Article

Exposure to Dihydroxyacetone in Sunless Tanning Products: Understanding the Risks

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Abstract

The public has been warned for years about the dangers of ultraviolet exposure from natural sunlight and tanning beds due to the associated risk for skin cancer development. An alternative to obtaining the sun-kissed look without ultraviolet exposure has been self-tanning products, which are applied directly to the skin via lotions, sprays, foams, and wipes. However, recent research has indicated that the chemical dihydroxyacetone (DHA), which is the active agent in most sunless tanning lotions, may cause cell damage via free radical reactions. Changes in pigmented lesion appearance during dermoscopic examinations after use of products containing DHA have been documented, and these findings will be analyzed. This integrative research review will examine evidence-based research regarding the risks of using DHA-containing products. Nola Pender's health promotion model is recommended to identify strategies that healthcare providers can use when developing anticipatory guidance to address factors leading to barriers in health promoting behaviors. This model is focused on improvement of well-being while preventing diseases.

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As the desire and popularity of a tanned appearance continues, the social effects of UV‐free tanning are becoming more important. Dihydroxyacetone (DHA) has seen extensive use as the main tanning agent in sunless tanners. The DHA‐induced tan is a result of brown melanoidins formed by a non‐enzymatic Maillard reaction between DHA and amino acid species found in the stratum corneum. DHA, thereby, provides a safer route to a tanned appearance compared with exposure to ultraviolet radiation. However, DHA is a highly reactive molecule, posing a multitude of challenges for potential product formulations. With their increased use, the safety considerations of topically applied DHA tanners has been investigated. Many different vehicles have been used for topical delivery of DHA, and they are becoming increasingly multifunctional. This review provides a holistic overview of dihydroxyacetone sunless tanning products.
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