Aplastic anemia associated with canthaxanthin ingested for 'tanning' purposes

Aplastic anemia with a fatal outcome occurred in a previously healthy young woman after ingesting canthaxanthin taken for the purpose of skin "tanning" and provided to her by a commercial tanning salon. Canthaxanthin is a synthetic, non-provitamin A carotenoid that is highly lipid-soluble; it colors the skin by deposition in the epidermis and subcutaneous fat. It is readily available through commercial tanning salons and mail advertisements, but despite advertising claims that it is harmless, investigation regarding the safety of oral doses of canthaxanthin in humans has not been conducted. It is not approved as a prescription or an over-the-counter preparation by the Food and Drug Administration. The drug's present means of distribution makes monitoring for toxic effects difficult. Thus, the frequency of adverse effects associated with canthaxanthin use, such as bone marrow suppression, is unknown. Even if there is only a small risk of these toxic effects, the use of the drug for cosmetic purposes does not justify this risk.