When I diagnose a basal-cell skin cancer in a patient, the first thing I say is congratulations, because you’re walking out of my office with a longer life expectancy than when you walked in. -Dr. Richard Weller from the Jan 2019 issue of Outside Magazine

The sun is out, and the recent recall of over 40 sunscreens has me thinking about sunscreen usage. In our household, I have historically applied sunscreen liberally and often. We are a fair bunch, and I have seen enough skin cancer and photo-aging that I view a sunburn as a major catastrophe. Like any Mom, I want to protect my children from all ills (the youngest child, as my husband says, is “so pale he is almost see through”).

But what if we aren’t getting this quite right? What if there are actually more risks to sunscreens than benefit? When most of us think about sunscreen safety, we think about aerosolized nano-particles of zinc oxide and titanium dioxide and the potential effects on our lungs (very likely there is no risk of inhalation damage from sunscreen). We think about contaminants like benzene. We think about allergens and rashes from organic elements (these are common but can be avoided by avoiding organic components and sticking to products like those listed below). What if we are actually missing some of the biggest risks of sunscreens? Here I am talking about the harms that come from blocking our own skin’s ability to synthesize vitamin D.

As Rowan Jacobson points out in his 2019 Outside article, vitamin D synthesized by our skin through sun exposure leads to numerous health benefits. Direct sunlight also lowers our blood pressure. Vitamin D is central to many of our body’s functions, and people with more sun exposure have lower rates of diabetes, heart disease, stroke and cancer. The perils of too much sun exposure, it turns out, are largely in the form of non-lethal skin cancers and photo-aging. For many years we have thought (or at least hoped) that these ill effects of low vitamin D levels can simply be wiped away by taking a vitamin D supplement. Study after study however, has simply not shown this to be the case. Put another way, taking a vitamin D supplement does not seem to negate the ill effects of a low vitamin D level. As it turns out, those who spend more time in direct sunlight have longer lifespans and lower rates of diabetes, heart disease, stroke, depression and fractures. Interestingly, while people with more sun exposure have higher skin cancer rates, they have LOWER skin cancer DEATH rates. If you missed his viral article in 2019, it is worth a read now.

The American Academy of Dermatology continues to recommend that “in addition to seeking shade an applying sunscreen, wearing sun-protective clothing goes a long way in protecting you from the sun’s harmful rays”. There is little controversy in the medical world. Sunscreen is recommended for all.

So where do I stand with sun exposure and vitamin D? I view it as yet another evolutionary mismatch disease. Our rapidly changing environments have yet again outpaced our genes. Similar to the way obesity and diabetes have become prevalent as our lifestyles became sedentary (our ancestors walked an average of 10 miles a day hunting and gathering), we now spend our days in offices and homes out of the sun for most of the day. This lifestyle leads to depleted vitamin D levels and subsequent ill effects on health. Does this mean I am anti-sunscreen? Not necessarily. Like all choice we make, there are trade offs in decisions to wear sunscreen. The negative effects of avoiding sun exposure, however are far greater than I think people realize.

At this point in time I view sun exposure as primarily healthy. Does it cause photo-aging? Of course. Does it cause certain skin cancers? Absolutely. Do those things kill us? Nope. As a woman I definitely understand the value and importance that we place on flawless skin. I think if I am really honest, what I would like to see is more of us embracing the mental and health benefits of being outside and spending less time on our skin care regimens. What if we can get to a place of embracing our skin’s pigment changes and grooves as story of a life well lived? One where we ambled outdoors and soaked up nature? One where we enjoyed parks with our kids, walks with our friends and time in our gardens? What if we accept the trade off of an imperfect complexion for the healthier bones, longer lives, and lower rates of depression?

p.s. If you are not ready to embrace natural sunlight just yet, or if you are fair like our family, and you need to ease into your sun exposure , here are some products I have used and like or seen recommended by dermatologists:

  • Bare Republic Mineral Sunscreen
  • EltaMD
  • Alba Organics

A final note: the more darkly pigmented you are, the less likely you are to benefit from sunscreen. Skin cancer is a rare event in very dark skin types. Here I immediately think of daycare and camp polices where all kids are covered up in sunscreen. If you have lots of melanin, you already have a natural defense.

Recently over 40 sunscreen products have been recalled due to the presence of benzene, a potential carcinogen. You can find a list of the implicated sunscreens here so you can get to tossing.

Aside from this recent recall, sunscreens are generally accepted as having an excellent safety profile. For those of us wanting to minimize any potential risks from organic substrates (which can cause rashes and allergies such as hives and contact dermatitis) we can choose products containing inorganic substances (zinc oxide, titanium dioxide).

Happy ☀️ playing.