Concerns about Vitamin D should not negate skin cancer prevention advice
April 18, 2019
Abstract
Background: Sunscreen use can prevent skin cancer, but there are concerns that it may increase the risk of vitamin D deficiency.
Objectives: We aimed to review the literature to investigate associations between sunscreen use and vitamin D3 or 25 hydroxy vitamin D (25(OH)D) concentration.
Methods: We systematically reviewed the literature following the MOOSE guidelines. We identified manuscripts published in English between 1970 and 21 November 2017. Eligible studies were experimental (using an artificial ultraviolet radiation source), field trials, or observational studies. The results of each of the experimental studies and field trials are described in detail. Two authors extracted information from observational studies, and applied quality scoring criteria that were developed specifically for this question. These have been qualitatively synthesised.
Results: We included 4 experimental studies, 3 field trials (2 were randomised controlled trials) and 69 observational studies. In the experimental studies sunscreen use considerably abrogated the vitamin D3 or 25(OH)D production induced by exposure to artificially generated ultraviolet radiation. The randomised controlled field trials found no effect of daily sunscreen application, but the sunscreens used had moderate protection (sun protection factor ~16). The observational studies mostly found no association or that self‐reported sunscreen use was associated with higher 25(OH)D concentration.
Conclusions: There is little evidence that sunscreen decreases 25(OH)D concentration when used in real life settings, suggesting that concerns about vitamin D should not negate skin cancer prevention advice. However, there have been no trials of the high sun protection factor sunscreens that are now widely recommended.
Source:
Neale, R. , Khan, S. , Lucas, R. , Waterhouse, M. , Whiteman, D. and Olsen, C. (2019), The effect of sunscreen on vitamin D: a review. Br J Dermatol. Accepted Author Manuscript. doi:10.1111/bjd.17980