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Skin Cancer Explained

Understanding Vitamin D levels and how to stay sun safe

Worried that you’re not getting enough vitamin D? Or too much? In this article, we discuss the signs of a vitamin D deficiency, debunk some common myths, and show you how to get your vitamin D levels right while still staying safe in the sun.
MoleMap Team
April 25, 2021
12 minutes

Known as ​‘the sun­shine vit­a­min’, Vit­a­min D is essen­tial to our bod­ies. It enhances bone growth, boosts the immune sys­tem and is also believed to help reduce dis­ease, while a Vit­a­min D defi­cien­cy can increase your risk of con­di­tions such as osteo­poro­sis and oth­er poten­tial ail­ments.

Sun expo­sure is the eas­i­est way to ele­vate your Vit­a­min D lev­els. How­ev­er, Aus­tralia has one of the world’s high­est rates of melanoma so we also need to pro­tect our skin from the sun. So how do you do both – ensure you’re get­ting enough sun to main­tain your vit­a­min D lev­els, yet avoid get­ting sun­burnt and increas­ing your skin can­cer risk? Read on and we’ll show you.

Vit­a­min D defi­cien­cy

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What are the ben­e­fits of vit­a­min D?

This essen­tial, but often over­looked, vit­a­min has a myr­i­ad of health ben­e­fits. New research is con­stant­ly being released that sup­ports the ben­e­fits of vit­a­min D, espe­cial­ly around treat­ment and pre­ven­tion of osteo­poro­sis and car­dio­vas­cu­lar dis­ease.3

Vit­a­min D has mul­ti­ple roles in the body. Among oth­er ben­e­fits, it assists in pro­mot­ing healthy bones and teeth, sup­port­ing immune, brain, and ner­vous sys­tem health, reg­u­lat­ing insulin lev­els and sup­port­ing dia­betes man­age­ment, lung func­tion and car­dio­vas­cu­lar health.

It’s well known that a Vit­a­min D defi­cien­cy can increase the risk of osteo­poro­sis. But on the bright side, a recent US analy­sis found that vit­a­min D intake of over 600 IU per day (from milk, fish, sup­ple­ments and sun­light expo­sure) can reduce the risk of osteo­poro­sis by 27 per cent.4

Oth­er stud­ies claim that peo­ple with mod­er­ate vit­a­min D defi­cien­cy are more like­ly to suf­fer heart attack, stroke or heart fail­ure than those with high lev­els of the vit­a­min5 – anoth­er very com­pelling rea­son to ensure your vit­a­min D and Vitamin B3 lev­els are up to scratch!

Above: Vit­a­min D can be absorbed from foods such as oily fish.
Above: Vit­a­min D can be absorbed from foods such as oily fish.

How does your skin pro­duce Vit­a­min D?

While small amounts of Vit­a­min D can be absorbed from foods such as oily fish, liv­er and eggs, the pri­ma­ry source of Vit­a­min D is sun­light, which helps your body man­u­fac­ture vit­a­min D. The sun’s ultra­vi­o­let B (UVB) rays inter­act with a pro­tein called 7‑DHC in the skin, con­vert­ing it into vit­a­min D3, the active form of vit­a­min D6.

Your skin needs a cer­tain amount of sun­light to allow this impor­tant process to hap­pen … how­ev­er, bak­ing in the sun or using tan­ning beds is not the answer because it can increase your risk of sun dam­age and skin can­cer, such as melanoma.

In fact, a whop­ping 90% of non-melanoma skin can­cer is linked to sun expo­sure7, so choos­ing to get your vit­a­min D through too much sun expo­sure is to put it sim­ply huge­ly dan­ger­ous. Instead, if your Vit­a­min D lev­els are low, experts rec­om­mend sup­ple­ment­ing your diet with Vit­a­min D3 (the active form of Vit­a­min D), ide­al­ly at around 1000 iu a day.

Peo­ple who have low vit­a­min D lev­els can suf­fer from mus­cle aches, mus­cle weak­ness and bone pain.
Above: Peo­ple who have low vit­a­min D lev­els can suf­fer from mus­cle aches, mus­cle weak­ness and bone pain.

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Are you one of the near­ly 75% of Aussies low in Vit­a­min D?

A new Aus­tralian study has revealed that near­ly one-third of Aus­tralian adults are vit­a­min D defi­cient and near­ly three quar­ters of all Aus­tralians have insuf­fi­cient vit­a­min D lev­els – a sur­pris­ing­ly huge pro­por­tion when you con­sid­er our high sun­shine lev­els!8

In the ground-break­ing study, researchers assessed over 11,000 Aus­tralians from all around the coun­try (aged 25+) for vit­a­min D defi­cien­cy. The results revealed that 31% of the group were vit­a­min D defi­cient, (22% of men and 39% of women). What’s more, 73 per­cent had lev­els below 75 nmol/​l and four per­cent of the study group had vit­a­min D lev­els less than 25 nmol/​l – which is con­sid­ered extreme­ly low.9

What are the signs of a Vit­a­min D deficiency?

Peo­ple who have low vit­a­min D lev­els can suf­fer from a range of symp­toms includ­ing mus­cle aches, mus­cle weak­ness and bone pain. In severe cas­es, by reduc­ing cal­ci­um absorp­tion, defi­cien­cy can lead to slow­er growth, bone soft­en­ing and weak­ened bone struc­ture, increas­ing the risk of osteo­poro­sis, skele­tal defor­mi­ties and frac­tures10.

To get dai­ly dose of Vit­a­min enjoy the sun­shine but don’t for­get to put SFP 30+ sun­screen every day
Above: To get dai­ly dose of Vit­a­min enjoy the sun­shine but don’t for­get to put SFP 30+ sun­screen every day.

How much sun expo­sure do I need to main­tain nor­mal vit­a­min D levels?

It all depends on how much sun you get. For those liv­ing in south­ern states of Aus­tralia, the Can­cer Coun­cil rec­om­mends two to three hours of sun expo­sure per week at this time of year. Most peo­ple can achieve ade­quate lev­els by being out­doors with typ­i­cal day-to-day activ­i­ties – out­side of peak UV peri­ods, that is. 11

For those who get enough sun, Osteo­poro­sis Aus­tralia says 400 – 800 IU of vit­a­min D dai­ly will suf­fice. But for those who don’t, they rec­om­mend tak­ing around 800‑2000 IU a day.12

Most peo­ple can main­tain ade­quate vit­a­min D lev­els through reg­u­lar, inci­den­tal expo­sure to the sun – just by spend­ing a few min­utes out­doors on most days of the week (dur­ing sum­mer, when the UV Index is 3 or above ). How­ev­er, it’s impor­tant to still take Sun­Smart mea­sures because even a few min­utes of inci­den­tal sun expo­sure all adds up to long-term sun dam­age and melanoma risk.

In late autumn and win­ter in some south­ern parts of Aus­tralia, when the UV Index falls below 3, it’s okay to spend time out­doors in the mid­dle of the day with some skin uncov­ered. Being phys­i­cal­ly active (e.g. gar­den­ing or going for a brisk walk) can also help ele­vate vit­a­min D lev­els.13

Does NOT wear­ing sun­screen increase vit­a­min D production?

In a nut­shell, no. It’s a com­mon myth that the best way to obtain enough Vit­a­min D is through unpro­tect­ed sun expo­sure – how­ev­er, that can lead to a whole oth­er set of issues, includ­ing sun dam­age and an increased skin can­cer risk.

How­ev­er, sen­si­ble sun pro­tec­tion DOES NOT put peo­ple at risk of vit­a­min D difi­cien­cy3, while unpro­tect­ed sun expo­sure puts you at risk of all types of skin can­cer includ­ing melanoma, the fastest-grow­ing and most life-threat­en­ing type of skin cancer.

In fact, the World Health Orga­ni­za­tion has iden­ti­fied solar UV radi­a­tion as a proven car­cino­gen, with stud­ies link­ing it to about 90 per­cent of non-melanoma skin can­cers and about 86 per­cent of melanomas, as well as pre­ma­ture skin aging.14

In Aus­tralia, we need to bal­ance the risk of skin can­cer from too much sun expo­sure with main­tain­ing ade­quate vit­a­min D lev­els. In fact, new sun­screen guide­lines for both Aus­tralia and New Zealand rec­om­mend that we should be apply­ing a broad-spec­trum, SFP 30+ sun­screen every day when the UV index is pre­dict­ed to reach 3 or above1.

So if you want to get your dai­ly dose of Vit­a­min D, enjoy the sun­shine before 10am and after 4pm dur­ing the sum­mer months (or any­time the UV index is pre­dict­ed to be under 3) – with su

Elder­ly are most at risk of Vit­a­min D deficiency.
Above: Elder­ly are most at risk of Vit­a­min D deficiency.

Can your body still pro­duce Vit­a­min D if you’re wear­ing sun­screen?

We know that sun­screen can reduce the dam­ag­ing effects of the sun, but it’s com­mon­ly believed that it might inhib­it the body’s pro­duc­tion of vit­a­min D. How­ev­er, in a new study, par­tic­i­pants showed an increase of vit­a­min D in par­tic­i­pants dur­ing a week of cloud­less weath­er, with a very high UV index, even when sun­screens were used prop­er­ly and pre­vent­ed sun­burn.15

So short answer sun­screen won’t stop you get­ting an ade­quate intake of Vit­a­min D. Just make sure you get your dose of sun­shine at the right time of day – most peo­ple can main­tain ade­quate vit­a­min D lev­els by spend­ing just a few min­utes out­doors most days of the week.15

Who’s most at risk of Vit­a­min D defi­cien­cy?

The recent Aus­tralian study revealed cer­tain pop­u­la­tion groups were more like­ly to be at risk than oth­ers: women, the elder­ly, those who are obese, those who do less than 2.5 hours of exer­cise per week, those with dark­er skins, and those who spend a lot of time indoors. Liv­ing in a south­ern Aus­tralian state was also a risk fac­tor.16

As you’d expect, the study high­light­ed that defi­cien­cy lev­els appears to be sea­son­al. Dur­ing sum­mer and autumn months, defi­cien­cy lev­els were 6% of men and 13% of women in the cen­tral and north­ern regions of Aus­tralia, and 27% of men and 42% of women in south­ern Aus­tralian regions.

How­ev­er, in win­ter and spring, defi­cien­cy lev­els dou­bled to 15% of men and 31% of women in the north­ern regions, and increased to 35% of men and 58% of women in the south­ern states.

So yes, more expo­sure to the sun is def­i­nite­ly a fac­tor, as long as it’s not too much sun exposure!

What is a healthy lev­el of vit­a­min D?

As a gen­er­al guide, Osteo­poro­sis Aus­tralia rec­om­mends most peo­ple should have a vit­a­min D lev­el of at least 50 nmol/​L at the end of win­ter, which means peo­ple may have lev­els 10 – 20 nmol/​L high­er dur­ing sum­mer (60−70 nmol/​L).17

This help­ful Vit­a­min D chart gives you a guide to what’s nor­mal and what’s not:

Below 30 nmol/​L: You have a Vit­a­min D defi­cien­cy — ask your doc­tor about supplements.

30 – 50 nmol/​L: Not ade­quate for bone and over­all health – talk to your doc­tor about ele­vat­ing your Vit­a­min D levels.

50 and above: Your lev­els are ade­quate – keep up what you’re doing.

125 and above: Your lev­els are too high – talk to your doctor.

Exer­cis­ing out­doors dur­ing safe times for sun expo­sure will also help you get some vit­a­min D‑producing rays.
Above: Exer­cis­ing out­doors dur­ing safe times for sun expo­sure will also help you get some vit­a­min D‑producing rays.

What can you do to main­tain healthy vit­a­min D levels?

Next time you see your doc­tor, ask for a blood test to check your vit­a­min D lev­els. In most cas­es, a defi­cien­cy can be cor­rect­ed with sup­ple­men­ta­tion. Exer­cis­ing out­doors dur­ing safe times for sun expo­sure (before 10am and after 4pm in the sum­mer months) will also help you get some vit­a­min D‑producing rays.

If you have low vit­a­min D lev­els, you may need to take a reg­u­lar sup­ple­ment. Avail­able as tablets, cap­sules, drops or liq­uid, most vit­a­min D sup­ple­ments are ​‘D3’ and the dose on the prod­uct is shown in Inter­na­tion­al Units (IU). Your doc­tor will advise you on the right dose for you, and your phar­ma­cist can also pro­vide gen­er­al advice on vit­a­min D supplements.

Over-expo­sure to the sun is nev­er rec­om­mend­ed, even if you have a vit­a­min D deficiency.
Above: Over-expo­sure to the sun is nev­er rec­om­mend­ed, even if you have a vit­a­min D deficiency.

Vit­a­min D lev­els and sun­shine lev­els – how much is too much?

Ade­quate lev­els of vit­a­min D can be restored by sun­light sur­pris­ing­ly quick­ly. Just a few days of care­ful sun expo­sure can make up for sev­er­al days of no sun­light expo­sure18. Body fat acts like a kind of stor­age bat­tery for vit­a­min D: stor­ing it dur­ing peri­ods of sun­light and releas­ing it when sun­light is gone.

How­ev­er, over-expo­sure to the sun is NEV­ER rec­om­mend­ed, even if you have a vit­a­min D defi­cien­cy – because of the increased risk of skin can­cer, includ­ing melanoma. If you are con­cerned about your vit­a­min D lev­els, speak to your doc­tor who may advise supplementation.

If your Vit­a­min D lev­els are low, aim to get just a lit­tle sun expo­sure every day – ide­al­ly in the ear­ly morn­ing or late after­noon – rather than going all out and fry­ing your skin in the mid­day sun!

If you’re concerned that you’ve been getting too much sun, we recommend having a thorough check-up of your skin check and mole check every year to detect any signs of skin cancer early – when it’s most treatable.

Partnering with Australian Skin Cancer Clinics like MoleMap that ensures comprehensive surveillance of all your spots and moles, offering peace of mind and proactive care.

Are there any side effects of tak­ing vit­a­min D tablets?

Most peo­ple do not com­mon­ly expe­ri­ence side effects with vit­a­min D sup­ple­ments, unless too much is tak­en. Some side effects of tak­ing too much vit­a­min D include weak­ness, fatigue, sleepi­ness, headache, loss of appetite, dry mouth, metal­lic taste, nau­sea, vom­it­ing, and oth­ers.19

Before tak­ing vit­a­min D sup­ple­ments, we rec­om­mend check­ing with your doc­tor to check your Vit­a­min D lev­els and to see whether you need sup­ple­ments – or whether you sim­ply need a lit­tle more (care­ful) sun exposure.

References:

1,3,4,6,10,19. Skin.cancer.org: https://www.skincancer.org/ski... 2,7. Melanoma Institute Australia: https://www.melanoma.org.au/understanding-melanoma/melanoma-facts-and-statistics/ 5. https://www.blackmores.com.au/everyday-health/the-case-for-vitamin-d 8,9,16. Blackmores Australia https://www.blackmores.com.au/everyday-health/vitamin-d-deficiency-major-health-risk-for-australians 11,15,18 Cancer Council: https://www.cancer.org.au/cancer-information/causes-and-prevention/sun-safety/vitamin-d 12,17. Osteoporosis Australia: https://www.osteoporosis.org.a...13. A.R. Young, J. Narbutt, G.I. Harrison, K.P. Lawrence, M. Bell, C. O'Connor, P. Olson, K. Grys, K. Baczynska, M. Rogowski‐Tylman, H.C. Wulf, A. Lesiak, P.A. Philipsen. Optimal sunscreen use, during a sun‐holiday with a very high UV index, allows vitamin D synthesis without sunburn. British Journal of Dermatology, 2019; DOI: 10.1111/bjd.17888 14. World Health Organisation: https://www.who.int/gho/phe/ul...

MoleMap Team

At MoleMap we check, detect and treat skin cancer. Find out how you can protect your skin at your nearest MoleMap skin cancer clinic.

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