If you're like most Americans, you probably have a vacation scheduled for this summer. Hanging out on a beach, swimming at a lake, or simply playing outside will likely be on your itinerary.
Sun exposure is a hot topic (no pun intended!) these days. I see patients who take drastic extremes. Some bask for hours by the swimming pool, slathering on high level sun protective factor (SPF) sunscreen they believe will protect them against the sun's ultraviolet (UV) rays.
Others fearfully avoid the sun, covering their entire bodies in protective clothing and adamantly avoiding daytime outdoor activities.
Yet like most things, sun safety involves finding balance. The key is not overexposure or avoiding exposure altogether, but to bask in the sun's rays for a few minutes at a time.
I can understand why people would fear sun exposure. According to the Environmental Working Group (EWG), more than 2 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 creates wrinkles on your face when you have been exposed to too much sunlight over the years.
At the same time, we were meant to enjoy sunlight. Staying out of the sun or over-relying on sunblock can make us depressed or anxious and contribute to numerous problems. That's because when we avoid sun exposure, we often become deficient in the sunshine vitamin -- vitamin D -- an important key to health and vitality.
The Sunshine Vitamin You're Probably Deficient In
Basking in the sun feels good, but it also allows your body to make vitamin D.
Some people fear sunlight because of its potential cancer risk. Yet interestingly, the one vitamin the sun helps supply can actually protect against skin cancer. Optimal vitamin D levels can help reduce the risk of melanoma and help protect against other cancers.
Vitamin D is almost totally absent from our food supply. We require up to 25 times more than what the government's Recommended Daily Allowances (RDAs) recommend for us to be healthy. Vitamin D deficiencies are the hidden cause of so much suffering, and it is so easy to treat. http://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/.
Each nutrient has its role, but vitamin D deficiency is a major epidemic that is off the radar for most doctors and public health officials. It has been linked to depression, dementia, an increased risk of death, and even autism.
Most doctors think that if you don't have rickets you don't have vitamin D deficiency. They couldn't be more wrong. Most ask what is the minimum dosage to avoid rickets? Answer: 400 international units (IU) a day. But the real questions to ask are: How much were we designed to have and how much do we need to be healthy? Answer: approximately 5,000 to 10,000 IU a day. That's quite a range between avoiding disease and maintaining optimal health.
While almost never diagnosed, 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.
Correcting vitamin D deficiencies wouldn't take much. In fact, achieving blood levels of 45 ng/ml would result in 400,000 fewer premature deaths per year.
Amazing things start to happen when my patients' vitamin D statuses reach optimal levels. Having witnessed these changes, there's no doubt in my mind: Vitamin D is an incredible asset to your health.
Vitamin D and Sunlight
Your body makes vitamin D when it's exposed to sunlight. In fact, 80 to 100 percent of the vitamin D we need is created because of exposure to the sun. The sun exposure that makes our skin a bit red (called one minimum erythemal dose) produces the equivalent of 10,000 to 25,000 IU of vitamin D in our bodies.
The problem is that most of us aren't exposed to enough sunlight.
Overuse of sunscreen is one reason. While these products help protect against skin cancer, they also block a whopping 97 percent of your body's vitamin D production.
If you live in a northern climate, you're not getting enough sun (and therefore vitamin D) to begin with, especially during winter. And you're probably not eating enough of the few natural dietary sources of vitamin D, including fatty wild fish like mackerel, herring, and cod liver oil.
Plus, aging skin produces less vitamin D -- the average 70-year-old creates only 25 percent of the vitamin D that a 20-year-old does.
Skin color makes a difference, too. People with dark skin produce less vitamin D. And I've seen very severe deficiencies in Orthodox Jews and Muslims who keep themselves covered all the time.
I recommend that you supplement with a high-quality vitamin D3. It can be an expensive supplement but it's the best way to get optimal levels of this crucial vitamin.
Beyond that, the best way to make vitamin D involves full-body sun exposure for about 15 to 20 minutes between 10 a.m. and 2 p.m. daily, without sunscreen (although I would recommend sunscreen on your face).
This works only in the summer, so I recommend you take additional vitamin D to optimize your levels. Most people require an additional 2,000 to 5,000 IU of vitamin D3 a day.
The exact amount needed to get your blood levels to the optimal range (50 to 80 ng/ml) will vary depending on your age, genetics, how far north of the equator you live, how much time you spend in the sun, and even the time of the year.
I strongly encourage you to test your vitamin D levels regularly to ensure your blood levels fall within the optimal range.
What Kind of Protection Should I Use in the Sun?
During your vacation, you find yourself wanting to spend an hour by the lake or in the ocean, so you slather on a high-SPF sunscreen all over your body to provide the best protection against the sun's harmful rays, correct?
The EWG recommends against choosing a high-SPF sunscreen. In fact, they believe that manufacturers should stop selling high SPF products altogether.
"[People] are more likely to use high SPF products improperly and as a result may expose themselves to more harmful ultraviolet radiation than people relying on products with lower SPF," says their report.
That doesn't mean you shouldn't use sunscreen. But you want to take other precautionary measures first and then use a good sunscreen but don't over-rely on it.
"When people use sunscreen properly to prevent sunburn, they often extend their time in the sun and increase exposure to UVA rays," the EWG says. (In case you were wondering the difference: UVB rays make up about three to five percent of the ultraviolet spectrum, whereas UVA rays are more prevalent and penetrate deeper into your body.)
Choosing the Right Sunscreen
Not only are we overusing sunscreen or choosing the wrong SPF; most over-the-counter sunscreens also contain harmful ingredients. "American sunscreens are far from ideal and not as good as their European counterparts," the EWG says. "Until FDA tightens its rules, people will continue to misuse inferior products."
In 2015, the EWG found 80 percent of the 1,700 products they examined provided inferior sun protection or contained worrisome ingredients like oxybenzone.
"Only 21 percent of the sunscreens, 19 percent of the moisturizers with SPF and 21 percent of the lip balms in EWG's database for 2015 scored 1 or 2," says the report. "Most major sunscreen brands ... score poorly. EWG estimates that more than half of the sunscreens on the American market would not make it to store shelves in Europe."
The EWG also cautions against sunscreens with vitamin A. One study by U.S. government scientists says retinyl palmitate (a form of vitamin A) could speed the development of skin tumors and lesions when applied to the skin in the presence of sunlight.
That's particularly disturbing when you consider the sunscreen industry adds vitamin A to nearly 18 percent of the beach and sport sunscreens, 17 percent of moisturizers with SPF, and 13 percent of all SPF-rated lip products in EWG's 2015 sunscreen database.
The bottom line for sunscreen: Choose the right one, opt for a lower-SPF type, and don't over-rely on it for total protection.
7 Strategies for Optimal Sun Safety
- Get at least 20 minutes of exposure to sunlight a day. Do this preferably first thing in the morning. Among its benefits, sunlight triggers your brain to release specific chemicals and hormones such as melatonin that are vital to healthy sleep, mood, and aging.
- Only use sunscreen if you need it. According to the EWG, sunscreen should be your last resort when going into the sun.
- Be proactive about protection. Over-exposure can damage your skin and increase your risk for skin cancer. You can reduce these risks by seeking shade under an umbrella, tree, or other shelter before you need relief from the sun. Protective clothing can also shield your skin from sun overexposure.
- Prevent skin cancer with these strategies. The EWG recommends covering up (sunglasses and protective clothing), don't get burned, choose a sunscreen with optimal UVA protectionm avoid tanning beds, and getting optimal vitamin D to minimize your skin cancer risk. Keep in mind, too, while studies indicate regular sunscreen use lowers the risk of squamous cell carcinoma, researchers have not found strong evidence that sunscreen use prevents basal cell carcinoma. Visit your dermatologist regularly, especially if you notice any unusual moles or other skin irritations.
- If you use sunscreen, scrutinize ingredients. Stop using creams, sun block, and cosmetics that contain paraben, petrochemicals, lead, or other toxins. Drugs and chemicals are well absorbed through your skin. If you wouldn't eat it, don't put it on your skin.
- Download the EWG's Sunscreen Guide. You can get the 2015 guide here, as well as a guide to sun safety here.
- Stay hydrated. Many of us are chronically dehydrated and consume caffeinated drinks or alcoholic beverage when we're basking in the sun, which makes us even more dehydrated. That is why it's so important to drink at least eight glasses of water every day, especially on hot days.
Going to a sunny locale this summer? Share where you'll vacation and what strategies you take to optimize sun safety below or on my Facebook page.
Wishing you health and happiness,
Mark Hyman, MD.
Mark Hyman, M.D. believes that we all deserve a life of vitality -- and that we have the potential to create it for ourselves. That's why he is dedicated to tackling the root causes of chronic disease by harnessing the power of Functional Medicine to transform healthcare. He is a practicing family physician, a nine-time #1 New York Times bestselling author, and an internationally recognized leader, speaker, educator, and advocate in his field. He is the Director of the Cleveland Clinic Center for Functional Medicine. He is also the founder and medical director of The UltraWellness Center, chairman of the board of the Institute for Functional Medicine, a medical editor of The Huffington Post, and has been a regular medical contributor on many television shows including CBS This Morning, the Today Show, CNN, The View, the Katie Couric show and The Dr. Oz Show.