The Sun and Your Health

Sun exposure is a hot topic these days and many folks are clouded by confusion (puns intended)! With conflicting information about how sun exposure causes cancer and yet we also know that the sun provides us with Vitamin D which is important for optimal health – it’s no wonder we’re confused about what advice to follow when it comes to sun exposure. Whether you’re the person that basks for hours in the direct sun at the pool or you fearfully cover yourself completely; we’re going to shed light on this subject so you can reap the health benefits of the sun while simultaneously protecting your skin. 

The fear of the sun is completely valid and understandable. According to the Environmental Working Group (EWG), more than two million Americans develop skin cancer each year. Half of Americans who live to 65 will be diagnosed at least once with rarely fatal forms of skin cancer called basal and squamous cell carcinomas, both linked to sun exposure. 

Cancer aside, too much sunlight can create oxidative stress or oxidation. Think of oxidation as the rusting of a car or a sliced apple turning brown. The same situation advances aging of the skin and contributes to wrinkles and uneven pigmentation when skin is exposed to too much sunlight over the years. 

More and more research, however, shows just how important it is for overall health to get enough sun exposure. According to the study The risks and benefits of sun exposure 2016, “Studies have shown a wide range of health benefits from sun/UV exposure. These benefits interestingly include natural defenses against various types of cancers, cardiovascular disease, Alzheimer’s disease, dementia, myopia and macular degeneration, diabetes, and multiple sclerosis.” In fact, In the early 1900s, nurses would roll beds outside so patients could get a healthy dose of sunlight. Why did we stop? 

While too much sun exposure can definitely cause premature aging, on the flip side there’s also research that shows the protective benefits of the sun, and interestingly, the one vitamin the sun helps supply can actually protect against skin cancer. Optimal vitamin D levels can reduce the risk of melanoma and help protect against other cancers.

Vitamin D deficiency is a major epidemic that is off the radar for most doctors and public health officials. I find it interesting that Vitamin D is often not a marker routinely checked with annual physicals. Vitamin D deficiency affects over half of the population and has been linked to many cancers, high blood pressure, heart disease, diabetes, depression, fibromyalgia, chronic muscle pain, bone loss, and autoimmune diseases like multiple sclerosis. Achieving healthy blood levels of 45 ng/ml would result in 400,000 fewer premature deaths per year.

Vitamin D (also called 25-hydroxyvitamin D) is a fat-soluble vitamin and acts in our body more like a steroid hormone. It is made in our bodies only when our skin is exposed to the sun. It’s considered an “essential” nutrient because the human body cannot make it on its own, without the assistance of food and sunlight. 

There are many reasons why individual’s aren’t getting enough sun exposure: 

• The overuse of sunscreen: These can block 97 percent of your body’s vitamin D production.
• Living in a northern climate: Especially in the winter months you naturally don’t get enough sunlight
• Not eating enough food sources of Vitamin D: fatty wild fish like mackerel, herring, and cod liver oil.
• As we age we produce less Vitamin D
• Having darker skin: Darker skinned individuals make less Vitamin D, thus they need more sun exposure
• Covering yourself up completely

So what are you supposed to do? 

Melanoma is the most dangerous form of skin cancer and much information we’re told states it’s caused by the sun. However, research shows that non burning sun exposure reduces the risk, while burning increases risk. According to the “Risks and Benefits of Sun Exposure 2016“ interestingly, it has long been observed that outdoor workers have a lower incidence of melanoma than indoor workers. A 1997 meta analysis found an odds ratio of 0.86. Odds ratio is an assignment of risk. If you’re above 1.0, depending on how the study is set up, you have an increased risk. If you’re below 1.0, you have a decreased risk. In another study, the authors concluded “We found that almost all epidemiological studies suggest that chronic, not intermittent, sun exposure is associated with reduced risk of certain kinds of cancer.” High-level science is showing that the most dangerous form of skin cancer, melanoma, is protected against by chronic, non-burning sun exposure.

This means that you’re not just getting five minutes in the sun or only exposing yourself to an intense amount of sun on vacation. It means you’re getting 20, 30, 40, 50 minutes in the sun on most days of the week. The amount of sun you need is dependent on the time of year and your skin type. 

So how do you reduce your risk of burning while maximizing the health benefits you receive from the sun? 

The Fitzpatrick scale, shown below, classifies six skin types based on the response of different skin types to UV radiation. Type 2 skin types burn quite easily while the darker your skin, the less prone you are to burn and the longer you need in the sun to absorb Vitamin D. So how much sun exposure should we be getting? Between 15-30 minutes of sun exposure two three times per week, with the duration depending on your skin type. One thing that’s recommended in the research is what’s called the minimal erythemal dose, which means get enough sun to cause a slight pigment change in your skin, a slight pinkening of the skin or a slight tanning of the skin, and that should be sufficient. You certainly never want to burn. 

Follow these tips to get your Vitamin D and protect your skin: 

1. The sun’s rays are at their strongest between the hours of 10am and 2pm and depending on where you are this can be up to 4pm. So be mindful to limit your exposure in direct sun during these hours based on your skin type.
2. Get your daily dose of sun exposure determined by your skin type and the Fitzpatrick scale, and see your dermatologist regularly.
3. Use sunscreen only if you need it:  According to the EWG, sunscreen should be your last resort when going into the sun. And avoid using a high SPF sunscreen.
4. Don’t get burned: After your daily dose has been met, seek protection under an umbrella, wear a hat and protective long sleeved clothing for the hottest times of the day.
5. Scrutinize the ingredients in your sunscreen: Stop using sunblock that contain paraben, petrochemicals, lead, or other toxins. Your skin is like a giant mouth – what you put on it, goes directly into your body. If you wouldn’t eat it, don’t put it on your skin. Choose a sunscreen recommended by EWG, download the Healthy Living app to evaluate sunscreens and other products while shopping
6. Stay hydrated: Many of us are chronically dehydrated and consume caffeinated drinks or alcoholic beverages when basking in the sun, which makes us even more dehydrated.
7. Take Astaxanthin: It’s a powerful antioxidant to heal damaged skin but also to increase skin resiliency.  Research shows that with regular astaxanthin use,  sunburn typically happens less quickly and less intensely when we are exposed to the sun (here’s another one). 

So what’s the takeaway? Don’t be a vampire and hide away from the sun! Hiding behind clothes, sunscreen and the like at every sun exposure can actually be damaging to your health. Instead, expose yourself to the sun but do it in a reasonable and responsible manner on most days to get the immune protective benefits and DNA repair your body needs for optimal health but do it without burning!

I would love to hear what you thought of this blog or if you have any questions about what was shared please do reach out to me here.

Resources:

• Dr Ruscio, Sun Exposure
• Dr. Mark Hyman, 7 Strategies for Optimal Sun Exposure
• Environmental Working Group, Skin Cancer On the Rise
• Environmental Working Group, The Trouble with SPF
• Grant WB. In defense of the sun: An estimate of changes in mortality rates in the United States if mean serum 25-hydroxyvitamin D levels were raised to 45 ng/mL by solar ultraviolet-B irradiance. Dermatoendocrinol. 2009 Jul;1(4):207-14. doi: 10.4161/derm.1.4.9841. PMID: 20592792; PMCID: PMC2835876.
• Hoel DG, Berwick M, de Gruijl FR, Holick MF. The risks and benefits of sun exposure 2016. Dermatoendocrinol. 2016 Oct 19;8(1):e1248325. doi: 10.1080/19381980.2016.1248325. PMID: 27942349; PMCID: PMC5129901.

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