Importance of Vitamin D & Protecting Your Skin
- July 15, 2020
- Written by : Rebecca LaMarca, MSN, APN-BC, CNS
THE DARK SIDE OF THE SUN.
It is alarming to know that the rate of skin escalates by 1.5% every year. In fact, skin cancer has become the most common cancer in the US, overtaking lung, breast, and colorectal cancers.
Further epidemiology shows that one in eight people will get skin cancer at some point in their lifetime. Therefore, it is vital to understand the etiopathogenesis of skin cancer to apply the best modalities of management or prevention entirely.
WHAT CAUSES SKIN CANCER.
There are many risk factors implicated in the development of skin cancer. However, recent studies have shown that the most critical risk factor is the degree of exposure to sunlight, especially UV-B radiation. Anyone that has chronic exposure to sunlight develops an increased risk for skin cancer over time.
Other less common risk factors include childhood exposure to sunburn, light skin, previous history or family history of skin cancer, presence of atypical dysplasia naevi, genetics (Xeroderma pigmentosum), immunosuppression, radiation (e.g., from acne treatment) exposure to toxic substances such as arsenic, etc.
You should have a high index of suspicion for skin cancer if you notice any of the following signs:
‣ A cutaneous lesion that changes its size, color, or shape
‣ Constant pruritus or itching
‣ Tender, crusted, or ulcerating cutaneous lesions in advanced stages
‣ Chronic ulcers are lasting more than six months and other premalignant lesions such as actinic keratosis
SKIN REGIONS TYPICALLY AFFECTED.
The most typical areas affected are the skin areas that are primarily exposed to the sun. This includes the face as a whole, scalp, lips, neck, ears, limbs and extremities, and chest.
This incidence strongly supports the fact that sun exposure contributes to a significant role in the development of skin cancers. Nevertheless, you could still find them in the less exposed areas such as the palms, nail beds, or genital area. It is best to see your doctor if you notice any worrisome skin changes.
TYPES OF SKIN CANCER.
There are three main types of skin cancer:
‣ Basal cell carcinoma (BCC)
‣ Squamous cell carcinoma (SCC)
‣ Melanoma
BCC and SCC are also called Non-melanoma skin cancers (NMSC). They are the most prevalent forms, and at least one million new cases occur every year. Nevertheless, they come with a better prognosis than the malignant melanoma.
Skin cancer affects people of all skin tones, but research has shown that melanoma is commoner with darker tones. 1 in 50 persons is affected by melanoma in the United States. A simple biopsy is a gold standard for investigation because it is fast and definitive.
BENEFITS OF SUN EXPOSURE.
Despite all the drawbacks of sun exposure, we must remember that sunlight serves as a significant source of Vitamin D. The skin makes the fat-soluble vitamin D from cholesterol when exposed to UV-B rays. Therefore, this summer or spring, you should not be too keen on avoiding the sun altogether.
Do you know that there is enough evidence to show that as much as 40% of American adults are deficient in vitamin D? The consequence of this deficiency is that there is a greater risk of developing chronic heart conditions and even cancers as a result.
Some of the benefits of Vitamin D include:
‣ Increased calcium and phosphorus absorption leading to healthy and strong bones
‣ Improved immunity and central nervous system health
‣ Insulin level regulation and a supportive role in the management of diabetes mellitus
‣ Improved lung function and management of steroid-resistant asthma
‣ A healthy pregnancy, according to the Journal of Midwifery & Women’s Health
We will take a look at some of the recommended sun exposure times and the best hours to make the most out of the sun.
THE OPTIMUM AMOUNT OF SUN EXPOSURE.
First, midday summer is seen as the best time to get sunlight for your skin. The reason behind this is that at that point, the sun is most intense, and consequently, you get exposed to more UV-B rays. More time in the sun might be needed for the colder seasons like winter and autumn.
The National Library of Medicine has shown that a 13-minute exposure to sunlight in summer midday produces an average of (> or =20 ng ml(-1)), and while this value might not be optimal, it is sufficient. An estimated 35% of the skin surface area gets exposed during this process. A healthy time range to spend in the sun would be around 20 to 30 minutes.
More so, you only need this amount of exposure at least three times a week, so it is best to make conscious efforts. People are encouraged to adopt other lifestyle modifications that increase Vitamin D synthesis. For instance, you could take a short walk to lunch, rather than drive.
If for some reason, you do not get enough sun exposure, it is best to supplement whatever amount of sunlight you get with other Vitamin D sources. Note that these sources do not entirely replace the role of adequate sunlight on your skin.
NOTE: Spending more time under the midday sun increases the risk of sunburns, suntan, and radiation from UV-A. Too much time in the sun causes faster aging, heatstroke, eye damage, and skin cancer. Also, you should avoid sun-sensitizing medications where possible.
OTHER SOURCES OF VITAMIN D.
‣ Fatty fish (This includes salmon, tuna, and mackerel)
‣ Eggs (particularly the yolk)
‣ Cheese
‣ Mushrooms
‣ Cod liver oil
‣ Fortified cereals
‣ Mushrooms
‣ Fortified milk
‣ Multivitamins
You would discover that most of the Vitamin D sources are mostly proteins. Therefore, increasing your protein intake, in general, is a good idea if you are low on Vitamin D. Note that some people are allergic to certain substances such as fish, cheese, eggs, etc. Such people should not worsen their allergies.
PREVENT VITAMIN D DEFICIENCY.
Common causes of Vitamin D deficiency include excess use of sunscreens, prolonged covering with clothes, housebound and night-shift workers, exclusively breastfed infants, people living in polluted environments. For this category of people, increased doses of vitamin D might be required to prevent nutritional deficiencies. One way that Vitamin D can be bolstered is through IV booster treatments. But how much Vitamin D is required?
DOSES OF VITAMIN D.
Vitamin D is measured in micrograms (mcg) or international units (IU). One microgram is the equivalent of 40 IU of Vitamin D. The recommended daily intakes for the different age groups are as follows:
‣ Infants 0–12 months – 400 IU (10 mcg)
‣ Children 1–18 years – 600 IU (15 mcg)
‣ Adults up to 70 years – 600 IU (15 mcg)
‣ Elderly over 70 years – 800 IU (20 mcg)
‣ Pregnant or lactating women – 600 IU (15 mcg)
You would notice that the Vitamin D recommendations for specific age groups are higher than others. For instance, the elderly are prone to osteoporosis and other bone deformities, therefore they need more Vitamin D.
Sensible skin exposure to the sun allows for proper vitamin D absorption. Nevertheless, Vitamin D breaks down relatively quickly, and stores can be depleted during winter. It is advisable to eat fatty foods judiciously to optimize Vitamin D stores, where there are no contraindications.
THE ROLE OF VITAMIN C IN HEALTHY SKIN.
Vitamin C is a water-soluble vitamin and potent antioxidant. Studies show that it plays an essential role in skin health by promoting keratinocyte differentiation and decreasing melanin synthesis. The resultant effect is that the skin gets protected from UV-induced damage.
Vitamin C deficiency should be prevented because it only makes the clinical picture worse. The recommended daily dosage of Vitamin C varies between 50mg to 100mg. You can get this from food sources, fruits, and vegetables such as broccoli, cabbage, tomato, and spinach. Alternatively, you can get the required dose from an FDA-approved dispensary.
THE BOTTOM LINE.
Sun exposure is a dilemma for many people who get stuck between hardly getting enough and getting overexposed. It is best to take caution against all the shortcomings mentioned in this article to enjoy the benefits of sun exposure. Regular exposure to sunlight remains the best way to get Vitamin D for your body.
Sun exposure time also depends on the individual. If you tend to get sunburned faster, you should spend less time in the sun and seek medical advice. For Vitamin D deficiency individuals, 50000 IU taken in eight weeks is the recommended treatment. Patients with identifiable risk factors for skin cancer or vitamin D deficiency should avoid those risk factors and seek medical help where necessary.
A healthier lifestyle generally improves skin condition. Therefore, it would also be advisable to cut down on the excessive intake of alcohol and smoking. There is a need to stay within a healthy range of sunlight exposure and Vitamin D. Both reduced and extreme levels of Vitamin D could lead to many health risks and conditions. Choose the right sunscreen and supplements from reliable vendors.
This summer/spring remains an excellent time to get the best out of your skin. By taking the right steps and employing cautions where necessary, you can enjoy better skin health. See your physician find out the next best action to consider for your skin health.
REFERENCES
- The Top 10 Cancers of America: https://www.fcppcentralvalley.com/specialties/cancer-center/top-10-cancers-of-america
- Skin Cancer – Melanoma: https://emedicine.medscape.com/article/846566-overview
- Skin Cancer: www.mayoclinic.org/diseases-conditions/skin-cancer/symptoms-causes/syc-20377605
- Prevalence and correlates of vitamin D deficiency in US adults: https://pubmed.ncbi.nlm.nih.gov/21310306/
- Evidence of an Association Between Vitamin D Deficiency and Preterm Birth and Preeclampsia: A Critical Review: https://pubmed.ncbi.nlm.nih.gov/31411387/
- Recommended summer sunlight exposure levels can produce sufficient (> or =20 ng ml(-1)) but not the proposed optimal (> or =32 ng ml(-1)) 25(OH)D levels at UK latitudes: https://pubmed.ncbi.nlm.nih.gov/20072137/
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