Skin cancer is part of my family history. My uncle died of melanoma, the deadliest form of skin cancer, when I was nine months old. He was in his early thirties, younger than I am now. Since childhood, I’ve been obsessed with sun safety. For many years, I made it a goal to avoid the sun as much as possible.
When I was diagnosed with a severe vitamin D deficiency several years ago, I realized I was just going from one extreme to another. As important as it was to protect myself from cancer, I wasn’t doing myself any favors by avoiding the sun entirely. Instead of being sun averse, I needed to learn how to be sun smart.
The health risks of vitamin D deficiency
A study published in the Journal of Internal Medicine in March 2016 included a shocking conclusion: “Nonsmokers who avoided sun exposure had a life expectancy similar to smokers in the highest sun exposure group, indicating that avoidance of sun exposure is a risk factor for death of a similar magnitude as smoking.” That’s right. This study suggests that avoiding the sun entirely can be as risky for your health as smoking.
Not everyone is entirely on board with these results. “I would not agree with [the conclusion of this study] totally, but I think a little bit of sun is important—especially when it comes to feeling happy, healthy, and having a good sense of well-being,” says Dr. Charles Crutchfield, a board certified dermatologist in Minnesota.
Overexposure to sun leads to risk factors like skin cancer, but underexposure is not the answer. In part, this is because of vitamin D, also known as the “sunshine vitamin.” Proper vitamin D absorption helps keep teeth and bones healthy. But only a few foods contain vitamin D, and typically in small amounts that aren’t sufficient for your health. The Vitamin D Council links a lack of vitamin D to conditions like cancer, asthma, diabetes, high blood pressure, depression, Alzheimer’s, multiple sclerosis and Crohn’s Disease.
The benefits of sun exposure
Unrepaired damage to skin cells through ultraviolet radiation from sunshine or tanning beds can lead to skin cancer. According to the Skin Cancer Foundation, one in five Americans will develop skin cancer in the course of a lifetime. In the past 30 years, more people have had skin cancer than breast, prostate, lung, and colon cancers combined. Those are some scary statistics—enough to send any level-headed person indoors.
But, again, being so afraid of the sun that you avoid it entirely is not the solution. While the consequences of overexposure to the sun are scary, the benefits of limited sun exposure are plentiful. Numerous scientific studies indicate it can facilitate better mood, deeper sleep, reduced risk of some cancers, stronger bones, and lower blood pressure and risk of heart attack and stroke. Sunshine triggers the release of serotonin and endorphins, making it a mood booster on par with exercise. Spending time in the sun gets you in touch with your circadian rhythm, which helps regulate sleep. And vitamin D absorption can lead to stronger bones and reduced risk of some cancers, including colorectal, prostate, and breast cancer, and non-Hodgkin's lymphoma (NHL). In many ways, sunshine is the best medicine.
Like so many things in life, moderation is key. If one glass of red wine is good, that doesn’t mean a bottle of wine is better. The same goes for sun exposure. Getting 10-20 minutes in the sun without sunscreen is an ideal way to get the benefits of sunshine without going overboard. The Vitamin D Council recommends taking vitamin D supplements on days when your body can’t get full sun exposure: “For most people on the Monday–Friday indoor work schedule, that means taking a supplement 5–6 days a week and getting sun exposure on a day or two during the weekend.”
Know when to seek shade.
The Sun Safety Alliance notes that the sun’s UV rays are strongest between 10 a.m. and 4 p.m. This means you have a higher likelihood of getting sunburned or increasing your risk of skin cancer if you’re exposed to sunlight during those hours. The alliance suggests this rule: When your shadow is short, seek shade.
Board certified dermatologist and skin cancer surgeon Dr. Bobby Awadalla thinks the most critical hours are between 10 a.m. and 2 p.m. “The UV radiation is strongest during this time and avoiding being outside is the best approach,” he says. He recommends taking a walk in the morning or after work. If spending time in the sun during the critical hours is inevitable, look for shade. “I tell my patients that if you want to sit on the patio for lunch to enjoy the outdoors, go ahead, but pick a table in the shade. You will actually enjoy your lunch more without the sun blazing down on you.” If you’re headed to the beach, he recommends using an umbrella to block some rays.
Remember to Slip, Slop, Slap, and Wrap
This catchphrase may be silly, but it’s a helpful reminder from the American Cancer Society. Let’s be real: Most of us are going to spend more than 10–20 minutes a day in the sun this summer. So when we’re out in those rays, a few basic precautions can help prevent burning and overexposure. The American Cancer Society suggests these four steps any time you’re out in the sun:
- Slip on a shirt.
- Slop on sunscreen.
- Slap on a hat.
- Wrap on sunglasses to protect the eyes and skin around them.
When it comes to sunscreen, Dr. Awadalla, who practices in sunny California, recommends using the highest SPF available. “We all use less than the recommended amount and don’t reapply after sweating or swimming as we should. This means we get a far lower SPF than what is on the bottle, which is very dangerous,” he says.
Dr. Crutchfield recommends looking beyond SPF. “Patients focus on the SPF number, but this is just an indicator to prevent burns,” he says. Ultraviolet A (UVA) protection is also important since it protects against deeper sun damage. “The key is using a sunscreen with SPF 30 or higher that says broad spectrum or UVA protection.”
What you eat can help prevent and repair sun damage
When you think about sun safety, food may be the last thing that comes to mind. Dr. Awadalla says the pigments in foods such as tomatoes, carrots, and peppers can fight back against sun damage. If the damage has already occurred, foods with high levels of antioxidants, such as pomegranates, can help with healing. Also look for foods with lycopene, lutein, and beta-carotene, which can protect the skin and regulate skin turnover. Guavas, tomatoes, carrots, sweet potatoes, eggs, and leafy greens are all good bets.
Dr. Awadalla says recent studies show vitamin C (red peppers) and vitamin E (wheat germ) work well together “to help prevent and repair cellular damage caused by UV radiation.” Omega-3 fatty acids, found in flaxseed oil and fish oil, can also increase the elasticity of damaged skin.
Summer is here. Don’t fear it. “I tell my patients to go out and enjoy yourself,” says Dr. Crutchfield. “Have fun! Just be sun smart and sun protect.”
“The sun is always present and constantly causing damage to the skin and that damage is cumulative,” says Dr. Awadalla. “Being sun wise is not just one thing or another but a culmination of things that, combined, can help protect you from long-term sun damage.”
Somewhere between housebound vampire and lobster-skinned sun damage, there is a happy, sunny spot. Slather on some sunscreen and go find yours.
Photo Credit: Corynne Olivia Photography