Under the Montecito Sun

Getting Vitamin D Without those Golden Rays

In ancient times, many civilizations revered the sun. Early Egyptians, Incas and other cultures worshipped it.

A quick drive by Butterfly Beach shows Montecitans aren’t so far removed from the ancients when it comes to the love of those golden rays. Now we know the sun is a good source of vitamin D.

In fact, new studies have warning of the dangers of vitamin D deficiency have provoked controversy and led some people to lay off the sunscreen. But that's not a good idea, say most doctors.

“If you wish to prevent blotches, possible cancers and wrinkles, never go in the sun without sunscreen,” cautions Dr. Martha Gonzalez, a Ventura anti-aging specialist certified in both internal medicine and endocrinology. “But sunscreen can block a percentage of vitamin D along with the harmful rays and many people, including women, older people and those with dark skin have trouble absorbing vitamin D. Most people need to take supplements to get the vitamin D they need.”

Dr. Gary Novatt, a Santa Barbara dermatologist who offers full-service dermatology care, including skin cancer and repairing damage done by sun, says sun exposure is a factor in at least 90% of the conditions he treats.

“Some people read about the new studies coming out touting the importance of vitamin D and conclude they'd be better off not using sunscreen,” says Dr. Novatt. “But chances are you're already getting too much sun, even if you use sunscreen daily. It can be hard to cover all exposed areas, and people don't always apply enough of it, or re-apply it often enough. Even if used correctly, it doesn't block all the rays – just reduces the percentage.”

This isn’t to suggest that vitamin D deficiency shouldn’t be taken seriously, but many, though not all, practitioners agree that the amount of incidental sun exposure received can be adequate for vitamin D production to take place. Besides, the risks of not getting enough vitamin D remain controversial, but skin cancer’s ties to the sun is a full-blown, unassailable fact.

“In my own practice, I see cancers daily and melanoma sometimes weekly,” says Dr. Keith Llewellyn, a Santa Barbara dermatologist who treats the gamut of sun-related problems, from cancer to cosmetic repairs for sun-damaged skin. “Nationwide, statistics predict one of five people will get skin cancer. If that doesn't convince you to use sunscreen, consider the fact that there is also no doubt sun causes premature aging and many other cosmetic problems.”

Dr. Novatt cites a long list of sun-related conditions he sees – skin cancer is just one of them. There are also pre-cancerous growths and other growths such as seborrheic keratoses; dilated blood vessels; and pebbling of skin texture and loss of elasticity. Not to mention unsightly pigment changes that include freckling, solar lentigo or “age spots.” And, of course, wrinkles.

It's not a pretty picture, and most dermatologists have an easy answer to those who need more vitamin D and wonder whether they should get more sun.

“It's a non-issue,” says Dr. Novatt. “You don't have to leave off sunscreen to get more vitamin D. Just use supplements.”

Several experts agree that there are some people who cannot get enough vitamin D from incidental sun exposure. There is growing evidence that many people in the U.S. – particularly older adults, women and darker-skinned people – may have deficient vitamin D levels. Experts warn that older people's skin is less equipped to process vitamin D absorption through incidental sun exposure and darker-skinned people have a reduced ability to photosynthesize vitamin D due to increased melanin, which gives skin its pigment.

“New studies show that vitamin D is more important than previously thought,” says Dr. Gonzalez. “It has been classified as a pro-hormone. Lack of it has not only been associated with increases in autoimmune disorders, but cancers of the breast, prostate and colon, bone loss, decreased calcium absorption, and higher rates of cardiovascular disease. The benefits of vitamin D are well-documented.”

Dr. Gonzalez points out that food and nutrition boards have increased the daily dose requirement for vitamin D to 1,000 international units, or IU. Many studies find the prior dosing guidelines were not sufficient.

“If you are deficient, and most of us are, you can safely take even more – up to 5,000 IU,” says Dr. Gonzales. “I myself take that amount.”

There is a limit to the amount of vitamin D3 you can take in pill form, although the upper limits are controversial. Much less controversial is the proper way to use sunscreen. The American Academy of Dermatology recommends a minimum of SPF 15 and many dermatologists recommend SPF 30.

“There isn't a benefit to going without sunscreen, but there is a lot of benefit to using it,” says Dr. Novatt. “Just pull up your shirt and look at the areas that never get sun, compared to those that have been exposed. That will tell you some of the story right there.”