Skin Doctors Turn Thumbs Down On Sun

Dermatologists hate the sun. There’s a good reason for their loathing. They see the effects of excessive sun exposure-not just wrinkles, age spots and leathery skin, but also a variety of skin cancers.
But do dermatologists go too far in advising everyone to shun the sun completely? Several weeks ago we wrote that a modest amount of sunhsine might be beneficial.
Dr. Edward Giovannucci of Harvard started a controversy by reporting that common cancers such as colon, lung, prostate or breast are less prevalent in sunnier states and countries where people get more sun exposure. The anti-cancer benefits of vitamin D may be due to its ability to suppress abnormal cell growth.
Human skin makes vitamin D when it is exposed to sunshine. But high SPF sunscreen blocks this biochemical activity. Fortunately, it doesn’t take much sun for adequate vitamin D. According to Dr. Michael Holick of Boston University, five or ten minutes on face, arms and legs two or three times a week is enough for fair-skinned people. Darker-skinned individuals need a little more time in the sun.
Dermatologists worry about any sun exposure. We received the following letter in response to our previous column:
“As the President of the American Academy of Dermatology, I am deeply concerned that your recent article is contributing to public confusion about sun exposure and vitamin D and ultimately doing a disservice to the public.
“The health benefits of vitamin D are well known. Prescribing sunshine to get vitamin D is highly irresponsible, however. People should NOT increase their exposure to UV light because there is a high risk of developing skin cancer from repeated exposure.
“At current rates, an estimated 105,750 people in the U.S. will be diagnosed with melanoma (the most serious form of skin cancer) this year. This is a 10 percent increase in new cases since 2004 and melanoma will claim approximately 7,770 lives this year alone.
“Rather than seek intentional sun exposure, the American Academy of Dermatology recommends that anyone concerned about getting enough vitamin D should supplement a healthy diet with multivitamins and fortified foods and beverages. Individuals who seek the sun are putting their health at risk.
“The Academy’s message is one of common sense and caution. When enjoying the outdoors, we recommend everyone take protective steps: seek shade, wear sunscreen and cover up with a wide-brimmed hat, long sleeves, pants and sunglasses. Also, avoid tanning beds.
“Sincerely, Clay J. Cockerell, MD”
We appreciate the call for common sense. Too much sun is clearly harmful.
But we are skeptical of getting adequate vitamin D from a multivitamin. Multivitamins contain only 400 IU (international units) of vitamin D, often in a less usable form than the skin makes.
Current estimates suggest adults may need 1,000 IU daily, and Dr. Giovannucci believes 1,500 IU might be closer to the mark. Taking several multiple vitamins to provide that much D would result in a dangerous overload of other vitamins. Vitamin D itself is toxic if too much is taken orally.
The inescapable conclusion, we feel, points to moderation in sun exposure as well as vitamin consumption for most people. A sunburn or even a tan is unhealthy, but a few minutes of sun a few times a week might have real benefit.