Commercial sunbeds should be banned in the UK

Patterns in distribution of tanning facilities

Neither the number nor location of sunbed outlets in the UK are monitored. A web scraping tool extracting data from websites and social media in January 2024 identified 4231 sunbed outlets in England and 232 in Wales.8 When outlets were mapped to local authorities, density of sunbed facilities per 100 000 population (based on the 2021 census) was highest in the north west and north east of England, while generally lower in southern England (fig 1).

Analysis using the Index of Multiple Deprivation, which measures socioeconomic disadvantage across domains of income, employment, education, health, crime, housing, and environment by local authority district,9 shows the area density of commercial sunbed outlets per 100 000 population increases (P<0.05) with increasing deprivation (fig 2).

Fig 2

Sunbed outlets per 100 000 total population by fifths of deprivation at local authority level

The distribution of sunbed density is also similar to that of melanoma incidence in young people, with the highest rates in north England (fig 3).3 Melanoma is one of the commonest cancers among young adults in the UK. Over 2600 new diagnoses were recorded annually in 25-49 year olds in England during 2018-20 and 146 deaths, with two thirds of cases in women.6 Notably, regions in the north east and north west with high melanoma rates among 25-49 year olds are significantly correlated (P<0.01) with areas of high sunbed outlet density for women (ρ=0.38) and men (ρ=0.27). However, other contributing factors must also be considered, including ultraviolet exposure from affordable sunny holidays. This reflects ongoing complacency around skin cancer risks in the UK, with low uptake of sun protection and sun safe behaviour. Over a third of those surveyed, and 42% of men, rarely or never use sunscreen in summer, while nearly half report annual sunburn, rising to 65% among 18-32 year olds.10

Fig 3

Melanoma incidence in 25-49-year-olds per 100 000 population by sub-integrated care board region, England 2018-20

Ineffectiveness of sunbed regulation

Even though adolescents are banned from using sunbeds in many countries, they still report surprisingly high use.1 A 2025 survey by Melanoma Focus of 100 16-17 year olds in the UK found that 34% were using sunbeds despite the ban.11

The Republic of Ireland introduced stricter regulation of sunbeds in 2014, including mandatory health information for clients, supervised use by qualified facilitators, and bans on certain marketing practices and health claims. Although the number of registered sunbeds dropped (from 609 in 2015 to 365 in 2023),12 an online survey in 2020 of 1043 people (representativeness unknown) showed that sunbed use remains high, with 42% reporting ever use and 11% use in the past year, with an average of eight sessions per person.13 The percentage of under 18s using sunbeds barely changed (7.5% before the age ban; 7.2% after).14 The Irish Institute of Public Health has now recommended a ban on sunbeds to reduce the risk of skin cancer in Ireland.15

Similarly, Iceland’s regulation of sunbeds, including mandatory display of health risks in 2003 and banning sunbed use by under 18s in 2011,16 led to a drop in sunbed availability but failed to protect young people, with those aged 15-17 now the primary users of sunbeds in Iceland.17

Australia’s 2016 sunbed ban

Australia banned sunbeds in 2016, but the context was different from the current position in the UK. The case was initially driven by high profile young patients with melanoma who had been frequent users, media advocacy, non-government organisations, and public health support. By 2010 all states in Australia had introduced strict regulation of sunbeds.18 The number of commercial tanning facilities reduced by 51%. Prevalence of sunbed use was considerably lower than in the UK—ever use in 2006-07 was 14% for adults aged 25-44 years,19 as natural ultraviolet is readily available for those wanting a tan. In addition, there was no strong advocacy group for the sunbed industry.

The case for an outright ban was led by New South Wales (NSW), the most populous state. It was based on two government audits showing poor industry compliance with regulations; the challenges of enforcing tighter restrictions; and the mounting evidence of a causal link between sunbed use and melanoma. In February 2012, the NSW government announced a plan to ban all commercial sunbeds by the end of 2014. Other states quickly shifted to supporting an outright ban. Some states operated “buy back” schemes before the bans, where businesses sold their tanning units to government as compensation, ensuring devices did not go into private hands.20 By 2017, adult sunbed use was under 1% and many businesses had diversified their services to spray tans and other beauty treatments.20

The sunbed ban was expected to avert over 31 000 melanomas (3.7% reduction) and over 468 000 basal cell carcinomas and squamous cell carcinomas (3.6%) over the lifetime of young Australians, as well as save over A$64m (£31m; €36m; $42m) in healthcare costs and bring over A$516m in productivity gains.20 The recent decline in melanoma rates among young Australian adults is attributed to effective prevention efforts, changes in patterns of recreational activities, and increased ethnic diversity of the population.7

Refuting industry claims

The current situation in the UK is a clear example of an under-regulated industry aggressively marketing a harmful product to a vulnerable population. Many people use indoor tanning to improve their self-esteem and in the mistaken belief that it provides a “base tan” that prevents sun damage to their skin.21 Such marketing promotes health inequalities with serious societal harms. Claims that modern sunbeds are safer are not substantiated by evidence of their measured radiation—for example, nine of 17 sunbeds tested in south Tyneside were above legal irradiation limits.22

Analysis of data from UK Biobank reported a reduction in all-cause mortality in sunbed users and those living in areas with higher ultraviolet levels.23 However, methodological problems, including selection bias (minimum recruitment age of 37 excluded the highest risk group of sunbed users) and lack of updated information on participants’ overall ultraviolet exposure and associated lifestyle factors after recruitment, make interpretation of such results difficult.

The tanning bed industry also promotes vitamin D synthesis as a benefit of use. However, sunbeds predominantly emit UVA rays whereas UVB is required for vitamin D synthesis. Furthermore, since the action spectrums for vitamin D synthesis and skin carcinogenesis are similar, vitamin D photosynthesis cannot be disentangled from the carcinogenic effects of UVB exposure from sunbeds.24 Thus, sunbeds cannot be recommended as a major source of vitamin D in fair skinned people.24 Cancer risk associated with indoor tanning outweighs any beneficial effect of vitamin D production, and sufficient vitamin D can be attained by modest sun exposure or supplementation.2425 A recent position statement on sun exposure in Australian adults recognises that the risk-benefit balance of sun exposure varies with skin type and local ultraviolet conditions and emphasises the need to tailor public health messages to acknowledge the population’s ethnic diversity when promoting sun safety.25

Enacting a ban

Current regulation has failed to prevent young people’s use of sunbeds. A study modelling the effect of a ban on people aged 18 in England in 2019, combined with a public information campaign, reported it would have a net monetary benefit of £10.6m and a gain of 530 quality life years.26 Moreover, these benefits would recur as successive cohorts of young adults avoid sunbed use.

Factors contributing to use of sunbeds include sociocultural appearance ideals, mood enhancement, self-treatment for skin conditions or seasonal affective disorder, and influence from social media trends.21 There is a tension between respecting individual consumer choice and supporting an activity with no meaningful health benefits that has serious potential consequences for users and the NHS. Similar arguments pertain to tobacco, alcohol, and highly processed foods. However, the challenges with banning these are more complex. For example, tobacco and alcohol have historically been deeply engrained in UK society and continue to bring in huge tax revenues, and there is a link between consumption of highly processed food and deprivation.

The economic impact of banning sunbeds on providers and communities also needs to be taken into account. It is difficult to model this accurately given that the number of providers is unclear. The reduction in providers in Ireland with the introduction of minimum quality and safety requirements suggests that many of these businesses were viable only in an unregulated environment.1220

An immediate outright ban on commercial sunbeds alongside public education offers the most cost effective solution to reduce skin cancer, save lives, and ease the burden on the NHS. Indeed, given the complacency about sun safety in general in the UK,10 a public information campaign about the dangers of indoor tanning accompanying the sunbed ban could be extended to raise public awareness about the long term dangers of intense sun exposure and the need for routine summer sun protection measures. Use of a buy-back scheme would remove commercial sunbeds from circulation and cost an estimated £11-55m,27 depending on the level of compensation to mitigate industry pushback and the potential effect on livelihoods.

The UK government has pledged to prioritise prevention and to reduce health inequalities. Commercial sunbeds target those who are most disadvantaged and susceptible to harm. Enhanced efforts to encourage sun safe behaviours are critically needed but will likely take a generation to have an effect. A ban on commercial sunbeds is the first step in this process. It would send a clear message and have an immediate effect on skin cancer.