Proper sun care is extremely important, we all agree on that. Yet, exposure to UV light carries both risks and benefits: over the last few decades the focus has only been on the risk of overexposure and that sunlight should be avoided at all cost. But in the last few years more and more studies are showing that the research used may have biases and moderate exposure may outweigh the risk of over exposure. Therefore, we feel the urge to call for a balanced discussion, in order to be part of the solution and address concrete challenges related to UV exposure, tanning and sunbeds use. As policies need to rely on solid evidence, let’s look at the key misconceptions in the sector.
Three out of the six facts of the factsheet include:
“The dogma, now fossilized in print, is that any tan is a sign of skin damage. Tell that to Darwin. Even if there was hard evidence that melanoma was UV-induced it would be all the more important to keep a protective tan” – Dermatology Professor Dr. Sam Shuster, Newcastle University, UK.
This is not the public health message we are getting today though, as sunlight and tanning are portrayed as something to be avoided at all costs. Sun avoidance has been repeatedly proven as harmful, as sunlight helps to keep healthy Vitamin D levels in the blood, along with other photoproducts like nitric oxide, which fights chronic diseases like hypertension and arteriosclerosis. Furthermore, a study showed, that the mortality rate is twice as high in women who avoid sun exposure compared to those who were more exposed to the sun. A 2019 commentary titled “Sun Exposure Public Health Directives” state “The public health directive regarding sun exposure and human health should be adjusted to reflect current scientific knowledge. We recommend a public health directive as follows: All persons in the world regardless of skin color or latitude of residence, other than those with extraordinary sensitivity to sunlight, should get enough sun exposure to maintain a serum 25(OH)D level well over 20 ng/mL (desirably at 30–60 ng/mL) while taking care to avoid sunburn.”
UV emitted from sunlight and sunbeds are more similar than generally thought: the UV in midday summer sunlight is made up of about 95% UVA light and 5% UVB light. Most indoor tanning equipment emit the same, with a maximum intensity equaling the midday sun in the Mediterranean. This is guaranteed through the European standard EN 60335-2-27, limiting UV output from sunbeds to 0.3W/m2 . The major difference however, is that UV from a sunbed is easily controlled to avoid overexposure by trained and industry certified operators following Professional Standards.
UV has a complex and often-misunderstood relationship with melanoma skin cancer risk. Consider: indoor workers who get less UV exposure get more melanomas than outdoor workers who get regular sun. The largest meta-analysis of risk factors for melanoma found that people with the most UV exposure, chronic UV exposure which was defined as continuous regular UV exposure, had a 5% REDUCED risk of melanoma.3 That’s why sunburn – not regular sun – is the main UV-related risk factor and total sun avoidance as proclaimed by the WHO4 is a major mistake.