Lack of sunless tanner education may cause diagnostic confusion, UV exposure

Key takeaways:

• Key ingredients in sunless tanners may alter pigmented lesions, causing diagnostic complications.
• Dermatologists should inform patients that sunless tanning does not replace sun protective measures.

NEW ORLEANS — Dermatologists should continue educating their patients on the ingredients found in sunless tanners to avoid diagnostic confusion and unknown ultraviolet light exposure, according to a poster presentation here.

“As awareness of sun damage increases, so does the popularity of sunless tanners,” Jonny Hatch, BS, a student at the Texas College of Osteopathic Medicine at the University of North Texas Health Science Center, and colleagues wrote in their poster presented at the American Academy of Dermatology Annual Meeting. “Dermatologists are uniquely positioned to counsel patients and the general public regarding active ingredients in these products.”

In this study, researchers identified the active ingredients in the top sunless tanning products on the January 2022 Amazon best sellers list. After excluding items classified as bundles, applicators or non-self-tanning cosmetics, 33 items were reviewed.

Results showed that dihydroxyacetone (DHA) was used in all products, making it the most active ingredient in sunless tanners. Other active ingredients include erythrulose, melanin, tyrosine and tyrosine derivatives.

According to the researchers, sunless tanners can cause temporary changes to pigmented lesions which may complicate diagnosis in various conditions.

DHA, along with erythrulose, causes an artificial pigment change in the stratum corneum called the Maillard reaction, according to the researchers. This results in melanoidins collecting in the stratum corneum and causing a tan appearance which may distort pigmented lesions.

Additionally, the researchers wrote that many users of sunless tanners may assume that these products can replace the use of sunscreen. Although the Maillard reaction has shown to confer a small degree of ultraviolet light protection, it is not enough to discontinue standard sun protective measures, according to the study.

As sunless tanners continue to grow in popularity, the authors recommend that dermatologists continue to inform their patients of the ingredients and procedures following usage.

“Patients should be educated on the minimal sun protection provided by sunless tanning products, and emphasis should be placed on the importance of concurrent sunscreen use,” the authors concluded.