For millions of Americans getting some summer sun is a popular pastime. But tans can bring skin cancer, while most sunscreens aren't effective enough or may be toxic.
Meanwhile, crucial vitamin D, much of which we get from being in the sun, is way too low.
The challenge for the public is walk the gauntlet of too much sun, too many bad sunscreens, and too little vitamin D.
In Hollywood where tans have long been in vogue, there are exceptions. Actress Nicole Kidman is from the world's skin cancer capital, Australia.
But she's not likely to become a victim to any of the three major skin cancers. Thanks to vigilant parents, she has pretty much avoided the sun from childhood up.
That's been great for her skin, but could leave her vitamin D deficient. That wouldn't be a good thing.
Low vitamin D can make people susceptible to winter germs, summer colds, depression, aches and pains, diabetic afflictions, heart disease and a wide range of cancers. Research over the years, including the latest research, finds nearly the entire population has less than optimum levels.
To Sun or Not to Sun?
So, to sun or not to sun: that is the question. And if so, how much? Dr. James Dowd, author of "The Vitamin D Cure," answers, "Enough is enough to make vitamin D. Too much is a sunburn. And the way we can utilize the sun is to work it into our lifestyle."
Dowd says that could simply mean leaving our desks for lunch in the sun. It could also mean a brief walk outdoors during the middle of the day.
Many doctors prefer that the public take vitamin D supplements. Dermatologists worry that talk of increasing time in the sun could lead to higher cancer rates.
Jane Houlihan, Vice President for Research at the Environmental Working Group, says you can be careful and still get a good dose of vitamin D.
"You wear sunscreen and you'll be getting some of that sunlight filtering through your sunscreen," Houlihan explained. "Ten to fifteen minutes for most people is going to give you enough vitamin D. And what's really important is to protect yourself from a known carcinogen, UV radiation."
But Dowd disagrees, saying people should wait to put on the sunscreen or cover up. That way your skin will be more likely to produce enough vitamin D.
He does caution that babies particularly, most children with medium to light skin, and all those with fair skin need to be extremely careful.
Dowd explains, "You want to go out without protection on for at least your 10 or 15 minutes for at least the average person in a southern latitude -- in a northern latitude, it may be more like 30 minutes that you need in that environment to make enough vitamin D."
With controversy over sun time, how can we be safe and healthy outdoors? First, there are some sunshine basics.
Ultraviolet light from the sun consists of two parts.
First, UVB forms the precursor to vitamin D in the skin, but too much of it causes sunburn and damages the skin surface. By contrast, UVA provides no benefit while making the skin wrinkled and leathery over time. This damage can also lead to melanoma, the most deadly form of skin cancer.
And UVA isn't just a summer thing. Unlike UVB, it's prominent year around -- even on most cloudy days -- and UVA passes right through most windows.
Sunscreen - A Super Safety Shield?
Sunscreen has long been publicized as a safety shield against the bad rays. Unfortunately it's not that simple.
Most sunscreens have only been blocking the less dangerous UVB as measured by the SPF factor. Again by contrast, UVA has had no such standard measure approved -- and has been largely unblocked.
The public assumed in blocking UVB alone, they were safe. In fact, the places where sunscreen became most popular were the same places where skin cancer increased: Australia, North America, and Scandinavia.
The good news is that more products are blocking UVA and UVB. That's known as "broad spectrum protection." Even there, beware, says Houlihan, "Right now there's no regulation at all of what "broad spectrum" means -- so manufacturers can print that on the label and it doesn't have to mean anything at all."
In fact, the Food and Drug Administration has hardly any mandatory requirements. That leads to a set of problems, according to Houlihan.
"What we found in our research is that about half of the products on the market have ingredients that break down when they're in the sun, have ingredients that don't protect you across that whole spectrum of UV radiation that can damage your skin, or contain ingredients that can penetrate your skin and pose other kinds of health risks," she said.
For instance, she cites the common sunblocker oxybenzone which is absorbed into the bloodstream. That raises concerns "for allergies, for cell damage, and it's even been linked in a recent study to birth defects, a preliminary study," she says. "So it is an ingredient that we we warn consumers that it's probably best to avoid."
Given those dangers, what are safe and effective blockers? Houlihan says look for metallic blockers like titanium and zinc. She says many of the best products are from specialty companies. Those include Vanicream, Lavera, UV Natural, California Baby, and Solar Rx.
And major sunscreen brands are also featuring better products among their selections. So being careful you can find acceptable products among such names as Neutrogena, Banana Boat, Coppertone, Peter Thomas Roth and Procyte.
Even if you don't block the sun, there's still a good chance you're low in vitamin D. So a few supplement manufacturers are helping the public get caught up on D -- with doses ranging from 2,000 and 4,000 to even 25,000 and 50,000 units. Those brands include Now Foods, Carlson Labs, Lifespan Nutrition, LifeLink Nutritional Supplements, and Bio-Tech Pharmacal.
The Vitamin D Cure
In Dowd's book, the "Vitamin D Cure," he sets a rough guideline for maintaining a good level. He suggests 25 units, or IUs, for every pound of weight -- about 11 IUs for every kilogram.
For a two hundred pound man, that would be 5,000 units a day. Yet for a ten pound baby, a dose of 250 units daily is suggested. These are above the government's recommendations and in keeping with what vitamin D experts are recommending.
For babies and those who don't like or can't take pills, there are liquid varieties. Pure Encapsulations makes a concentrated one available on request through healthcare providers. Another option carried in health food stores or available online is LifeTime Liquid Vitamin D.
To know how you're really doing, Dowd says have your vitamin D checked. For good health you should be above about 35.
Dowd explains, "You may have a level in the 20s in March and 60 in the summer and the more you are out of doors and the further north, the greater those seasonal fluctuations you have."
Estimates indicate that very few people achieve 60 even by the end of summer.
Weaving your way through vitamin D and sun issues can be tricky. Experts say to remember the importance of protecting your skin safely as well as getting enough vitamin D to protect your whole body.
*Original broadcast June 11, 2008.