A lean, toned physique. Shiny hair. Sparkling eyes. Straight, white teeth.
While our individual tastes may differ, most of us consider these physical characteristics attractive – an unmistakable sign of good health in both men and women. When it comes to a tan, though, the camps are divided.
A golden tan and radiant glow have long been associated with health and beauty, but dermatologists have long warned that sun exposure – which causes tanning – prematurely ages the skin and can also make you more susceptible to skin cancer. Yet there is also some research that suggests moderate amounts of sun exposure may not only have a positive influence on our mood but help prevent disease as well.
The Sun as Healer
The idea of using the sun to treat or prevent disease, called “heliotherapy,” might sound surprising, but it’s actually been around for years. At the beginning of the 20th century, tuberculosis patients were encouraged to sit in the sun to help treat the disease, and during the 1930s, people in industrial cities were encouraged to sunbathe to help prevent rickets.
As antibacterials and other drugs were developed, heliotherapy began falling out of favor as a medical practice. Today, most people are encouraged to minimize their exposure to sunlight’s ultraviolet rays in order to avoid skin aging and cancer, but according to some health experts, that may be a bum steer.
There’s no question that it’s best to give up baking on the beach and to avoid the sun during the peak hours of 10 a.m. and 3 p.m. But you shouldn’t shun the sun entirely, say many naturopathic physicians, including Joseph Mercola, O.D., an osteopathic physician based in Schaumburg, Ill.
“We need the sun – it’s a central part of life,” says Dr. Mercola, who operates www.mercola.com, a site offering all sorts of guidance on natural healing, including a variety of articles with pro-sun messages.
One of the most touted and well-documented benefits of adequate sun exposure (in both traditional and alternative circles) is that it enables the body to generate vitamin D and many important vitamin D derivatives. Today, foods like milk and cereal are fortified with vitamin D, but sunlight is still one of our most significant sources of this critical vitamin. And sunshine has also been credited with helping to ward off and treat a range of medical conditions not commonly associated with vitamin D.
Although there is less clinical research and less public information available to explain all the complex biochemical processes at work, there is evidence that adequate sunshine may play a role in regulating hormones, battling autoimmune diseases, perhaps even preventing cancer. Scientists know that the body’s endocrine system (the chemical-communication system that regulates our glands and hormones) is affected by, among other things, sunshine. Our pineal, pituitary, hypothalamus and adrenal glands all produce and regulate essential hormonal reactions within the body, and exposure to sunshine appears to play an important role in their integrated operation.
The problem is that many Americans may not get enough sun exposure to generate these potential vitamin-synthesis and endocrine-regulating benefits, both because we don’t spend nearly as much time outdoors as our ancestors did, and because most of us live too far from the equator. Studies have shown an interesting correlation, for example, between geographical latitude and the incidence of multiple sclerosis: The farther north of the equator you live, the more likely you are to develop it.
The more we hide from the sun in order to save our skins, the more we increase our odds of developing sunshine-based deficiencies. For one thing, certain skin conditions like psoriasis and acne have been shown to improve with sunshine. And although an excess of sun exposure is a notorious cause of skin cancer, apparently a lack of sun can pose its own cancer risks.
A recent article published in the journal Cancer found that cancer mortality rates for 13 types of cancers, including breast, lung, colon and bladder cancer, were inversely related to the amount of local solar radiation levels. In other words, the more ultraviolet (UV) light people with cancer received, the longer they lived.
Research also suggests that sun exposure may significantly reduce blood pressure. This is probably related to the body’s ability to absorb calcium, which is assisted by the presence of vitamin D. But some suggest it might also be an effect of sunlight’s positive impact on the endocrine system (which includes the stress-responsive adrenal glands).
Perhaps the best publicity that sunshine has received in recent years concerns its role in maintaining a healthy psychological and emotional state. Lack of sunlight has now been clearly associated with seasonal affective disorder, or S.A.D., which causes some people to experience symptoms of depression during the winter months. Treatment often involves light therapy, where people with S.A.D regularly expose themselves to artificial sources of ultraviolet light in order to help combat the condition.
Studies show that even brief exposure to ultraviolet radiation results in an elevation of mood. And even if you don’t have a full-blown case of S.A.D., sunshine can help you feel and function better in other ways. Some experts believe this is because when light from the sun enters your eyes, it triggers the hypothalamus, the brain gland that secretes the hormone seratonin. Seratonin plays a complex role in the body, helping to control moods and sleep patterns.
While the sun appears to play an important role in our health, there are, of course, proven drawbacks to getting too much of it. The primary concern is the damage the sun does to the structure of the skin.
“There’s no such thing as a healthy tan – at least not if it’s a real tan,” says dermatologist Debra Jaliman, M.D., a clinical instructor at Mount Sinai School of Medicine. “Any time you’re tanning the skin, you’re damaging it,” Jaliman insists. “We used to think that if you tanned and didn’t burn, you weren’t doing much damage, but now the research shows that you’re affecting the cells in the skin – the collagen, the elastic tissue, and the Langerhan’s cells [part of the body's immune system].”
Essentially, a tan is your skin’s biochemical reaction to ultraviolet light. The UVA and UVB rays in sunshine stimulate cells called melanocytes, which produce color. The initial color change is called immediate pigment darkening; a few days later, you’ll notice that your skin has become even darker, the result of delayed pigment darkening. If your skin is very fair, you may initially burn, and then notice darker skin when the sunburn fades.
Sun exposure can also trigger moles and what appear to be freckles. “If you get repeated sun damage where you’ve gotten bad burns, you’ll get what looks like freckling,” says Jaliman. “But it isn’t freckling – that’s really what we call solar lentigos, a more serious form of sun damage.”
The sun changes not only the color but also the surface and texture of the skin. With repeated exposure, it becomes more leathery – harder, rougher and more uneven. It may develop white spots or broken blood vessels as well as fine and deep wrinkling. None of the changes are good.
Doctors now realize that many of the surface changes we’ve attributed to aging are actually a result of sun exposure, says Jaliman. “If you look at the buttocks of a 90-year-old woman, the collagen and elastic tissue of that skin won’t be as good as a 20-year-old’s,” she explains, “but it also won’t have broken blood vessels, mottled discoloration or that leathery appearance you’d likely see on her face. None of that is from aging – it’s all sun damage.”
Weighing the Damage
While moderate sunshine appears to reduce the risk of some immune disorders, it is still a double-edged sword: Get too much sun and you may compromise, rather than enhance, your body’s ability to fight off disease. In support of this, many doctors point to the fact that many people with high amounts of sun exposure have a higher incidence of skin and other cancers.
Yet Dr. Mercola takes issue with this idea. “The traditional medical community has convinced the public that the sun is dangerous and that you need to avoid it entirely because of the risk of skin cancer,” says Mercola. “That’s a myth, in my view – a very dangerous myth that’s going to contribute to ill health in the long run.” Mercola maintains that it’s the intensity of the sun exposure and the incidence of sunburn that are the key factors in developing skin cancer. He also believes that an excess of omega-6 fats, like those found in many vegetable oils and animal products, predisposes people to developing skin cancer.
The clinical data on the sun’s relationship to skin cancer are somewhat contradictory. For example, the three most common types of skin cancers are grouped into three categories – basal cell carcinoma, squamous cell carcinoma and melanoma. While squamous and basal cell skin cancers are found most often on sun-exposed places like the head, neck, forearms and hands, the deadliest of the skin cancers – melanoma – is most prevalent on areas of the body that are generally covered. And while it appears that severe sunburns, especially during childhood and adolescence, do increase your risk of developing melanoma, some studies suggest that moderate tanning may actually provide a measure of protection against the disease.
All of these contradictions may lead you to think, “Damned if I do, damned if I don’t; I might as well get a decent tan.” Unfortunately, this is probably bad logic. Because the kind of sun exposure required to get truly bronzed is the same kind of exposure most likely to cause serious skin damage, your best bet is to try to get a moderate amount of sun without getting tanned – namely by getting outside for a few moments of sunshine first thing in the morning, when the angle and quality of light are ideal for revving up your circadian rhythms and catalyzing healthy brain-chemistry reactions.
Tanning Sans Sun
Okay, so you know it’s not wise to bake for hours in the sun, but you still want to show off a golden glow. Time to review your options: tanning booths and self-tanners.
Because tanning booths produce more UVA (so-called “tanning”) rays and fewer UVB (so-called “burning”) rays than sunlight does, you may be able to achieve a tan with less exposure, and experience less burning in the process. Tanning booths also make it easier to develop a very even, consistent tan. However, the booths’ concentrated rays are designed to penetrate deeper into the skin’s surface than natural sun, and they can damage more collagen and elastic tissue as a result. Plus, since you don’t get sunburned as easily in a tanning booth, you may brave the rays more frequently and more boldly than you would at the beach, possibly resulting in more damaging exposure overall.
Either way, your skin is likely to suffer. “There is no difference between overexposure from a lamp and overexposure from the sun,” says Mercola. “You have to be very careful with both.” Too much UVB exposure, regardless of the source, and you’ll become sunburned and increase your risk of skin cancer. A study published earlier this year suggested that the use of tanning beds may contribute to the incidence of basal cell carcinoma and squamous cell carcinoma, but the researchers couldn’t determine what effects factors like the frequency of tanning-lamp use or the amounts of UVA or UVB light might have on results.
Fortunately, if you’re looking for a sun-free tan, self-tanners offer another option. While they used to look embarrassingly artificial, they now offer a much more natural appearance. As a result, they’ve become very popular in the past few years and are currently offered by a wide array of cosmetics and skin-care manufacturers.
Self-tanners come in a variety of colors in both lotions and gels – usually the lighter formulations are easier to apply. Basic tips for the beginner: Exfoliate your skin to remove any dry patches before you apply it, and for a natural look, think about where the sun would hit your body (in other words, avoid getting it on your palms or the soles of your feet!).
Be forewarned: Self-tanners can be messy and time consuming to use. The good news is that self-tanners give you a chance to control the color of your skin. “Oftentimes the color you can make yourself with a self-tanner is prettier than the color you could make naturally,” says Jaliman. “Not everyone naturally turns a beautiful bronze color in the sun.”
The amount of ultraviolet radiation you receive daily depends on a number of factors, including how far north (or south) of the equator you live, the color of your skin, the cloudiness of the sky, the amount of pollution in the air, the time of year and whether you are wearing sunscreen. How you deal with that radiation depends on your skin type, your lifestyle and, to some extent, your personal health philosophy.
Most doctors agree that it’s smart to wear sunscreen on areas of your body that are chronically exposed. Over 20 years, they say, just 10 minutes a day of strong exposure can cause a lot of skin damage. But remember that even with sunblock, you’re still getting some UV light – there’s no perfect protection. And if you are a fair-skinned person using sunscreen to stay out longer than you know you should, you may be setting yourself up for cancer risks even if you aren’t burning.
Plus, in recent years there have been some concerns raised about the safety of chemical sunscreens. According to a study by the Institute of Pharmacology and Toxicology in Zurich, Switzerland, some commonly used ingredients – including benzophenone-3 (Bp-3), homosalate (HMS), 4-methyl-benzylidene camphor (4-MBC), octyl-methoxycinnamate (OMC), and octyl-dimethyl-PABA (OD-PABA) – are estrogenic substances that may be capable of causing endocrine disruption and reproductive problems. There is also some controversial evidence suggesting that certain chemicals in sunscreens generate free radicals, damage DNA and, yes, perhaps even contribute to skin cancer. If you are concerned about chemical safety, you may want to look into natural products that use titanium dioxide and zinc oxide to block rays instead. Also don a hat and long sleeves if you have to be out in strong rays for extended periods.
Finally, remember that if your skin looks pale or dull, the cause may not be a lack of sunshine but something else entirely. A healthy skin – whatever its hue or pigmentation – will have an underlying, luminous glow, and if that glow is diminished or missing, it’s likely your body needs more than surface attention. A buildup of internal toxicity, a nutritional deficiency, a lack of circulation or any of a host of other chronic health conditions may be to blame.
“Your skin provides a reflection of your health,” Jaliman asserts, noting that she once had a patient who complained that her friends kept making fun of her pallor and pasty complexion. “She was trying to get a tan to solve the problem,” says Jaliman, “but it turned out that she was anemic.”
Clearly, the sun is not a cure-all, but many indications suggest it’s also not the total villain we’ve been led to believe. Despite the bad rap the sun has taken over recent years, and the undisputed fact that too much of it will damage your skin, there are plenty of good reasons to enjoy a little daily sunshine, particularly during the early morning hours, which offer an excellent quality of light with fewer damaging rays.
It seems we’re just beginning to understand the vital role the sun plays in our health and well-being. In the meantime, instead of shunning the sun entirely or bronzing yourself to a crisp, consider a more moderate approach. By using common sense to balance the needs of your brain, your hormones, your skin and your emotional well-being, you’ll have the best chance of achieving optimal health – and the all-around radiant glow that comes with it.
Freelancer Kelly James-Enger writes about health, fitness and nutrition from Downers Grove, Ill. Her work has appeared in Self, Shape, Fitness, Marie Claire, Parents and Family Circle magazines. A self-admitted "very tan" former lifeguard, she now slathers on sunscreen before exercising outside. She can be reached at firstname.lastname@example.org.