ActinicKeratosesNet Article
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 Harmful
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 the damage.

Diet 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 requirement increases.

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 Without Calcium
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:

  1. 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.
     

  2. 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.
     

  3. Seek shade when possible. Remember, the sun’s rays are strongest between 10 a.m. and 4 p.m.
     

  4. Use extra caution near water, snow, and sand. These reflect the damaging UV rays of the sun, which can increase your chance of sunburn.
     

  5. 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.

Don’t 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.

References:
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.


All content solely developed by the American Academy of Dermatology

While the health benefits of vitamin D are well known, prescribing sunshine to get vitamin D is highly irresponsible.”

Clay J. Cockerell, M.D.
President of the American Academy of Dermatology


 

The science behind dermatologists’ recommendations:

Skin cancer is one of the few cancers for which the primary cause is known -- exposure to ultraviolet (UV) light.
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 skin cancer.
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 their
vitamin D through diet
and supplements.

 

     © American Academy of Dermatology, 2010  All rights reserved.
 

Page last updated 12/12/05

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