AUCTORES
Globalize your Research
Review Article | DOI: https://doi.org/10.31579/2578-8949/150
1 National Health Service (NHS), Community Dermatology Clinics (Health Harmonie). UK.
2 North Cumbria integrated care NHS Foundation Trust, Clinical Director & Consultant Dermatologist, and University of Central Lancashire UCLAN medical School. UK,
*Corresponding Author: Mohammed Al Abadie, Department of Dermatology, North Cumbria Integrated NHS Care Foundation United Kingdom, Email: mohammed.abadie@nhs.net
Citation: Zinah Sharara, Mohammed Al Abadie, (2024), Health Threat in the Tanning Trend, Dermatology and Dermatitis, 9(4); DOI:10.31579/2578-8949/150
Copyright: © 2024, Mohammed Al Abadie. This is an open-access article distributed under the terms of The Creative Commons. Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 03 March 2024 | Accepted: 27 March 2024 | Published: 20 May 2024
Keywords: self-tanning; sunbed; tanning nasal spray; tanning injections; melanotan I; melanotan II; dysplastic naevi; melanoma
Self enhancement products have become increasingly popular options to achieve tanning in the pursuit of darker complexion. This practice is relatively popular among both men and women for aesthetic purposes.
Melanotan-I and melanotan-II are synthetic alpha-melanocyte stimulating hormone (α-MSH) analogues that stimulate tanning, which are available in two forms, injectable and nasal spray, and can be purchased via online portals and media outlets. The health consequences of these products range from minor to acute and chronic clinical outcomes. Sunless tanning products are alternatively, perceived as “healthy alternatives” to sunbathing, however, no consistent data on their safety is standardized.
Appearance of tanned skin is currently perceived as a symbol of beauty and wellbeing.
In recent years, self-tanners have gained publicity, especially when similar outcomes can be achieved, avoiding the side effects of ultraviolet exposure [1], thus self-tanners in multiple forms are used as an alternative to sun tanning and tanning beds. Majority of self-tanning products contain dihydroxyacetone (DHA), a plant-based sugar molecule which reacts with keratin proteins in the stratum corneum [1].
Melanocortin hormones are involved in several biological functions including pigmentation, energy homeostasis, sexual function, immunomodulation, exocrine secretion, and steroidogenesis. The main melanocytic receptor in the skin is melanocortin-1 receptor (MCR-1) that when interact with a-MSH, modulate the process of pigmentation [2 ,3].
Synthetic melanocortin analogues like Melanotan I and Melanotan II are synthetic peptides that have a prolonged action, are enzymatically resistant, stable, and up to 1000 times more potent than α-MSH, and increase the expression of eumelanin, via the activation of melanocortin type 1 receptors (MC1R) of melanocytes [4]. Melanotan I and Melanotan II are unregulated, non-licenced products sold in two forms: powder for injection and as a nasal spray. Afamelanotide (formerly known as Melanotan I) is the first synthesised α-MSH analogue, that stimulates melanogenesis, and prevents phototoxicity in adult patients with Erythropoietic protoporphyria (EPP) for which it is approved [5, 6].
Bremelanotide is the third available analogue of α-MSH approved in the USA for the management of premenopausal women with acquired, generalized hypoactive sexual desire disorder [7].
The aim of this article is to pinpoint some reported outcomes and health consequences of tanning products in different forms.
• Ultraviolet tanning beds and booths
Ultraviolet tanning offered by (tanning beds and booths) is mostly used by adolescents and young adults, which can limit the dosage of UVB light and the likelihood of sunburn, although more sessions are needed to offer tan, which can consequently increase the total dose of UVA radiation. One indoor tanning session increased the risk of developing melanoma by 20 percent [8]. There is significant evidence that younger people may be more susceptible to the carcinogenic effects of artificial ultraviolet (UV) radiation [9]. Other detrimental consequences of skin UV irradiation have been proven, including premature aging, photodamage, rhytids, solar elastosis, and lentigo spots [10].
• Fake tan
Self-tanners are popular as these are less harmful than tanning beds or sunbathing. They are also often cheaper and more convenient; however, their application can result in a fake change in the appearance of a pigmented lesion that can affect monitoring in a skin cancer clinic or impact teledermatology image assessments [11]. Another emerging problem is that these tanners can induce contact allergic dermatitis in susceptible individuals [12].
• Melanotan
The development of synthetic α-MSH analogues such as afamelanotide has enhanced the study of melanocyte biological mechanisms and has prospective therapeutic purposes [13]. However, two other non-regulated forms of melanotan (nasal sprays and injectable powders) are sold via non authorised portals and are self-administered by the user [14]. They mimic the action of melanocortin on the MC-1 receptors of melanocytes, leading to eumelanin over-expression and thus skin tanning, due to the less selective nature of other physiological actions, such as enhancing sexual desire and decreasing appetite, which has been promoted by vendors as desirable effects [14]. However, they also elicit side effects [1, 4].
Warnings have been issued by the British Medicines and Healthcare Products Regulatory Agency (MHRA) [15], the US Food and Drug Administration (FDA) [16], the Irish Medicines Board and Several European national health authorities against the use of subcutaneous injections labelled as Melanotan after the upsurge in tan injections that has been noticed in recent years [17].
A PubMed search was performed to search for the terms Melanotan I and II, and a range of clinically undesirable outcomes were reported and will be stated in this review. Like any non-regulated medicine, there are general risks from non-sterile administration [11], moreover, high levels of impurities were detected in random samples purchased online, which may pose a hazard [18].
The acute adverse reactions associated with the administration of Melanotan II reported in phase I and II clinical studies include spontaneous erections, facial flushing, nausea, and vomiting [19,20].
Among the cutaneous complications that have been reported, are melanocytic changes and darkening of existing naevi and eruption of new naevi with dysplastic changes [21,22], [26-28], [31-33,35] and melanoma were reported from α -MSH analogue in its two forms Melanotan I and II [23,25,30,34]. (table 1). There is a sequential relationship between the event of injecting Melanotan products followed by the appearance of clinically and histologically atypical naevi and melanoma, which can highlight the carcinogenic potential of Melanotan, although the causal relationship was not suggested by the authors.
| Authors | Case report |
| Cardones and Grichnik (2009) 21 | multiple new naevi and dysplastic naevi in male aged 40 |
| Cousen et al. (2009) 22 | eruption of new naevi and darkening of existing naevi, female 19 years old |
| Ellis et al. (2009)23 | Melanoma in situ in male aged 23 |
| Langan et al. (2009) 24 | dysplastic nevi developed in existing moles, 2 females aged 38 and 48 |
| Paurobally et al. (2011) 25 | Melanoma, female 42 |
| Ferrandiz et al. (2011) 26 | dysplastic nevi developed in existing moles; male 63 years old |
| Thestrup et al. (2011) 27 | Emergence of new naevi and darkening of existing naevi, male 25 |
| Sivyer (2012) 28 | Growth and darkening of existing naevi, female |
| Mang et al. (2012) 29 | Pigmented Spitz naevus, male 24 |
| Ong and Bowling (2012) 30 | melanoma in situ, Female 23 |
| Burian and Burian (2013) 31 | Eruptive naevi, 2 females |
| Reid et al. (2013) 32 | Emergence of new naevi and darkening of existing naevi, female 33 years old |
| Schulze et al. (2014) 33 | Eruptive naevi |
| Hjuler and Lorentzen (2014)34 | Melanoma, female 20 years old |
| Al Abadie and Sharara (2024) 35 | Eruptive naevi, new dysplastic naevi, female 28 years old |
Table 1: Reports of eruptive naevi and Melanoma in relation to Melanotan use
α-MSH and its analogues are mitogenic for human melanocytes, with direct stimulatory and immunoregulatory activities on melanocytes [36].
Other noncutaneous side effects have been reported, including neurological outcomes during the use of Melanotan II, sympathomimetic toxidrome, renal dysfunction, and rhabdomyolysis after using Melnaotan for sexual stimulation [37,38]. Moreover, a male developed posterior reversible encephalopathy syndrome one week after using Melanotan [39].
There is great public perception about the hazards of ultraviolet exposure. Artificial tan has been identified as a safe alternative to sun‐tanning practices, although it has been found to hinder the accurate diagnosis of suspicious skin lesions.
Further clinical research is needed to investigate the incidence and health outcomes among melanotan users. Unexplained tan and rapidly pigmenting naevi provide clues about the use of recreational, unregulated products that can cause diagnostic confusion via distortion of the appearance of pigmented moles. Dermatologists play a significant role in highlighting these risks.
Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.
Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.
Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.
Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.
We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.
The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.
Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.
Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.
Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.
Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.
Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.
This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
