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Cutaneous melanoma attributable to sunbed use: systematic review and meta-analysis

BMJ 2012; 345 doi: (Published 24 July 2012) Cite this as: BMJ 2012;345:e4757

Re: Cutaneous melanoma attributable to sunbed use: systematic review and meta-analysis

Increasing indoor UV tanning is leading to increased melanoma incidence (BMJ 2012;345:e4757). Surprisingly, recommendations against UV exposure are coming from an equally trendy source--tattoo artists. Tattoos constitute an ancient form of body modification, globally used for religious, cultural, and personal expression. Tattoos once found mainly on male motorcyclists, sailors and military personnel, now appear on one in four persons of both genders.(1-3) Tattoos remain more common among individuals with greater risk taking behavior—those who are younger, lower paid, less educated, use recreational drugs, drink alcohol, or have served time in prison.(2)

While many governments regulate tattoo parlors to ensure patient safety, post tattoo care instructions are not standardized.(4) On January 4, 2012, we explored post-tattoo care instructions by conducting a Google® search using the terms “tattoo care” and archived the top 50 web results using WebCite®. Four researchers (ES, MS, JTJ, MF) categorized the results by consensus (Table 1).

The most common recommendation (30/50) was to avoid manipulation at the tattoo site. The next most common recommendations were to apply non-antibiotic ointment (25/50), to keep the site dry (25/50), and to use sunscreen to prevent the tattoo ink from fading (25/50). Two other frequent recommendations were to avoid UV exposure long term (19/50) and to avoid sunburning the tattoo (13/50).

Although much of the focus was restricted to tattoo preservation and widespread UV protection is not emphasized, these results reveal online tattoo care instructions as a surprising source of UV protection advice, targeted to a population associated with risky health behaviors. As both tanning bed popularity and melanoma continue to rise, a unique opportunity to further educate tattoo artists on sun safety, and expand their UV recommendations to their cliental presents itself.


[1] Urdang M, Mallek J, Mallon, W. Tattoos and Piercing: A Review for the Emergency Department Physician. West J Emerg Med. 2011;12(4): 393-398.

[2] Heywood, W, K Patrick, et al. "Who Gets Tattoos? Demographic and Behavioral Correlates of Ever Being Tattooed in a Representative Sample of Men and Women ." Annals of Epidemiology. 22.1 (2012): 51-56. Web. 5 Jan. 2012

[3] Laumann A, Derick A. Tattoos and body piercings in the United States: a national data set. J Am Acad Dermatol. 2006; 55:413–421.

[4] SeverJ.TheHarrisPollNo.58, October8, 2003. Harris Interactive Website. Available at: index.asp?PID1⁄4407. Accessed April 23, 2008.

Competing interests: No competing interests

16 November 2012
Emilee K. Sandsmark
Medical student
Monica Salazar, Jamira Jones, Marie Freyta, Barbara Walkosz, Robert Dellavalle
University of Colorado School of Medicine
Building 500 - 13001 E. 17th Place, Campus Box C290, Room E1354, Aurora, CO 80045