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Ill effects of the sun not overemphasized

October 4, 2009 12:36 am

WE HAVE practiced dermatology for more than 30 years in this community, and were therefore delighted to see Dr. Patrick Neu-statter's recent column address the important issue of sunshine and vitamin D and the skin ["Is sunshine a safe source of vitamin?" Sept. 27].

But we were surprised to read his conclusion: "My personal bias is that some UV light/sun is not so harm-ful--and its ill effects may have been overemphasized."

We know Dr. Neustatter to be an effective and compassionate physician, but we believe that his conclusion might be misinterpreted in ways that will be harmful to readers, and so we would like to set the record straight from the standpoint of having to treat patients who are suffering the consequences of such a belief as his.

It is true that ultraviolet radiation from the sun is responsible for cutaneous synthesis of vitamin D, a vitamin critical for good bone health and for a variety of other as yet ill-defined conditions.

It is equally true that that same ultraviolet radiation is responsible for both prematurely old-looking skin and for the vast majority of skin cancers. Every minute spent in the sunshine (or in the pseudo-sun environment of a tanning bed) causes damage to the skin cells that is permanent and irreversible, said damage leading ineluctably to prematurely aging skin and to cancer.

The dilemma comes in trying to find a balance between these two effects.

We do need vitamin D, of course. But dietary supplementation has been shown to be efficacious and safe and, in spite of faithful use of sunscreens (which isn't always the case) most of us get at least 10-15 minutes of sun exposure on our face and hands daily, a degree of exposure that alone is enough in most cases to reach effective levels of vitamin D.

To be told to "deliberately expose ourselves to UV light," or to "question the wisdom of slathering ourselves with sunscreens," is to be told that it is OK to expose ourselves to a carcinogen in moderation. Does that make sense in light of the fact that there are effective non-carcinogenic alternatives?

To be told "to avoid the sun like the plague" is to be told something that no dermatologist would say. We know of no one who is seriously promoting no sun exposure; rather, we are encouraging lifestyles that minimize exposure.

To be told that "some UV light/sun is not so harmful--and its ill effects may have been overemphasized" is to be told something to which many of our patients, suffering deformity and death from skin cancer, would take strong exception.

Dr. Neustatter should discuss all this with some of his skin cancer patients. He might just change his mind.

Mike Stevens, M.D., and Pat Stevens, M.D., are dermatologists in Fredericksburg. They live in Stafford County.