Is Our Heightened Fear of Skin Cancer Leading Us to Deny Our Children Sunlight’s Vitamin D?

Fear of skin cancer could be depriving children of essential exposure to sunlight. Experts are worried that some children and teenagers are not getting enough sunshine to satisfy the body’s requirement for vitamin D throughout the year.

The concerns have led to a barrage of calls for the annual sun awareness campaigns, which urges people to protect themselves against harmful UV rays, to be abandoned.

But, writing in today’s British Medical Journal, a scientist said the worries do not justify abandoning such important skin cancer awareness campaigns.

Professor Brian Diffey, clinical director at Newcastle General Hospital, said simply walking on the sunny side of the street would be enough to boost vitamin D production without compromising sun safety warnings.

Vitamin D is made by the body through the action of sunlight on the skin and is essential for absorbing calcium and maintaining healthy bones.

Exposing the skin to sunlight provides between 80% and 90% of the body’s vitamin D levels.

But the heightened awareness of skin cancer – especially in Wales, which has up to 2% more cases than elsewhere in the UK – may have led to children spending less time exposed to sunlight, therefore reducing the opportunities for vitamin D production.

Evidence has also shown that sunlight exposure and the resulting synthesis of vitamin D might reduce the risk of certain cancers and, perhaps, multiple sclerosis.

Professor Judo Diharrdjo, medical director of the Cellite Clinic in Cardiff, said, ‘The general advice from dermatologists would be not to expose yourself to the sun.

‘But there is a group of experts saying there is evidence of vitamin D deficiency in the population – up to 40% in the USA.

‘But 10 to 15 minutes sun exposure would be sufficient to get enough exposure to the sun. And you can also get vitamin D from oily fish such as mackerel, cod liver oil and vitamin supplements.’

Prof Diffey said that ‘adequate’ sun exposure is not easily defined, but it is thought that a weekly dose of 1 MED (minimal erythema dose) – the exposure necessary to result in a just perceptible reddening of the skin – to the face, hands and arms in the spring, summer, and autumn is more than enough to satisfy the body’s requirement for vitamin D throughout the year.

He added that if only the face and hands are exposed, then a weekly dose of about 2 MED would be required.

Research by Prof Diffey in 1994 to measure the sun exposure of 180 children and teenagers in three regions of England during the spring and summer found that 98.5% and 91% of children and adolescents, respectively, exceeded a weekly dose of 1 MED.

But only 58% of teenage boys, who generally exposed only their hands and face, exceeded 2 MED.

Writing in the BMJ he said the findings would account for the fact that the winter-time vitamin D status of almost all teenage girls living in northern Europe is insufficient.

But such evidence is not enough to justify abandoning current awareness campaigns about skin cancer, which are aimed primarily at avoiding excessive exposure.

He said, ‘British children and adolescents need not deliberately spend extended periods in strong sunshine.

‘Rather, those whose lives are spent almost entirely indoors, in the shade, or in vehicles should take the opportunity during casual everyday activities to walk on the sunny side of the street and, when possible, avoid taking the car.’

A spokesman for Cancer Research UK, which runs the SunSmart campaign, said, ‘Avoiding the sun completely is likely to result in vitamin D deficiency, especially in the elderly.

‘But it is possible to take sensible steps to protect yourself from the sun’s damaging UV rays and still receive enough ultraviolet radiation to produce adequate vitamin D for general good health.

‘Most people in the UK get enough sunlight during their normal daily routine between the months of April and October.

‘There is no evidence that acting on current sun safety messages is causing falling levels of vitamin D in the UK population.

‘People should be careful to avoid excessive sun exposure, especially if it causes reddening of the skin – only a small amount of sunlight is needed to maintain healthy vitamin D levels.

‘There is no extra benefit from the levels of sun exposure that cause deliberate tanning or sunburn and potentially increase the risk of skin cancer.’: Code for cutting the risk:The SunSmart code was developed by Cancer Research UK to help people understand what steps they can take to reduce their risk of developing skin cancer. The code is: Stay in the shade between 11am and 3pm; Make sure you never burn; Always cover up with a T-shirt, hat and sunglasses; Remember to take extra care with children; Then use factor 15-plus sunscreen.