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By Frieda Wiley

Frieda Wiley-finalWith the advent of the long glorious days of summer right around the corner, many of us are anxiously anticipating fun in the sun, even moreso if you live in regions recently plagued by El Niño’s seemingly incessant deluge. The necessity of sunlight is undeniable, and not just because it helps plants make energy: It also provides what is quite arguably the easiest-to-obtain, natural source of vitamin D for humans as we know it. But the benefits—and risks—of vitamin D obtained from sunlight remain a controversial topic of discussion.

Vitamin D has gotten a lot of press in recent times, as many studies have associated vitamin D deficiencies with many morbidities and conditions other than rickets and osteoporosis. The gamut now includes a variety of illnesses, such as cancer and depression, to name a few. But according to the American Cancer Society and other reputable sources, experts have yet to reach a solid agreement as to whether vitamin D deficiency truly causes disease. And while vitamin D’s involvement in disease propagation or mitigation remains under debate, the consequences of excess sun exposure (wrinkles, sunburns, and most importantly, skin cancer risk) still persist.

From my perspective as a pharmacist, the ability to empower patients with information that helps them make better choices for preventative care and optimizing their health is just as important as reminding oneself of some of the misconceptions regarding this alleged vitamin, which most scientists recognize as behaving more like a hormone than a vitamin or cofactor.

But aside from actual vitamin D intake, other factors regarding sunlight exposure’s impact on health are important to consider. For example, the length of time of sun exposure, the time of day in which the exposure occurs, and even skin condition not only affect the amount of vitamin D your body makes upon sunlight exposure but your risk for skin sensitivity, sunburns, and skin cancers. Dry skin and certain medications (such as tetracyclines, topical acne treatments, and psoralens, etc.) can increase skin sensitivity. In fact, people using these products might find themselves more sensitive to the sun than usual and burn sooner.

Additionally, skin color is important. While people with the fairest of complexions are not only more susceptible to sunburns and likely to burn more quickly, they also have the advantage of not requiring as much sunlight to meet the recommended daily vitamin D intake of 600 IU (for most adults under 70 years of age). The time of day in which the sunrays are the strongest is the time in which the rays are not only more damaging to the skin, but it’s also the most efficient time of day to raise your vitamin D levels: Because sunrays are so strong during this time, your body can make the most vitamin D in the least amount of time than it would any other time of day. Having a natural tan or darker complexion also means it takes your body a bit longer to make vitamin D than your fair-skinned counterparts, so you’ll have to spend more time outside to meet your requirements.

New information suggests that people with darker complexions may not be as well-protected from the sun as previously thought, especially if they are carrying a specific variant of a gene known as melanocortin-1 receptor-1, or MC1R, that increases risk of melanoma. The Medical University of Vienna is sponsoring a trial that will further investigate this potential association.

Still, these concerns don’t necessarily mean that one should never leave home without a parasol in tow. People who struggle with digestive disorders such as Crohn disease or gastroparesis might find sunlight exposure to be a more efficient way of attaining vitamin D as opposed to taking supplements or drugs because they already have trouble absorbing food and nutrients, let alone drugs. Similarly, vitamin D deficiency is not uncommon in people with kidney disease or liver disease. A little fun in the sun may also be warranted for people who take drugs that may deplete or hinder the absorption of certain nutrients. For example, certain diet drugs, like Xenical or Alli (orlistat) decrease the absorption of fat-soluble vitamins like vitamin D. Other people at risk for low levels of vitamin D are elderly people, anyone who’s bedridden or spends a lot time indoors, and people with darker skin complexions.

While some of this information may appear to be obvious, in cases where people may lack adequate medical care, have a variety of health conditions, or already take many drugs, omissions of something as simple yet crucial as vitamin D is quite easy—and common.

The take-home message is this: Moderation is key. Some sunlight is beneficial for anyone, but it doesn’t mean that you should basking in the sun for 12 hours a day either. Also, be vigilant: Many people who use sunscreen or sunblock to help protect their skin from the damaging rays of the sun often forget to reapply the creams and lotions to their skin after sweating, swimming, and/or several hours after having applied the solutions (varies per product and manufacturer). Some fun in the sun is okay and absolutely healthy. But remember, just as with your favorite ice cream, a little sunlight’s a good thing as long as you don’t get too much!

Frieda Wiley, Pharm.D., C.G.P, R.Ph., is a board-certified consultant pharmacist and freelance medical writer.