Sunlight for Public Health: Common sense prevails!

By Dr. Marc Sorenson

An excellent paper by Dr. Hoel and Dr. de Gruijl is titled “Sun Exposure Public Health Directives.” It decries the vilification of sunlight and suggests people return to its healthful rays.

So is dermatology awakening to the truth about sunlight?

One of the authors, Dr. de Gruijl, works at a dermatology department in the Netherlands. He is also a photobiologist and melanoma skin cancer research specialist. It seems like the dermatology world is returning to common sense, since other dermatologists have lately suggested more sunlight exposure. And well they should suggest more sunlight! Sunlight can save millions of lives, yet much of the population is dying in the dark due to misinformation. Many dermatologists consider sunlight exposure to be a killer, and thus frighten their patients away from sun exposure. Why? Because they are fearful of skin damage from sunlight, something they need not fear if they advise their patients properly.

Sunlight and skin cancer: the truth

One of my pet peeves is the statement that “sunlight causes cancer.” First of all, there are about 18 major cancers that are reduced by sunlight. And in addition, there are also myriad non-cancer maladies that are reduced or eliminated by safe sun exposure. These disorders run the gamut from arthritis and heart disease to psoriasis, erectile dysfunction and osteoporosis. Secondly, not even skin cancer is caused by sun exposure unless people burn themselves. Therefore, it is a lack of both caution and common sense that leads to skin damage. The authors state that the public has been taught that health benefits of sun exposure are limited to bone health. That is another egregious error (italics mine).

The aforementioned paper reads almost like a synopsis of Embrace the Sun, the book by Marc Sorenson and William Grant,

Here are the major points on sunlight that make the research in the paper so compelling:

There is a public health message that “overexposure” to the sun causes skin cancer. Nevertheless, those who promote this message do not define overexposure. Therefore, due to the lack of a definition, the public is led to believe that sun exposure is an enemy. In addition, the public is not educated regarding the detriments of “sun avoidance,” or should we say “underexposure.” Due to this omission, the public is exposed to disability, destruction and death (italics mine).
Furthermore, the paper states that people believe sun avoidance is risk free. That is a colossal error as previously stated.
Another mistake is to believe vitamin D supplements are an adequate substitute for sunlight. That is simply not so. Sun exposure causes the production of serotonin, nitric oxide, endorphin, brain-derived neurotropic factor (BDNF), dopamine and urocanic acid. All of these substances are vital for human health and wellbeing.
Another important point stated by the authors is as follows: “This public health message is potentially causing significant harm to public health and should be changed immediately.” And, based on the analysis from Embrace the Sun, mentioned above, that should be an easy conclusion.
The authors also state that melanoma risk is reduced by non-burning sun exposure. And only severe sunburns increase risk. In addition, they mention that melanoma in the U.S. has steadily increased at an annual rate of 3–4%. There was 1 case per 100,000 in 1935, when accurate records were established. Yet, there were 25.8 cases per 100,000 in 2015. [That is about a 2,600% increase!
The authors also make it clear that the common assertion—that tanned skin affords insignificant protection against sunburn—is not correct.
In conclusion, the commentary made this statement: “All persons in the world regardless of skin color or latitude of residence, other than those with extraordinary sensitivity to sunlight, should get enough sun exposure to maintain a serum 25(OH)D level well over 20 ng/mL (desirably at 30–60 ng/mL) while taking care to avoid sunburn.

I agree and would like to reiterate that vitamin D supplements are not an adequate substitute for sunlight. Consequently, these measurements should be used only among those who do not take supplements. That is, if we expect to really measure sunlight exposure.

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