Why Australia Doesn’t Agree with the U.S. “One Size Fits All” Approach to Sunscreen Use
In the United States, many experts believe that everyone should use sunscreen on a daily basis. According to the American Academy of Dermatology, everyone should use sunscreen because, “People of all skin colors get skin cancer. More than 3.5 million skin cancers in more than 2 million people are diagnosed annually. Many of these skin cancers could have been prevented with protection from the sun’s rays.”
But Australia, a country that has one of the highest rates of skin cancer deaths in the world (Australia is ranked 4th – the U.S is ranked 29th for all skin cancers and is has the highest rate of melanoma) believes “for most people, sun protection to prevent skin cancer is required when the UV index is moderate or above.” The use of sunscreen, however, should be balanced with the need for Vitamin D, which is produced in the body when exposed to the sun. Their recommendations state, “Some groups in the community are at increased risk of vitamin D deficiency. They include naturally dark skinned people…they could safely increase their sun exposure.”
Australia doesn’t have a “one size fits all” recommendation for the use of sunscreen, protective clothing or seeking shade during daytime hours. They do believe this is important and have developed a UV alert system. When the UV radiation levels are 3 or above, most people, including fair skinned people, should use sunscreen. This alert system is posted in daily newspapers, on the Bureau of Meteorology website, announced on some radio stations and available on smartphones via an app.
Despite the constant monitoring of the UV index and warning their citizens to protect their skin, Australia believes that some people, such as people of color, would benefit more from higher exposures to the sun and therefore, higher levels of vitamin D. According to an article by Jessica Seigel on Nautilus, “America is Getting the Science of Sun Exposure Wrong,” this change has come about because science has shown that vitamin D offers many health benefits, including lower rates of cancer and autoimmune diseases. Research on melanoma and other skin cancers has also narrowed down who is most at risk of skin cancer, such as those with blonde or red hair or those with multiple moles on the legs. Seigel explains that some research has shown that daily exposure to the sun can protect against burning and that those who work indoors and have intermittent tans based on the season actually have a heightened risk of developing skin cancer.
Based on this research, Australia, along with New Zealand and Britain have revised their recommendations based on skin color and the sun’s strength at different times. This, they believe, provides protection against deficiencies in vitamin D in dark skinned individuals and those who don’t get regular sun exposure, such as those who cover their body for religious or cultural reasons.
But experts in the United States don’t believe in this approach. Dr. Brett Coldiron, President of the American Academy of Dermatology, wrote a letter to the editor of Nautilus, expressing, “serious concerns” about the article citing studies that have found DNA damage from even low-level exposure to UVA and UVB rays in all populations. Coldiron further wrote that most people still produce enough vitamin D, even with the use of sunscreen and for those who are deficient, diet and supplements can help. Everyone, regardless of ethnic background, should use sunscreen to protect themselves from the sun’s rays, Coldiron states. In addition, he asked that the editor correct misinformation in the article.
The Nautilus, however, is standing by its article. Dr. Michael Segal, Editor in Chief of Nautilus, responded, explaining that that the article gives a “balanced view of the risks and rewards of sun exposure…”
Both the Nautilus and the American Academy of Dermatology agree on one thing. Education is important. Each person needs to understand the risks involved in over exposure to the sun. Each person needs to understand the benefits and the need for sufficient vitamin D levels. Your doctor can determine whether you are deficient in vitamin D and develop a treatment to raise your level within the normal range. At this time, recommendations in the U.S. remain that everyone should protect their skin by using sunscreen with at least 30 SPF every day, use protective clothing and seek shade between the hours of 10:00 A.M. and 4:00 P.M.