Several of my patients have recently asked me whether the benefits of going into the sun to obtain vitamin D outweigh the risk of developing skin cancer. Other patients have raised concerns about using sunscreen altogether, arguing that people have been out in the sun for thousands of years and only after the invention of sunscreen did people begin developing skin cancer. Could it be the chemicals in sunscreen, and not the sun, that are causing skin cancer?

I would like to share with you several facts that dispute these myths…

First, skin cancers have always existed. While there has been an increase in the lifetime risk of developing invasive melanoma (in 1935, the risk was 1 in 500; it is now 1 in 55), this can be attributed to a number of factors, including longer lifespans (the sun damage that leads to skin cancers generally accumulates over time);the thinning ozone layer, which allows greater amounts of harmful ultraviolet radiation (UVR) to penetrate the earth’s atmosphere; the increased popularity of outdoor activities; clothing styles that leave more skin exposed; and the advent and popularity of tanning booths. Improved diagnostic techniques also allow doctors to detect more skin cancers at an early stage.

Until the 1920s, a tan was not considered a desirable attribute. Fair, untanned skin indicated that a person did not have to work outdoors and enjoyed higher social standing. Fashionable people wore protective clothing, including hats, to avoid tanning. But in 1929, fashion and beauty magazines began promoting tans as signs of beauty, health, and affluence. The greater UV exposure that tanning entails, rather than the advent of commercial sunscreens, provides the most compelling explanation for the increase in skin cancers.

Current evidence points to the need to protect skin against the sun’s rays, regardless of skin type and ethnicity. Dermatologists recommend using sunscreens that protect against both ultraviolet A (UVA) and ultraviolet B (UVB) rays, in addition to other protective measures such as wearing a hat, sunglasses, and long-sleeved shirts and pants.

Regarding vitamin D, no convincing scientific evidence suggests that sunscreen use prevents adequate vitamin D production. Current vitamin D intake recommendations rise with increasing age, but everyday, incidental sun exposure manufactures sufficient vitamin D for most people, even with the use of sunscreens. For example, merely walking from your outdoor parking spot into a building gives you adequate exposure. Furthermore, the body can produce only a certain amount of vitamin D from sun exposure; after reaching that limit, additional UV exposure actually results in the breakdown of the vitamin!

Finally, sun exposure does not represent the only – or the best – source of vitamin D. Dietary sources such as fatty fish (salmon), cod liver oil, and fortified milk and orange juice provide substantial amounts of the vitamin, as do supplements, which are available at relatively low cost. Current evidence strongly suggests that detrimental effects of sun exposure far outweigh the benefits, especially since vitamin D can be obtained without risking your skin’s health!