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Testimony to the FDA Hearing on Tanning Bed Classification. Barbara A. Gilchrest, M.D. Practicing Dermatologist & Professor of Dermatology Boston University School of Medicine Boston, MA. March 25, 2010. Drugs and devices are evaluated based on a risk: benefit analysis.
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Barbara A. Gilchrest, M.D.
Professor of Dermatology
Boston University School of Medicine
March 25, 2010
Tanning beds pose a well documented risk of skin cancer, photoaging, and (less often) exacerbation of multiple skin diseases.
The only claimed benefit, aside from cosmetic tanning, is vitamin D production.
Melanoma is unquestionably among the types of skin cancer caused by UV exposure.
Should the public maximize vitamin D levels through intentional UV exposure in order to prevent cancer, hypertension, diabetes, multiple sclerosis … ?
Which is the lesser evil?
Skin cancer and photoaging or cancer of the colon, breast, prostate, and other organs in combination with the other listed diseases?
What evidence supports the argument that “insufficient vitamin D” or its proxy – lack of UV exposure – causes these diseases?
Reddy & Gilchrest. JID 130:321-326, 2010.
Ample vitamin D can be obtained from diet, supplements, and incidental sun exposure.
A supplement of 1000 IU/day is safe and “sufficient” by even generous criteria.
The group most responsive to the “unprotected sun exposure” message is at lowest risk of vitamin D deficiency
Cutaneous vit D photosynthesis is least efficient for population groups at highest risk of vit D deficiency
Wolpowitz & Gilchrest. JAAD, 2006.
Adapted from Matsuoka et al. J ClinEndocrinolMetab, 1987; de Gruijl. Eur J Cancer, 1999; and Parrish et al. PhotochemPhotobiol, 1982
for UV Effects
From: Gilchrest BA. Editorial / review in
J. Steroid Biochem Mol Biol, 2007.
U.S. state legislatures are bombarded with selected epidemiologic studies that support a cancer prevention effect of high 25(OH)D levels.
1000 IU Tablets Cost/tablet
CVS Pharmacy $.06
Nature Made $.09
Life Fitness $.07
CVS Pharmacy $.05