Having stated this fact, let’s take a serious look at the cosmetic epiphany to safe tanning and understand the solid science behind it.
The American Academy of Dermatology has reported the incidence of melanoma has more than tripled in the last couple of decades and is more common than any non-skin cancer among women between the ages of 25 to 29. Given the current information and based on this warning juxtaposed with the innuendo of safety regarding certain “chemical” tanning booths, how can we still acquire that magnificent bronze tan color on the largest and most complicated immune organ without sacrificing our health for beauty?
The answer is simple given there are several varieties of sunless tanning products and modern techniques available in salons, spas, skin clinics, and medical spas providing the skin care professional and client with a wide menu of preference options. Many of these “sun alternatives” include sprays, bronzers, consecutive body tanning treatments, and a plethora of products ranging from pills, towelettes, creams, lotions, mists, and gels.
Since the 1950s when cosmetic tan preparations first appeared in the consumer marketplace, fake tanning has become increasingly more popular despite the first generation challenges of self-tanners produced. One infamous past consumer product, QT – short for “Quick Tanning” – is the acknowledged pioneer preceding the thousands of formulas currently on the market today. If you are old enough to remember QT, you will recall the notorious orange hue it produced on the skin, not even coming close to the end-point bronze color consumers expect with the contemporary alternative tan formulations now available.
With the passing of decades, improvements on DHA formulations have brought forth superior products that no longer turn the skin a putrid orange; instead they produce a bronze color so real they are mistaken for a week in the sun. I personally can attest to the efficacy of these products and recreate a better tan than what the sun could ever produce by using a DHA safe self-tanner, body exfoliant, and AHAs. So real has been my golden color I was once scolded by a doctor with the University of Utah regarding the dangers of acquiring a tan! I did set the record straight and later we enjoyed a laugh.

What is DHA?
According to the American Academy of Dermatology, the most effective safe self-tanners are those that contain dihydroxyacetone (DHA). DHA (C3H6O3) is a white, crystalline hygroscopic colorless 3-carbon sugar powder that interacts with the cells of stratum corneum in the epidermis. Calling this a ‘sweet action,’ as the sugar interacts with the skin cells, the browning transformation occurs.
The scientific explanation i.e: the Maillard, or browning reaction, has been defined as the response of an amino group of amino acids, peptides, or proteins with the glosidic hydroxyl group of sugars. DHA in the context of this outcome is with free amino groups available as amino acids, peptides, and proteins supplied by the keratin to form products or chromophores (referred to as melanodins) that possess physicochemical properties similar to naturally occurring melanin. Once the color has developed and because millions of dead skin cells are constantly in a daily shedding mode, the bronzing is eventually worn away as the cells naturally desquamate from their host, the epidermis.
There is an interesting history behind every ingredient we use in cosmetics today and in the case of DHA, the story is no less fascinating. The first mention of DHA as an active ingredient in medicine appeared in the 1920s when it was proposed as a substitute for glucose in diabetics. In the 1950s, the oral administration of DHA was examined as a diagnostic procedure for glycogen storage disease when it was given in large doses orally and rendered non-toxic and safe. It was noticed when children spit up this sweet concentrated material, the skin became pigmented in areas splattered on the skin without staining the clothing. Subsequent to this observation, aqueous solutions were developed and when applied to the skin resulted in pigmentation production. Would this action be considered ‘artificial’ tanning? I think not given the science behind the ingredient and the chemical response of the skin. This is simply skin logic.
Self-tanning products are either swiped, massaged in, or sprayed on the skin and can take several minutes to one hour to begin effect. Color change can even be seen under a Wood’s Lamp within 20 minutes. Most “tanning” occurs within a three hour time frame with maximum darkening taking eight to 24 hours to fully develop. It is recommended to make several successive applications every few hours to achieve desired color that can last five to seven days with a single use. The concentration variance of DHA can range the depth of shade function from 2.5 to 10 percent with the lower potency more forgiving of uneven application and the higher concentration a deeper tan color.
Depending on the anatomical local of application, the same color can be maintained with repeated applications every one to four days. The face, however, requires fewer but more frequent reapplication to maintain the color. Depth of color varies with the thickness and compactness of the stratum corneum. The palms, heels, soles, knees, elbows, and rougher hyperkeratotic area of the skin will stain uneven and deeper and requires a less concentrated, more thorough, and even application. Hair and nails will color rebound but none of the mucous membranes lacking a stratum corneum or keratin layer will react to the staining. Photo-damaged and chronically aged skin with kerastosis and hyperpigmentation will not produce an even tan color. The setting phase of DHA products is also an important factor and premature ready time can compromise the outcome of tanning if clothing or other articles rub against an area of the skin that has not completely dried.
Dry, scaly epidermal conditions, alkaline residues from soaps or detergents, and the skin’s pH can interfere with the reaction between DHA and the amino acids on the skin surface, affecting the outcome of the tanning application. Preparing the skin prior to DHA tanning is recommended by using a body exfoliant in conjunction with a light, hydrating, and fast penetrating AHA lotion to lower the skin’s pH and increase bronzing color intensity. AHAs have the ability to detach old worn out cells by removing dead skin more effectively than other types of exfoliants. The low pH and pKa of the alpha-hydroxy acids increase the DHA activity and produce an intense bronze tan in a shorter period of time! This action is primarily due to the alpha-hydroxy group with electron withdrawing sets known to increase reactivity. The number one rule to a faster and bronzer self tan: use an AHA body lotion prior with a pH no higher than 4 and a minimal percentage of 10 percent.
After application, hands also need to be washed immediately by using a cleanser with exfoliant beads to ‘lift and remove’ the DHA from the thicker stratum corneum of the palm and help avoid darkening of the fingers and nails. Given that, the best way to ensure avoidance of color in the hand area, in addition to increasing a smoother application, is to wear latex-free gloves when applying a DHA self-tanning product.
DHA can also increase noticeable skin dryness after approximately seven days if the epidermis is not continually hydrated. Because of this, it is very important to exfoliate and apply a body lotion in-between application of self-tanner to maintain a moisture rich skin environment.
Other caveats to a successful application (aside from using latex-free gloves) is protect your floor with paper when spraying the mists. Also make sure the self-tanner is dry before putting on your clothes or going to bed. You can increase the drying time by using your hair dryer and “blow-drying” the area. Keep in mind the knee caps, feet, and elbows have a thicker stratum corneum, therefore less is more when applying a self tanner in these regions. I again recommend going over the area with a light application of an AHA lotion prior to application on the feet, knees, and elbows to create a more even texture.

It is important to understand that most of the self-tanning products do not contain a sunscreen, and although a darker color is produced via the change, the self-tanner will not protect you from the sun’s UVA and UVB rays as the genetic dark skin types do. Even products that claim to contain a sun protection will not be effective since they lose their efficacy with application. If you plan on being outdoors for any extended period of time with your new bronze tan, wear added SPF protection and re-apply frequently!
As the improvement in DHA self-tanning formulations continue, the color achieved still remains dependent on Skin Protection Type (SPT). Individuals with skin protection types of II or III, as opposed to those who are lighter (I) and darker (IV and VI), will obtain a more satisfying end point color. Individuals with underlying golden skin tones will achieve better results than individuals with a rosy, sallow, or olive complexion.
In addition to the beautifying cosmetic bronzing effects, self tanners with DHA have shown to be medically therapeutic when used to ‘camouflage’ temporarily some skin irregularities such as leg spider veins and light to medium SPT skins affected by vitiligo (an auto-immune skin disorder). These DHA products have shown color improvement with the vitiliginous areas and may even provide some protection for individuals with certain skin photosensitivity disorders.

Is DHA safe?
The visible skin color change associated with the use of tanning products might suggest these products are hazardous. Based on the chemistry of DHA and its toxicological profile, it is considered non-toxic and reacts quickly in the stratum corneum minimizing systemic absorption. As previously stated, DHA was investigated for diabetics in the 1920s and oral intake was deemed safe. Given that, as a manufacturer advising both professionals and consumers on safe and efficacious use of a DHA tanning product, I respect the following FDA cosmetic act.
The Food, Drug and Cosmetic Act (FD&C Act) Section 71, authorizes the regulation of color additives, including their uses and restrictions. DHA is listed in the regulations as a color additive for use in imparting color to the human body. However, its use in cosmetics-including sunless “tanning” products – is restricted to external application. According to the CFR, “externally applied” cosmetics are those applied only to external parts of the body and not to the lips or any body surface covered by mucous membrane. In addition, no color additive may be used in cosmetics intended for use in the area of the eye unless the color additive is permitted specifically for such use. The CFR defines the “area of the eye” as follows: “the area enclosed within the circumference of the supra-orbital ridge, including the eyebrow, the skin below the eyebrow, the eyelids and the eyelashes, the conjuctival sac of the eye, the eyeball, and the soft areolar tissue that lies within the perimeter of the infra-orbital ridge.”
Although DHA is extremely safe and classified non-toxic, this information is an important guideline when instructing use of any of the self-tanning creams, gels, towelettes, and mists you currently retail to your clientele. Many customers ask if they can use these products around the eye area and based on the safety guidelines, the answer is no. However, FDA safety rules do not stop here.
In recent years the FDA has received many inquires and questions regarding the safety and legality of sunless tanning booths, in which consumers receive an application of the color additive DHA (dihydroxyacetone) in the form of a mist or spray in commercial “tanning” stalls to achieve the appearance of a tan. Exposed during these tanning sessions are the mucus membranes of the eyes and nasal passages of the client.
What do the laws intended to protect the consumer mean for these professional “spray tanning” booths? Many would argue this law is left open for interpretation and subjective at best. The rules are clear when using DHA products in a commercial spray tanning booth and it may be difficult to avoid exposure in a manner for which DHA was intended and not approved.
Currently any spa owner who offers this service or is considering commercial facilities where DHA is applied by spraying or misting should ask themselves the following safety guideline questions, as established by the FDA, before proceeding:

1. Are consumers protected from exposure in the entire area of the eyes, in addition to the eyes themselves?
2. Are consumers protected from exposure on the lips and all parts of the body covered by mucous membrane?
3. Are consumers protected from internal exposure caused by inhaling or ingesting the DHA product?

If the answer to any of these questions is no, the consumer is not protected from the unapproved use of this color additive. Spas, skin clinics, and salons should insure these FDA measures to protect their client’s eyes and mucous membranes to prevent unapproved inhalation of DHA.
Fake tanning is still much healthier than sunbathing, but choose the wrong product and things can go horribly wrong. How does one avoid the streaking, orange color, and uneven texture of the fake tanning products? By specifically following the previous professional suggested guidelines recommended in this editorial.

In Conclusion
Why should non-toxic DHA self-tanning products be an important skin care product to the aesthetician and physician? In addition to incorporating these products as a great business decision to boost profitability, increasing awareness to the risk of accumulative ultra violet light exposure will continue to fuel the demand of your clients for safe alternatives to an environmental tan. It has been proven by sound science indoor DHA stimulated tanning is the safest way to avoid UVR generated skin damage and produce the fastest tan color in a shorter period of time without risking health. The end point results obtained with these alternative-tanning formulations are always dependent on individual application technique, SPT type, and pre-preparation of the skin.

An inducted Legend in American Aesthetics by DERMASCOPE Magazine and Aesthetics International Association in 2008, Christine Heathman has been a practicing licensed master aesthetician, educator, and a leader in the research and development of skin care and progressive clinical protocols for over 25 years. A recent testimonial to Heathman’s skin knowledge selected her amazing product formulas out of thousands and recently featured them on the nationally syndicated TV show called The Doctors, as an alternative option to cosmetic surgery. www.glymedplus.com