Des Spence is a general practitioner based in Glasgow, Scotland, UK, who writes a weekly column in the British Medical Journal. Although I’ve never met Des, I like him a lot. I like how he writes and what he writes, almost always. He’s never afraid, it seems, to buck the trend and express a view that is out of keeping with conventional ‘wisdom’. Earlier this year I wrote a post based on one of his columns which took the practice of cardiology to task. You can read the blog post here.
This week’s focus for Dr Spence was sunlight, and the growing clamour that children should be protected from it [1]. In this column he makes the point that sunshine is healthy, and that the reason some of us have pale skin is because evolution selected for this, as it was an advantage in terms of making sufficient vitamin D (from sunlight) for health in areas where sunlight is in generally short supply.
Then he casts a critical eye over melanoma and its relationship with sunlight. He makes the point that melanoma most commonly occurs in places that are less sun exposed. He also alludes to the fact that melanoma is more common in indoor workers than outdoor workers. He doesn’t mention this, but I think it’s also worth bearing in mind that most melanomas do not occur in typically sun-exposed parts of the body. Dr Spence does point out, though, that there is scant evidence that sun protection reduces the risk of melanoma, and none at all that it saves lives.
Dr Spence also makes the point that the rising incidence of melanoma is almost certainly due to ‘overdiagnosis’. Increased awareness of melanoma by the medical profession and members of the public have led to increased diagnosis of lesions which were not destined to pose a threat to health in the long term.
Finally, Dr Spence draws our attention to increasing issues regarding vitamin D deficiency, and the fact that sunscreens block vitamin D production. As Dr Spence points out, low vitamin D levels can cause bone disease and is linked with enhanced risk of cardiovascular disease and several forms of cancer.
Here’s Dr Spence’s last paragraph in full:
“I pale at the potential consequences of the current sun policy on the long term health of our children. We should trust evolution: the current policy is counterintuitive, and bad medicine.”
He’s right, too.
References:
1. Spence D. Bad medicine: melanoma. BMJ 2011;343:d5477
I’m confused about sun exposure – we spend the month of August with my in-laws in the south of France, & I rarely put sunscreen on my children (11 & 14) However, they run around all day in swimsuits, and the eldest got a little red, especially around the ears, on the first day. If they refuse to cover up, should I put sunscreen on them for at least part of the day? Their French grandmother doesn’t believe in it anyway, and tells them just to keep running in & out of the sea & stay in the shade when the sun’s at its zenith.
Thanks for your thoughts on this – we hear such terrifying tales of the skin having a memory, and getting burned just once can result in cancer later in life…
yeah! a dr that has some sense!!
i ‘used’ to put suncream on my pale children as i was scared they would burn as media promote…well they often did go pink & have to cover up as they never got a gentle tan to ‘protect’ them from stronger sun. who knows how much chemical junk they used then…some evidence of which ‘standard suncreams’ esp those with vit A in them can actually PROMOTE skin cancers!
then about 6 years ago i ditched the suncream… in the uk i have only used it on them twice this year – once in april when we were at the beach and another time when swimming outside all day- admittedly the older 3 are now aged between 11-16 but my youngest is 4. i encourage them to go outside in the spring and summer to build up some vit d. obviously i dont get them to bake in the sun for an hour or two, but they are kids they are always moving around and in and out the shade.
they all have a suntan now (as do i) and havent burnt. also my 16 yr old went on holiday with my family to greece in july and said he barely needed his (chemical free) suncream on his face, arms and legs as these areas are where he gets the sun to in the uk and they just went brown! his back was another story (lack of enough chance to sun in UK!)and needed frequent cream and being covered up -far more likely to burn badly and increase the cancer risk!
my family who all use (chemical) sun creams regularly in uk had to keep applying it and still burnt! also my sister and cousin have these sun spots that make their faces blotchy DESPITE always using suncreams and (chemical laden) makeup with SPF. i threw these products all out and what areas i had that were looking slightly patchy have gone! i now look younger than i did 10 years ago! 🙂
also the last few years my children seem to have decreased their incidences of colds, flus etc in the winter…is this from the extra vit d? and i know i feel much better after a few days on sun on me!
i sometimes feel its only me that tells the schools my kids dont need suncream at 9am! or uses natural coconut oil on our skin. hopefully others will notice in time that they also DO look healthy, healthier than those that use these toxic creams and potions
!
I live in the mid-Atlantic area of Virginia, USA. Sun pours down, often feeling like it is burning your skin on the way to the auto. Hard to avoid. I have always lived near the ocean
I am always deficient in Vit. D, even though I take a supplement. When tested I ask why I am repeatedly deficient in D. No answers!
I’ve been taking Vit D3 for over two years and its taking me a while to get a decent level, so increased my daily to 15,000iu and its getting better. I’ve recently been using magnesium oil as there seems to be a connection, if you take Vitd3. Anyone know why? I spray the magnesium oil on my feet, I know I can reach every part – the foot in reflexology is the whole body, so anyone can cover all over. At the same time rubbing it into the skin your body will get a good massage. The body absorbs it faster via the skin. AH are you using D3? its not the same as D2, my pal was using the wrong one.
Liz
You might be interested to read this piece about magnesium/vitamin D:
http://www.vitamindcouncil.org/about-vitamin-d/vitamin-d-cofactors/magnesium/
The BMJ would be a dismal place without Des Spence. I posted a rapid response to his article this morning underlining the point that melanoma often occurs in areas of the skin that are little exposed to the sun. The BMJ seem to have placed an embargo on my responses at the moment (five waiting for a week) so I’ll post it here.
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“Sun exposure and the riddle of melanoma”
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Des Spence is spot on in highlighting the contradictory mythologies of skin cancer. I was introduced to my first patient with melanoma as a medical student over thirty years ago: the old man was about to be wheeled into the operating theatre to have his right leg amputated when I met him. I vividly remember being shown the large black, fungating lesion on the sole of the foot. The patient was African and I was studying on a student elective period in Malawi. The riddle of melanoma is still a long way from being solved and Des Spence is right: the current cover up policies are bad medicine.
Competing interests: None declared
Thank you John, answers the questions.
I have been gardening and planting by the moon this year and I recall an old pen pal in USA saying she watered her garden with Epsom Salts, about 1 tspn to gallon of water. Wonder if that will improve the intake, they say all the vegetables are deplete of magnesium.
Thanks for the responses. I do use Vit. D3, 2000 mg per day.
Will check out the Magnesium. Still wonder what causes a person to be depleted of Vit D…
Ann
The rising incidence of melanoma seems to correlate best with the rising use of sunscreens. Since my eyes burn & water and my nose stuffs up just from sunscreen fumes, I’ve been motivated to do without. If they cause resiratory allergies, what can they doing to my biggest organ (skin)?
As a blue-eyed redhead, for the past ~5 years I’ve started in April getting a few minutes of sun and slowly adding a few minutes each day to build up a gentle tan. By July I can hike all day at 4500-7000′ in the Canadian Rockies and not get burned. I do wear hats, long sleeves & pants for much but not all of the day, and enjoy shade when it is hot, but make sure I get as much sun/vit D as I can.
You may want to check out this article about how some people just don’t seem to produce Vitamin D in spite of sun exposure:
http://jcem.endojournals.org/content/92/6/2130.abstract
About 10 years ago I was encouraged to take Blue green algae and a side effect was that I didn’t burn when out in the sun. I just realised that I had not burned when in Tahiti every other person looked like cooked lobster I was just pale pink. Ive never used sunscreen since and dont burn. I can spend longer in the sun but take shade breaks. You never see babies in buggies with lovely brown legs. Having stayed out of the sun most of my life my Vit D level must have been very low hence the long time it is taking to get to a good level. Many years of cool wet summers cannot have helped our cause. Its taken two years to see the improvements that I have achieved. Recently read that minimum iu’s we should be taking (adults) is 5,000iu daily. The more I take the better I feel.
I’d be interested in some comments please. I fully believe that sunscreen in the UK is a waste of time and probably bad for your health. After living in the UK for 24 years I have moved back to my home country of NZ. Now there they say the increase in skin cancer is due to thinning of the atmosphere and therefore we all need to stay out of the sun or put sunscreen on. The sun can be pretty fearsome so I would stay out of it in very hot weather, but is the argument about the ozone justified? Lots of older people here get moles burned off their hands because they are considered a risk of cancer. Seems a bit extreme to me. The back of my dad’s hands are covered in scars!
I live in new Zealand where the burn time in summer is 20 minutes (that’s being generous it’s usually less) – we all use sunscreen here – as well as hats and appropriate clothing – the UV rate here is so high you can get burnt through some lightweight materials!!
Yes, I know Rikki. When I was a kid we ran and played at the beach and in the garden and didn’t have to worry about getting burnt. Is this down to thinning of the ozone then because it wasn’t an issue when I was growing up in NZ in the 60’s and 70’s.
I notice the Australia is changing its guidance on the amount of sunlight required for vitamin D. They are differentiating between parts of the country, season and skin colour which seems to me a much better approach. Unfortunately I can’t find the paper but I came across this in my searches which indicates the complexity of the subject.
http://www.mja.com.au/public/issues/186_02_150107/jan10896_fm.html
I started taking vitamin D about 5 years ago after reading all about it on a low carb forum called Who will join the vitamin D experiment. I have not had a cold since and have a slight tan all year round. I don’t burn anymore but go brown straight away. I live in Holland so take 5000 Iu’s in winter and if we have a terrible summer like the last one I will take 2000 Iu’s a day if it is clowdy. Even when visiting family in Australia in October/November I don’t have to worry about burning. As my immune system is up to scratch I don’t worry about melanomas. I would be more worried about the other types of cancer you can get when you are seriously vitamin D deficient. I would recommend reading “Sunlight Robbery” just google it and it can be douwnloaded free.
fearful consumers make for good consumers – and there’s no shortage of things to be fearful about.