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

Research output: Contribution to journalArticle

A. R. Young, J. Narbutt, G. I. Harrison, K. P. Lawrence, M. Bell, C. O'Connor, P. Olson, K. Grys, K. A. Baczynska, M. Rogowski-Tylman, H. C. Wulf, A. Lesiak, P. A. Philipsen

Original languageEnglish
Pages (from-to)1052-1062
Number of pages11
JournalBritish Journal of Dermatology
Volume181
Issue number5
Early online date8 May 2019
DOIs
Accepted/In press14 Mar 2019
E-pub ahead of print8 May 2019
PublishedNov 2019

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Abstract

Background: 

Sunlight contains ultraviolet (UV)A and UVB radiation. UVB 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. 

Objectives: 

To assess the ability of two intervention sunscreens to inhibit vitamin D synthesis during a week-long sun holiday. 

Methods: 

The impact of sunscreens on vitamin D status was studied during a 1-week sun holiday in Tenerife (28° N). Comparisons were made between two formulations, each with a sun protection factor (SPF) of 15. The UVA-protection factor (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 the correct application. Comparisons were also made with discretionary sunscreen use (n = 22) and nonholiday groups (51·8° N, n = 17). Sunscreen use in the intervention groups was measured. Behaviour, UV radiation exposure, clothing cover and sunburn were monitored. Serum 25-hydroxyvitamin D3 [25(OH)D3] was assessed by high-performance liquid chromatography–tandem mass spectrometry. 

Results: 

Use of intervention sunscreens was the same (P = 0·60), and both equally inhibited sunburn, which was present in the discretionary use group. There was an increase (P < 0·001) in mean ± SD 25(OH)D3 (28·0 ± 16·5 nmol L−1) in the discretionary use group. The high and low UVA-PF sunscreen groups showed statistically significant increases (P < 0·001) of 19·0 ± 14·2 and 13·0 ± 11·4 nmol L−1 25(OH)D3, respectively with P = 0·022 for difference between the intervention sunscreens. The nonholiday group showed a fall (P = 0·08) of 2·5 ± 5·6 nmol L−1 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.

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