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Br J Dermatol. 2019 May 8. doi: 10.1111/bjd.17888. [Epub ahead of print]

Optimal sunscreen use, during a sun-holiday with a very high UV index, allows vitamin D synthesis without sunburn.

Author information

1
King's College London, St John's Institute of Dermatology, London, SE1 9RT, UK.
2
Medical University of Łódź, Department of Dermatology, Pediatric Dermatology and Dermatological Oncology, Łódź, 90-647, Poland.
3
Walgreens Boots Alliance Inc, Nottingham, NG90 5EF, UK.
4
Bispebjerg Hospital, Department of Dermatological Research, Copenhagen, 2400, Denmark.
5
Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, Didcot, Oxfordshire, OX11 0RQ, UK.
6
Dermoklinika Centrum Medyczne, Łódź, 90-436, Poland.

Abstract

BACKGROUND:

Sunlight contains UVA and UVB radiation. The latter is essential for vitamin D synthesis but is the main cause of sunburn and skin cancer. Sunscreen use is advocated to reduce the sun's adverse effects but may compromise vitamin D status.

METHODS:

The impact of sunscreens on vitamin D status was studied during a one-week sun-holiday in Tenerife (28°N). Comparisons were made between two formulations, each with a sun protection factor of 15. The UVA protection factor (UVA-PF) was low in one case and high in the other. Healthy Polish volunteers (n=20 per group) were given the sunscreens and advised on correct application. Comparisons were also made with discretionary sunscreen use (n=22) and non-holiday groups (51o 5N, n=17). Sunscreen use in the intervention groups was measured. Behaviour, UVR exposure, clothing cover and sunburn were monitored. Serum 25(OH)D, was assessed by HPLC MS/MS.

RESULTS:

Use of intervention sunscreens was the same (p=0.599) and both equally inhibited sunburn, that was present in the discretionary use group. There was an increase (p=9x10-8 ) of 28.0±16.5(SD) nmol/L 25(OH)D3 in the discretionary use group. The high and low UVA-PF sunscreen groups showed statistically significant increases (p≤6.7x10-5 ) of 19.0±14.2 and 13.0±11.4 nmol/L 25(OH)D3 respectively. The non-holiday group showed a fall (p=0.08) of 2.5±5.6 nmol/L 25(OH)D3 .

CONCLUSIONS:

Sunscreens may be used to prevent sunburn yet allow vitamin D synthesis. A high UVA-PF sunscreen enables significantly higher vitamin D synthesis than a low UVA-PF sunscreen because the former, by default, transmits more UVB than the latter. This article is protected by copyright. All rights reserved.

KEYWORDS:

SED ; UVR ; UVA protection factor; Vitamin D; erythema; holiday; sunburn; sunscreen

PMID:
31069787
DOI:
10.1111/bjd.17888

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