Florida’s commercial tanning facilities outnumber McDonald’s restaurants and CVS pharmacies in the state, according to a new study. Tanning salons flourish in the “Sunshine State,” despite known links between tanning beds and skin cancer.

"Recently, availability of indoor tanning facilities has drastically increased, and this business has become one of the fastest-growing industries. Despite tanning bed exposure being labeled as 'carcinogenic to humans,' increasing use by adolescents is a concern," the University of Miami Miller School of Medicine researchers wrote. "The prevalence of indoor tanning facilities in Florida compared with commonly frequented businesses in our study has alarming implications. ... Further investigation of the impact of indoor tanning facility type, geographic location, and use on skin cancer incidence may promote regulation of these carcinogenic devices."

Florida has the second highest rate of melanoma in the country. According to the Mayo Clinic, melanoma is the most serious type of skin cancer. It develops in the cells that produce melanin, the pigment that gives your skin color. Exposure to ultraviolet radiation, like that of tanning lamps, does increase one’s risk of developing melanoma. The most common symptom of melanoma is a mole on the skin, especially an unusually shaped or strangely-colored one. Scales on the skin, itching, and bleeding are also known symptoms.

Florida is one of quite a few states — accompanied by Arizona, South Carolina, and Virginia — that does not place age restrictions on who can use tanning beds, according to the National Conference of State Legislatures (NCSL). Under Florida law, children under the age of 14 have to be accompanied by a parent in order to receive an indoor tan. Between the ages of 14 and 18, a parent doesn’t have to be present for the child to go tanning at a salon. Instead, they merely need parental permission or consent. Compared to states like New York, where there is a strict ban on tanning in a salon under the age of 17, the sunshine state’s laws seem pretty lax. And with tanning salons available to teens and children, it’s no wonder the state has such a booming tanning industry.

“We were shocked,” said Dr. Robert Kirsner, a University of Miami Miller School of Medicine dermatology professor, according to the Miami Herald. “Even in the Sunshine State, where we get plenty of exposure, the beds are proliferating.”

The researchers recommend placing age limits on tanning bed use in Florida, and restrictions on how tanning sessions are marketed, so that teens and young adults are not so drawn to them.

“We found 100 facilities associated with college dormitories and residences,” Kirsner said. “Many of the facilities are associated with wellness centers and health spas, when it’s quite the opposite. They’re a health detriment.”

Source: Sonia A. Lamel, MD; Nicholas A. Richmond, BS. The Characterization of Indoor Tanning Facilities in Florida. JAMA. 2013.