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Old 04-18-2002, 07:26 PM   #1 (permalink)
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For the full story, click on the link below:

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Old 04-20-2002, 09:31 AM   #2 (permalink)
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wow thanks!

here it is as well :

Medical: Is Tanning Replacing Phototherapy?
Posted on Friday, April 19 @ 00:24:50 CDT by tangirl

Dermatologists are losing phototherapy business at an alarming rate. Are tanning salons poised to pick up this business? Yes and no. (Special Report from Tanning Trends magazine’s May 2002 issue.)

A funny thing happened at this February’s annual meeting of the American Academy of Dermatology: Dermatologists gave a presentation in favor of using tanning salons to treat skin conditions. Without much fanfare, and no doubt without the full endorsement of the dermatology community, a University of Utah research team presented data suggesting that indoor tanning salons may be a better alternative for some dermatology patients who cannot afford expensive phototherapy sessions in a dermatologist’s office.

“Commercial tanning beds represent a form of light therapy that is widely available and frequently utilized by many psoriasis patients,” University of Utah researcher Dr. Christopher S. Carlin presented in a poster presentation at the Academy’s New Orleans annual meeting.

This startling public statement comes at an interesting time. Phototherapy visits in dermatologists’ offices plummeted 94 percent from 1993 to 1998 – from 873,000 in 1993-94 to just 53,000 in 1997-98, according to a report published in April in the Journal of the American Academy of Dermatology. Conversely, Smart Tan believes no less than 1 million indoor tanning customers in the United States come to tanning salons to treat skin conditions. And tanning salons cannot even advertise this service. That means about 19 times more people are obtaining phototherapy in tanning salons today than in dermatologists’ offices. Has the research community finally figured this out?

Carlin, Dr. Kristina Callis and Dr. Gerald Kruger, all of the University of Utah’s Department of Dermatology, presented data at the AAD meeting supporting their theory in a poster presentation titled, “Acitretin and Commercial Tanning Beds: An Effective Treatment for Psoriasis.” The data have yet to be published as a study, but have been submitted to medical journals. Here’s what the team found:

Utilizing standard low-pressure tanning equipment with 4.7 percent UVB light, Carlin and Callis exposed 26 psoriasis patients to tanning bed light and treated them with the drug acitretin, a product produced by Roche Pharmaceuticals, which co-sponsored the study. The participants tanned four to five times a week for 12 weeks, starting at as little as 2 minutes and working up to 30 minute session times. After 12 weeks, 82.6 percent showed clearance or near clearance of their psoriasis, and another 8.7 percent showed moderate improvement. Only two subjects showed no change.

“Side effects attributable to acitretin, commercial tanning or their combination were few,” the researchers reported. “Acitretin in combination with commercial tanning beds is an effective therapy for moderate to severe psoriasis…Based on the cost of treatment at our institution, acitretin in combination with tanning bed light was less expensive than acitretin plus PUVA, acitretin plus UVB, PUVA alone, UVB alone or acitretin monotherapy.”

What’s Going On Here?

Carlin and Callis’ presentation flies in the face of the dermatology industry’s official dogma about tanning. Officially, the dermatology community has gripped tight to the oversimplified statement that there is no such thing as a good tan and that tanning salons should go away entirely. “It’s a politically charged area,” Callis told Smart Tan in an exclusive interview. “The American Academy of Dermatology is against the idea of using tanning bed light for therapeutic purposes.”

But behind the scenes – far from the headlines, at the community level – something completely different has been happening: Doctors are actually referring clients to tanning salons as informal therapy for different skin conditions like psoriasis.

Every salon has customers who “treat” acne, eczema and psoriasis by tanning in tanning units. A 1997 Smart Tan survey showed that 70 percent of tanning salons report having customers whose main reason for tanning is to treat a skin condition, and – perhaps more surprising – 70 percent of salons know they have clients who were referred to them by dermatologists to treat a skin condition. What’s more, many tanning salons have customers whose tanning visits are paid for by insurance companies who would rather pay a tanning salon $5 a session than pay a dermatologist eight to 10 times that amount for the same treatment, or 15 times as much when the cost of phototherapy drugs is added.

Callis said her team is very aware of the economic woes of phototherapy as well as the problem of access: Many of the 6 million people with psoriasis live far away from phototherapy clinics. Tanning salons, on the other hand, are virtually everywhere.

Perhaps the ones who figured this out are the co-sponsors of the Utah study – Roche Pharmaceuticals. Roche may be aggressively looking for an application for its acitretin product, Soriatane, which is marketed as a once-a-day oral medication for psoriasis (See http:www.soriatane.com).

For the tanning industry, it all adds up to an estimated 1 million tanners who pass through your doors to treat skin conditions. Whether you can advertise it or not (see accompanying sidebar for what you can and cannot say about treating psoriasis) that is the reality. The question is: What should the tanning industry do about this prospective chunk of business knocking at our doors?

The Psoriasis Story

The Utah study is not the first paper to explore the efficacy of using tanning beds to treat psoriasis.

In 1997, Wake Forest University research dermatologist Dr. Alan Fleischer published a case study in the Archives of Dermatology showing that tanning bed light alone – without the addition of a drug like acitretin is often an effective treatment for psoriasis. Indeed, Fleischer – who spoke at Smart Tan’s 1997 educational conference in Orlando about the study – states in his paper, “Recent short-duration psoriasis studies using (photosensitizing drugs) show comparable (psoriasis) reduction to this tanning study.”

In other words, tanning bed light alone – without the addition of a pharmaceutical product – may be adequate to control psoriasis for some people. Callis points out, however, that acitretin combined with tanning bed light appears to be more effective for more people than either product used independently. Further, using both together appears to speed the time necessary to gain clearance of psoriasis patches.

Opportunities and Challenges

All of which presents a great challenge to professional indoor tanning salons in the United States. Indoor tanning is a cosmetic industry – salons are restricted by federal rules to only market their services as having cosmetic benefits. And there are some problems – serious problems – that stand in the way of you hanging a “phototherapy” shingle in front of your salon.

First is the fact that tanning salons are not medical professionals. Tanning salons cannot market their services for medical reasons. Second is the fact that acitretin – the metabolite of the drug etretinate, is a potential photosensitizing medication.

“That’s a tough position for the salon to be in,” Callis acknowledges, suggesting that the tanning industry explore developing protocol for interfacing with the medical community.

That, of course, would require the dermatology industry’s lobbying groups to acknowledge tanning salons as a legitimate industry. That kind of flip-flop in policy would be nothing short of amazing at this point.

Article written by Joseph Levy. Levy is vice president of the International Smart Tan Network.

How To Handle Psoriasis Customers

A 35-year-old, dark-skinned, brown-haired, brown-eyed female enters your salon as a first-time tanner. She declares to you that she has tanned at other salons in the last month and that she has come to your salon to treat her psoriasis. She has a note from her doctor asking that she be allowed to tan for 20 minutes in your new 20-minute tanning bed – her insurance company is even reimbursing her for the tanning sessions. What do you tell her? What do you do?

1. Like tanning an acne patient, treat her like any other new customer. Explain to her that you are in the business of getting people tan, and that you make no guarantees that her psoriasis will improve, even though many people may tan for that reason.

2. Process her like any other customer, including evaluating her skin type and checking her for medications.

3. Be extra careful to check her psoriasis medications – since she has told you she has seen a doctor and the doctor told her to tan, she may be taking a medication that is photosensitizing. One such medication, psoralen, can be extremely photosensitizing.

4. After assessing her skin type (she likely is a skin type III from the description above) assign her exposure time based ONLY on where she should be in your incremental exposure schedule. The exposure time should never be based on a customer’s desire for any kind of therapy. It should only be based on her tanning schedule.

5. Monitor this customer closely – because she is seeing a doctor for her psoriasis, she may eventually be prescribed a medication that may be photosensitizing.

6. You are likely to have some customers whose health insurance carriers will offer to pay for their tanning sessions as an alternative to treating their psoriasis in a dermatologist’s office. That’s because the average tanning session is eight- to 10-times less expensive than a “phototherapy session” administered by a dermatologist, but uses essentially the same equipment. Even if the insurance company is paying, do not deviate from you standard procedures for processing a tanning customer. You are not a licensed medical professional. Your job is to give people tans, and to base your procedures on protecting that individual from sunburn. Your approach should always be the same.

From “Understanding Skin Conditions” published by International Smart Tan Network as part of the Accredited Tanning Professional(TM) series of training.

For more information visit: http://www.smarttan.com/beta/article.php?aid=129
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Old 04-20-2002, 10:11 AM   #3 (permalink)
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As I said over yonder, this is very encouraging because the study focused on real tanning lamps with 4-5% UVB. Great.

Most existing "phototherapy" devices are either UVB booths or PUVA applications, not natural sunlight spectrum.
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Old 04-20-2002, 10:24 AM   #4 (permalink)
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I appreciate this information! THANKS
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Old 10-21-2009, 05:18 AM   #5 (permalink)
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Re: Is Tanning Replacing Phototherapy?

This thread is seven and a half years old. The original posters have had their ditches dug, laid down in them, and covered over already.
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Old 10-21-2009, 09:23 AM   #6 (permalink)
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Re: Is Tanning Replacing Phototherapy?

I hadn't heard, where should I send flowers?
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