Are skin cancer prevention campaigns scaring people away from healthy sun exposure?

couple sitting in the sun
One researchers says the current public health debate is dominated by concerns about cancer, with little focus on the health benefits of safe exposure to sunlight.

Skin cancer prevention campaigns, particularly in Australia with its high rates of skin cancer, have focused largely on the dangers of exposure to sunlight. As a result many people avoid the sun altogether or use sunscreen for even very short periods of time spent outdoors. One scientist has recently suggested that it’s time for a ‘radical re-think’ and that health authorities should be advising people to ensure sensible sun exposure for its health benefits.

Speaking at the Australian Health and Medical Research Congress in Melbourne, Professor Martin Feelisch, a professor of clinical and experimental sciences at the University of Southampton, said that recent epidemiological studies suggest that the health benefits of moderate sunlight exposure outweighed the harmful effects of UV radiation on the skin.In a recent study at the University of Edinburgh, researchers found that a dose of UV equivalent to about 30 minutes of sunshine during the summer in southern Europe lowered people’s blood pressure. Several other studies have shown that people with mild hypertension tend to have lower blood pressure in summer compared to winter. Given that high blood pressure is a key risk factor for heart disease and stroke – a major killer worldwide – should health authorities be focusing more on the health benefits of sunlight?

Professor Feelisch stated,

We have to balance the benefits with the detrimental effects for the greater good of the entire population. The current public health advice is dominated by concerns about cancer…That may be very important for a high risk group, but that high risk group comprises the minority of the population.”

In response, Professor Ian Olver, head of the Australian Cancer Council, said that current health advice in Australia balances the pros and cons of sunlight for vitamin D and emphasizes high UV index times when people are more likely to burn. In Australia skin cancer is a serious concern, with about 2000 people dying from the disease annually.1 He said,

If the UV index is three or above, the sun is intense enough to burn you and therefore you need to take some protection measures. If it's less than three, you can probably safely go out in the sun. So for vitamin D, early in the morning or late in the afternoon, it might be fine to go out without protection but in the middle of the day, it usually isn't."

Finding a healthy balance: safe sun exposure

Aside from research pointing to the many probable health benefits of sunlight and, specifically, vitamin D, it has long been known that vitamin D is essential for bone and muscle health. Most experts recommend at least 10 to 15 minutes of daily sun exposure for musculoskeletal health. The fact is that while sun safety is a concern, particularly in some countries and in people with fair skin, vitamin D deficiency is also a major concern. Low levels of vitamin D are found in all age groups and in all parts of the world – and the increasingly sedentary urban (i.e. indoor) lifestyles of both children and adults have magnified the problem. While supplementation is possible, most healthy people should be getting their vitamin D intake from safe sun exposure (in addition, there are some - although few - foods which contain vitamin D.

People should also be aware that there are a number of factors that increase the risk of having inadequate vitamin D. These include:

  • Use of sunscreen: Sunscreen-use blocks most of the skin’s production of vitamin D. While dermatology organizations would tend to advocate no sun exposure without sunscreen, many vitamin D experts recommend a more moderate approach and say that arms and legs should get a small amount of unprotected sun exposure (ca. 15 minutes) before applying sunscreen or covering up. (2)
  • Geographic location and season: The body stores vitamin D from summer sun exposure, but it must last for many months. By winter, many people who live at higher-latitudes with little sunlight during the autumn and winter season may be vitamin D deficient.3
  • Older age: Skin production of vitamin D declines with age, leaving seniors with a 4-times lower capacity to produce vitamin D compared to younger adults.3
  • Darker skin tone: People who have a darker skin tone have more melanin in their skin, which acts as a “natural sunscreen” that slows down skin production of vitamin D.
  • Excess body fat: People who are overweight or obese have a higher risk of having inadequate vitamin D.

For those who do not go outdoors or are at risk of low vitamin D (including seniors aged 60 years and over), supplementaiton is often recommended. However for most people, the key is to find a healthy balance that ensures regular safe sun exposure (restricted to low UV index times in sunny climates) to address individual needs.

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