The harmful effects of ultraviolet (UV) light on the skin apparently do not scare off teenagers, who are flocking to indoor tanning salons. Among non-Hispanic white high-school students, about 29 percent of girls and about 7 percent of boys admit to indulging in frequent trips to tanning salons. Now medical researchers are taking state governments to task for lax or nonexistent regulations surrounding teenage indoor tanning. “This is no longer just a prom phenomenon—kids are using tanning beds frequently,” says Alan Geller, a public health researcher of Harvard University School of Public Health and co-author of a new study of tanning regulations. “And all we have to protect these teenagers is a patchwork quilt of poor regulation.”

Protecting young skin from the sun’s rays is especially important because early exposure increases the risk of skin cancer later in life. Although people who develop melanoma, the most serious form of skin cancer, have a 98 percent chance of surviving the next five years, the survival rate drops to 62 percent if melanoma is detected late. During the past 20 years, the incidence of melanoma in young women has doubled. No single cause can account for this increase, but many doctors point to the parallel rise in tanning bed use, which increases the risk of melanoma by 59 to 75 percent for those under the age of 35.

In light of these trends Geller and his colleagues analyzed tanning laws in all 50 states, accounting for age bans, parental consent laws as well as operating and warning requirements, and the overall enforcement of these regulations. The researchers found that the lion’s share of regulations rely on parental consent or parental accompaniment, and that both requirements, Geller says, are “really quite weak.”

Currently, six U.S. states have strong parental consent enforcement procedures, such as regular salon inspections, and another six have banned underage indoor tanning altogether. Yet 13 states continue to have no underage tanning regulations.

One of those states is Missouri, where 65 percent of tanning salon operators say they would be okay with having kids as young as 10 years old use their facilities, according to a 2013 survey. The reasoning behind this answer, according to 80 percent of operators, is the belief that tanning “prevents sunburns,” which means they are providing a public service. In truth, any change in skin color because of sunlamp or sun exposure is a sign of UV radiation damage, which is unequivocally bad for the skin. Having a “base tan,” Geller says, is equivalent to sun protection factor (SPF) 3, “far less than what you need to prevent really bad sunburns or suntans.” And for each indoor tanning session, customers increase their lifetime risk of melanoma by 1.6 percent per year.

Although some legislation has attempted to address this $5-billion industry’s impact on the health of Americans—in 2010 the Obama administration passed a 10 percent federal tax on tanning services—teenage tanning bed use continues to hold steady. A 2003 study, for instance, reported that 28 percent of white female adolescents and 6 percent of young white males frequented tanning facilities regularly. The apparent persistence of teen indoor tanning begs the question as to why so many states have not clued into the need for regulation. Geller says some of this delay has to do with push-back from tanning salon operators. “They talk about the ‘nanny state’ and how regulations are bad for business,” he says. “Many argue it should be the job of the parents to enforce these rules.”

But many parents do not know about the risks. “We need broad counteradvertising,” Geller says, but the U.S. Food and Drug Administration should also implement a countrywide law banning indoor tanning for children under the age of 18. “If we leave it up to each state,” he says, “it will take an extraordinarily long period of time.”

In England salons are inspected regularly and can face fines of up to about $30,000 if they fail to turn teenagers away. In France, where underage tanning has been banned since 1997, researchers report that 1.4 percent of minors engage in illegal tanning bed use compared with the 15.6 percent of American adolescents who frequent tanning salons today. Moreover, since 2003 the number of countries that have bans on underage indoor tanning has increased from two to 11—an increase due, in part, to the World Health Organization’s 2009 reclassification of sunlamps, tanning beds and UV light as high-level carcinogens. Indoor tanning is a serious health concern, Geller says, and because of lax regulations we do not know if 10-year-olds are using tanning beds. “That’s why we need a ban across the country.”