at a young age,” said Bobby Mukkamala, MD, president of the American Medical Association (AMA), in a statement provided to Medscape Medical News.

He noted that the AMA “has long supported restrictions on indoor tanning for young people.” The organization enshrined that support in a 2019 policy that also advocated for greater warnings about the dangers of indoor tanning, especially from UVA radiation.

The withdrawal “really disappoints me,” said Kavita Mariwalla, MD, president of the American Society for Dermatologic Surgery. It signals “that tanning beds are somehow safe,” she said. “It’s a proven cancer-causing exposure,” she told Medscape Medical News, adding, “why are we going backwards?”

Mariwalla, who practices in West Islip, New York, said the action demonstrates the FDA’s failure to protect the public, especially vulnerable adolescents. Skin cancer surgeons know that UVA-heavy radiation “before the age of 18 severely impacts your risk for skin cancer as an adult and increases your risk of melanoma,” she said.

Deborah S. Sarnoff, MD, president of The Skin Cancer Foundation, said that the FDA decision “is very sad.”

“I’ve spent my career treating skin cancer and seeing young people with melanoma and watching young people die,” Sarnoff, who is a clinical professor of dermatology at New York University in New York City, told Medscape Medical News.

She noted that the World Health Organization’s International Agency for Research on Cancer classified UV-emitting tanning devices as carcinogenic in 2009. And The Skin Cancer Foundation reports a 75% increased risk for melanoma for individuals who start using indoor tanning beds before age 35.

“We’re talking about young people exposing themselves to something that we really know is dangerous,” said Sarnoff, adding that minors don’t understand the risks, in part “because when you’re that age, you think you’re invincible.”

States Have Prohibitions

The FDA has enacted some restrictions on indoor tanning. In 2014, the agency reclassified sunlamps from class I to class II, which meant they carried a higher risk and were subject to stricter regulation. The order also required device makers to include warnings on the products or in product brochures that the sunlamps should not be used on anyone younger than 18 years.

But indoor tanning operators are not subject to those rules.

The FDA spokesperson, however, said that “to ensure that consumers are appropriately educated about the risks,” “the FDA requires warnings on product labeling and in promotional materials,” including that a sunlamp “should not be used on persons under the age of 18 years.”

In the absence of FDA regulation, some 22 states and Washington, DC, have enacted bans on indoor tanning for individuals younger than 18 years. Another 22 states have laws that restrict minors’ use of tanning beds, but there has been little appetite in Congress for a federal law, according to The Skin Cancer Foundation.

The FDA’s withdrawal of its proposed restrictions makes it harder for Congress and individual states to act because they don’t have the agency’s science to undergird their legislation, said Mariwalla.

It also “allows people who don’t necessarily support the science to then say, well, the federal government doesn’t think it’s a problem. Why do you?” she said.

Will the FDA Revisit?

In its notice, the FDA said the withdrawal “does not preclude the agency from reinstituting rulemaking” on indoor tanning.

The FDA spokesperson said that “withdrawal of the proposed restrictions does not mean that exposure to UV radiation does not cause skin cancer,” adding that the agency “encourages users of sunlamp products to discuss the potential risks with their physician.”

Clinicians said they want the agency to issue a new proposal. “We encourage the reintroduction of the proposed rule,” said Taylor.

Mukkamala said, “we hope it will do so soon.”

Sarnoff and Mariwalla reported having no relevant disclosures. The Skin Cancer Foundation is supported in part by corporate donations from sunscreen manufacturers.

Alicia Ault is a Saint Petersburg, Florida-based freelance journalist whose work has appeared in many health and science publications, including Smithsonian.com. You can find her on X @aliciaault and on Bluesky @aliciaault.bsky.social.