The Truth About Vitamin D and Sun Exposure
Dermatologists continue to recommend sun protection
Are you concerned that you are not
getting enough vitamin D? Several newspapers, magazines, and
broadcasts have recently reported findings from research studies
that show a significant number of Americans do not get adequate
levels of vitamin D.
Low levels of this important nutrient can cause medical conditions
ranging from rickets and poor bone density to increased risk of
falling in elderly persons. Some reports even claim that a vitamin D
deficiency increases one’s risk for certain types of cancer.
If you have actinic keratoses (ak-'tin-nik ker-e-'to-ses) or AKs,
what are you to do? Your dermatologist tells you to protect your
skin from the sun, but you also are concerned about developing
brittle bones and increasing your risk for other types of cancer.
You may be thinking, surely, a few minutes a day of unprotected sun
exposure won’t hurt.
A Few Minutes Each Day
The truth is a few minutes a day of unprotected sun exposure can do
plenty of damage, especially if you already have AKs. AKs are caused
by years of overexposure to ultraviolet (UV) rays. This overexposure
suppressed your immune system, allowing abnormal cells to grow.
Continuing to expose your skin to sunlight — even for a few minutes
a day — can exacerbate the damage already done. This increases your
risk for developing more AKs and different types of skin cancer,
including melanoma. In the United States, one person dies from
melanoma every 68 minutes.
This is why dermatologists urge all of their patients with AKs to
protect their skin from the sun. Twenty-plus years of research shows
that sun protection can be beneficial for people who have UV-damaged
skin. Anyone with AKs has extensive UV-damage. Sun protection can
prevent further damage and may even allow the skin to repair some of
and Supplements Best Sources for Vitamin D
Protecting your skin from the sun does not mean you cannot get the
vitamin D your body needs. Renowned medical experts agree that UV
light, such as that emitted by the sun, does not
provide us with a better source of vitamin D than foods and dietary
supplements. Furthermore, as we age, our skin becomes less able to
process vitamin D absorbed through the skin and our daily vitamin D
If you are concerned about not getting enough vitamin D,
dermatologists recommend that you take a supplement or include
vitamin D rich foods in your diet.
To add vitamin D rich foods to your diet, you may want to include
some seafood. Swordfish, sardines, and mackerel provide the highest
levels. Salmon, herring, and raw tuna (not canned) are other good
sources as is shrimp. While not as rich in vitamin D as the seafood
just mentioned, vitamin D fortified milk is another good source.
Other dairy products, such as yogurt and cheese, are usually not
fortified with vitamin D and should not be relied on as a source of
this important nutrient.
To avoid potential toxic side effects, your intake of vitamin D
should not exceed 2,000 IUs per day unless directed by a physician.
Vitamin D Useless
If you are still tempted to get a bit of vitamin D from the sun,
consider this: Without calcium and phosphorous, which you cannot get
from the sun, your body cannot use vitamin D. Eating a balanced diet
offers a much healthier way to ensure you are getting all of the
nutrients that your body needs.
Comprehensive Sun Protection Vital for Patients with AKs
Dermatologists recommend that all of their patients, including their
patients who have AKs, follow a comprehensive sun-protection plan.
The American Academy of Dermatology recommends:
Wear protective clothing when
outdoors. A long-sleeved shirt, pants, a wide-brimmed hat, and
sunglasses should be worn when possible.
In general, clothing made of tightly woven fabric provides the best
sun protection. Woven fabrics that have see-through holes between
individual threads allow UV rays to penetrate through to the skin
and are not recommended. Darker colors, particularly navy blue, are
favored over lighter colors.
You also may want to wear clothing that is specially designed to
provide sun protection and use laundry additives that boost
clothing’s ability to protect against the sun.
Generously apply sunscreen to all
exposed skin. The sunscreen should have a Sun Protection Factor
(SPF) of at least 30 and be broad spectrum (provides protection from
both UVA and UVB rays). Sunscreen should be re-applied approximately every two
hours, even on cloudy days, and after perspiring or swimming.
Seek shade when possible.
Remember, the sun’s rays are strongest between 10 a.m. and 4 p.m.
Use extra caution near water, snow,
and sand. These reflect the damaging UV rays of the sun, which
can increase your chance of sunburn.
Avoid tanning beds. If you want
to look as if you have been in the sun, consider using a
self-tanning lotion or spray-on salon treatment.
Seek the Sun
The truth is you do not need to seek the sun to get the vitamin D
your body needs. Getting vitamin D from the sun exposes you to a
known cancer-causing agent. If you have AKs, continuing to expose
your skin to the sun significantly increases your risk of developing
more AKs and various skin cancers.
Eating foods rich in vitamin D or adding a supplement can provide
you with the vitamin D your body needs.
American Academy of Dermatology Association, “American
Academy of Dermatology Association Reconfirms Need to Boost Vitamin
D Intake Through Diet and Nutritional Supplements Rather than
Ultraviolet Radiation.“ May 2, 2005.
O’Donoghue, MN. “Sunscreens and
the Vitamin D Controversy.” Presented at the American Academy of
Dermatology’s ACADEMY ’05: General Session 161. July 2005: Chicago.
content solely developed by the American Academy of Dermatology
the health benefits of vitamin D are well known,
prescribing sunshine to get vitamin D is highly
Clay J. Cockerell, M.D.
President of the American Academy of Dermatology
The science behind
Skin cancer is one of the few cancers for which the
primary cause is known -- exposure to ultraviolet (UV)
Research shows that UV radiation causes skin cancer. The
evidence is so strong that the United States Department
of Health and Human Services added UV radiation to its
list of known carcinogens (cancer-causing agents). The
sun, tanning beds,
and sun lamps emit UV radiation.
Vitamin D from diet and supplements prevents
deficiency without increasing the risk of developing
Science shows that people with a rare inherited medical
condition called xeroderma pigmentosum, which
causes multiple skin cancers in person exposed to the
smallest amounts of UV radiation, have normal vitamin D
levels despite virtually no UV exposure. They get all of
vitamin D through diet