It’s mid-summer here in Connecticut, and the dance between soaking up the sun and avoiding it is in full swing. The sun is literally the center of our universe, it is responsible for life on this planet, but we have come to view it as dangerous and something to be avoided. Skin cancer, especially melanoma is on the rise despite the increase in sunscreen use – the two are both rising at over 30% in the last decade. On top of that, the majority of people are suffering from extreme vitamin D deficiencies, which has been directly linked to the rise in sunscreen use and an increase in chronic illnesses. A few weeks ago, I listened to a podcast and began to explore this topic. It’s difficult to wade through all the information and synthesize it into a conclusion – in part because to understand it well you have to get into the scientific nitty gritty, and due to the massive amount of information out there created by the sun screen and dermatological industries that is very hard. The Skin Cancer Foundation and Melanoma.org are examples of websites that are actually funded by the sunscreen industry – just checkout the list of the Corporate Council of the SCF, which reads like an aisle in CVS.
On the other side of the coin, many holistic health leaders go the opposite direction to an extreme. The truth is that UV radiation has been tied to skin cancer over and over again – the issue is that most of these studies were done with man-made UV and not the actual sun. Many who study the sun and how it affects our bodies believe that there are many benefits, apart from vitamin D, including how natural infrared light, which comes from the sun early in the morning, can combat depression. Studies evaluating the skin cancer rates of populations have found that people in professions that lend them to be outside – farmers, construction workers, lifeguards – all have low incidence of skin cancer and people who work inside most of the time – and are only exposed to the sun on vacations – have the highest incidence of skin cancer. When it comes to deadly melanoma, the leading scientists and oncologists are discovering it is closely linked to genetics and family predisposition. A deep dive on sunscreen revealed that, in addition to blocking vitamin D absorption, its main ingredients in are killing our oceans and disrupting our hormones.
Is there a safe medium that we can strike where we embrace the sun for all its benefits while also being cautious about over-exposure to the dangers of UV radiation? The following is my attempt to distill what I discovered about the sun, vitamin D, skin cancer and sunscreen. There is more research to be done, but I feel as though I came far enough to come to a conclusion for myself. It’s a long post, but such important information.
As you know, I am not a doctor, or a scientist, just a concerned citizen and mother looking for information, and all the opinions and conclusions here are my own. Feel free to skip to the bottom to see my personal takeaways for how I will approach my relationship with the sun going forward.
The Skinny on Vitamin D
We have receptors for vitamin D in every cell in our bodies, and it affects everything from our DNA to turning genes on and off. Vitamin D is a hormone, not a vitamin, and it is incredibly important for our health and wellness. It has a role in bone formation and calcium absorption, it prevents cancer, heart disease, and autoimmune diseases. Our primary source of vitamin D throughout history has been from the sun – our bodies use UVB rays to create it in our bodies and our skin is designed to be exposed to the sun’s rays. Melanin, the pigment that changes color in our skin when exposed to the sun, is our ancient biological mechanism for sun-exposure – it transmutes UV radiation into heat, protecting our bodies from further radiation. Sunburns are our body’s early warning system, which keeps us from being in the sun for too long. Melanin has been inversely correlated with the amount of DNA damage that occurs due to excessive UV radiation. A small amount of exposure of the eyes to the sun, without sunglasses, can be beneficial for melatonin production. Melatonin regulates our sleep-wake cycles, is an immune booster, antioxidant and delays neuro-degeneration.
Modern life has dramatically decreased our sun exposure, causing a massive increase in vitamin D deficiency. The recommendations for what constitutes adequate vitamin D vary widely, with leading vitamin D researchers recommending 3,000 to 4,000 IU per day as necessary and safe. Full-body exposure of pale skin to sunshine without clothing or sunscreen for thirty minutes can result in the synthesis of between 10,000 and 20,000 IU of vitamin D. It was found that in the UK, even just 13 minutes of midday sun three times a week was enough to maintain healthy levels of vitamin D in Caucasian adults. There have been misconceptions around latitude affecting vitamin D production – in the last few years it has been shown that vitamin D could be effectively synthesized across the globe for three quarters of the year. However, even SPF 8 reduces UVB penetration by 98 percent and essentially stops all vitamin D production.
Scientists believe that while vitamin D foods and supplements can be beneficial, they lack the full benefits of the sun due to the oxidation of cholesterol and sulfur on our skin, and the fact that the form of D3 we get from the sun is water soluble, not fat soluble. Basically what this means is vitamin D from the sun is a much bigger boost to our immune system that vitamin D from supplements and food sources. Foods such as oily fish (i.e. mackerel, sardines, cod liver oil), oysters, egg yolks, red meat, and mushrooms all contain vitamin Additionally, only UVB rays can create vitamin D, and UVB rays do not cause a tan, only UVA rays do. UVA rays penetrate glass but UVB rays do not. Be aware that manufacturers can tell you that their product provides UVA protection when it does not – FDA spokeswoman Ivy Kupec admitted that manufacturers “could still say [their product] protects against UV-A, because they can do it until we tell them not to.”
The Truth About Sunscreen
Sunscreen is something we all use daily, over our whole bodies. It is often ingested accidentally, and it’s designed to soak deep into our skin. In fact, sunscreen chemicals have been measured in blood, breast milk and urine samples. Most sunscreens utilize chemical filters such as oxybenzone, avobenzone, octisalate, octocrylene, homosalate and octinoxate. Studies have indicated that these chemicals are endocrine disruptors that mimic hormones and can also cause skin allergies.
Oxybenzone, the most common sunscreen ingredient, is particularly scary. Researchers recently found that adolescent boys with higher oxybenzone measurements had significantly lower testosterone levels. Three other studies reported statistically significant associations between oxybenzone exposure during pregnancy and birth outcomes, including shorter pregnancies in women gestating male babies and lower birth weights in daughters. Given the mass use of oxybenzone, more study is needed but intentional dosing studies are rare due to ethical concerns. Not only does oxybenzone have serious health affects for humans, it, along with octinoxate, is causing coral bleaching worldwide. According to the National Parks Service, 14,000 tons of sunscreen enters coral reefs every year. It is suspected that octocrylene, homosalate, and octisalate are also causing damage to other important marine life.
Mineral sunscreens with non-nano zinc oxide or titanium dioxide appear to be safer for coral reefs and for humans alike. Zinc reflects the rays rather than allowing you to absorb them, and is actually an ancient healing salve first described in Indian medicinal texts as far back as 500 B.C. In addition to providing broad-spectrum sun protection it can help lower skin inflammation, improve wound healing, help treat acne, keep skin moisturized, and prevent premature aging. The sunscreen industry is on the rise – it’s a $1.2 billion industry and has grown by more than 31% in the last ten years.
Skin Cancer’s Deadly Rise
Skin cancer is a serious disease and rates are only increasing. Specifically, melanoma, the deadliest form of skin cancer, has jumped 34% with the incidence of localized melanoma increased from 1 in 78 people in 2009 to 1 in 58 people in 2016. It is proven that over-exposure to UVA and UVB rays can cause damage to the skin at a genetic level. Enough DNA damage to our skin cells over time can build up and the cells can grow out of control causing skin cancer. I set out to find a scientific study that explicitly showed that sunlight caused cancer – not man-made UV light, not a survey about the correlation between behavior and skin cancer, but actual light from the sun.
I discovered many scientific studies started off making the general statement that sunlight causes skin cancer. However, when I checked the references the actual study didn’t say that at all. One such study, if read carefully stated that there is a significant positive association (i.e. more melanoma) with intermittent sun exposure, but a significantly reduced risk for melanoma for heavy occupational exposure. Literally, the way the study was referenced was the opposite of what it actually said – it found that more exposure to sunlight in people who worked outside resulted in a reduced risk of melanoma.
Another study linked sunburns and genetically sun-sensitive skin with higher rates of melanoma and skin cancer. These findings seemed well proven, however that same study also concluded that regular weekend sun exposure (without burning) may protect against melanoma in populations living at high latitudes. Another interesting fact I discovered is the rates of skin cancer are higher in Minnesota and Norway than Arizona and the South of France. Are you as confused as I am?
I found myself on the American Cancer Society website, which states that observational studies have found that basal and squamous cell skin cancers and melanoma are linked to certain behaviors that put people in the sun. This echoes what I had found in my searches – observational studies but nothing explicitly showing a link between sunlight and skin cancer. Observational studies are surveys on the behavior of people with sun damage and skin cancer – so my question is, what happened to correlation does not equal causation? If someone reading this blog post has a study where sunlight is proven to cause cancer, please send it my way. I am convinced it must be out there for the scientific community to have come to such a sweeping conclusion. Again, I am just a concerned citizen that is looking to see the research with my own eyes, but I haven’t found what I am looking for after hours on PubMed.
In terms of melanoma, the least common but most deadly skin cancer, leading doctors who study and treat malignant melanoma, including Dr. Daniel Coit, surgical oncologist at Memorial Sloan Kettering Cancer Center (MSKCC), and epidemiologist Marianne Berwick, also of Sloan-Kettering, have stated that they believe melanoma may be related to family history and gene mutations more than sun exposure and there is no evidence that sunscreen offers any real protection against malignant melanoma. The leading theories behind why the incidence of melanoma is so low for those with the highest occupational sun exposure is that people in these professions cover up and seek shade when necessary. In Queensland Australia – where the melanoma rate is the highest in the world - public health authorities have begun promoting covering up and staying in the shade. Once they did, melanoma rates started to flatten.
Can sunlight actually be beneficial and prevent cancer? Sufficient levels of vitamin D have been correlated with lower rates of cancer. A review of all epidemiological studies revealed that that chronic (not intermittent) sun exposure is associated with a reduced risk of colorectal-, breast-, prostate cancer and non-Hodgkin’s lymphoma. UVA light has been linked to increased release of dopamine, the feel good neurotransmitter that has also been linked to improving the efficacy of anti-cancer drugs. Again, the correlation does not equal causation issue is at hand, but these findings are important to note in light of the conclusions drawn about sunlight and skin cancer.
A Healthy Relationship with Sunlight
As you know, I am not a doctor or a scientist. These conclusions are my own. I encourage each of you to do your own research, and I would love if you shared your findings with me. I am going to continue to read and research this area, and in the meantime, this is how I am adjusting my relationship with the sun.
- Safe sunbathing for vitamin D synthesis: I am practicing getting in the sun without sun screen for a little while every morning. Some researchers recommend high noon at fifteen minutes as the most efficient way to synthesize vitamin D. But in the morning, UV rays are less harsh and there is less risk of sunburn, which has been correlated to increased incidence of skin cancer. Infrared rays are also highest in the morning, which have been shown to be beneficial for the skin and even protect against UV damage. After sunning for vitamin D it’s important to not bathe immediately afterwards – it can hinder the synthesis and absorption rates.
- Limiting additional time in the sun without sunscreen. Instead of layering on sunscreen and sitting out in the sun, I am being mindful of my time in the sun and watching for natural warning signs – such as getting too hot or beginning to get red skin. In the past, I would put on more sunscreen if I thought I was getting a burn. From my research, I now know that I should heed this natural warning sign and remove myself from the sun or cover up. When I am in a tropical location or will be outside a lot, I will use a non-nano mineral sunscreen on my body for extra protection. I apply this approach to my babies – I keep them out of the sun as much as possible and cover up with hats and clothing. In the early morning or late evening before bedtime we sometimes sit outside on a blanket in diapers in the very soft light to get a little naked fresh air time and vitamin D. I also give them cod liver oil in a bottle of breastmilk for vitamin D. After putting sunscreen on myself or my babies, I will always make sure to wash it off whenever we are out of the sun for the day.
- Applying non-nano zinc oxide sunscreen to my face every day during the sunniest months of the year and wear a hat often. The face has a small surface area so it is not efficient at vitamin D absorption. For this reason, I wear a reef-safe (also human-safe) sunscreen on my face during the spring, summer and into the fall. During the winter I choose to not wear a sunscreen on my face in order to absorb any vitamin D I can. I’ve always forgone face sunscreen in the winter instinctually. I realize that this could result in premature aging, and I am okay with that.
- Eating a diet rich in SPF foods all summer long and supplementing in the winter. Many fruits and vegetables provide internal SPF – researchers in the UK demonstrated a 30% increase in sun protection from eating a tomato-rich diet. Other SPF foods are watermelon, green tea, turmeric, peppers, berries, and chocolate. In the winter, I'll use a supplement - I am always on the search for a great vitamin D supplement so if you have any suggestions please send them along in the comments!
These are my picks for non-nano mineral sunscreens:
- For Face: Pratima Skincare Neem Sunscreen SPF 30
- For Body: Babo Botanicals Sunscreen
- For Tinted Moisture: Suntegrity 5 in 1 Tinted Sunscreen
- For Babies: Adorable Baby Sunscreen, SPF 30+
- The top two picks from the Environmental Working Group for safety and efficacy are California Kids Super Sensitive Lotion SPF 30+ rates well with Consumer Reports, especially with UVB protection, and Badger Active Unscented Cream SPF 30 rates well with Consumer Reports, especially with UVA protection. I love both of these brands but haven't used these sunscreens yet, but they are on my list to try!
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4745411/ https://thetruthaboutcancer.com/sun-exposure-cancer/
- https://theheartysoul.com/sunlight-prevents-cancer/ https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/sun-uv-and-cancer/how-the-sun-and-uv-cause-cancer
- https://www.ncbi.nlm.nih.gov/pubmed/9335442 - intermittent sun expsore