“Dr. Sadaty, what a great tan!!!”
To Sun, Or Not To Sun – That Is The Question
“Dr. Sadaty, what a great tan!!!” This is a frequent comment my patients share during their summer appointments with me. And this summer is no different.
Admittedly, I do not use sunscreen on my body and play outdoor tennis in the midday sun. Initially, I was a bit sheepish about admitting this to my patients, as it flies in the face of religious and obsessive sunscreen application rampant among most of my friends, by the majority of people at large, and the medical community!
I know how I feel when I am tanned. My mood is better. I feel healthier and more vibrant. I look fabulous in orange. I inherently feel that this is better for me than avoiding the sun while bathing in a clown-face makeup layer of SPF 500. So, I did the research, and what I found was not quite an “I told you so” — but more a listen to your inner voice.
Medical studies comparing tanned individuals (those with high sun or UV exposure) and non-tanned people (sun-avoiders) reveal a complex medical paradox: while tanned individuals face higher risks of local skin damage and skin cancer, large-scale population studies show they paradoxically have a lower rate of all-cause mortality (overall death) than those who largely avoid the sun. Why the distinction? One explanation is that the localized dangers of ultraviolet (UV) radiation to skin damage do not outweigh the systemic benefits of sunlight.
WHAT ARE THE RISKS OF SUN EXPOSURE?
Skin Cancer and Melanoma Risk:
Dermatological studies show that a tan is a sign of cellular injury. When UV rays hit the skin, they can cause DNA damage. The skin’s increase in melanin production acts as a defense mechanism to prevent further mutation. An overwhelming 92% of melanomas are directly linked to UV exposure. According to data compiled by the Skin Cancer Foundation, using tanning beds before the age of 35 increases your risk of developing melanoma by 59%.
Premature Aging :
Non-tanned individuals have significantly lower rates of skin aging. UV exposure breaks down collagen, leading to coarse wrinkles, leathery texture, and solar skin damage like spots and keratotic lesions. Not a great look for those concerned about looking younger. Which is why I DO wear sunscreen on my face and neck.
While the localized risks of tanning are clear, broad epidemiological data introduced a massive shift in how researchers view sun exposure.
WHAT ARE THE BENEFITS OF SUN EXPOSURE?
The All-Cause Mortality Paradox
While the localized risks of tanning are clear, broad epidemiological data introduced a massive shift in how researchers view sun exposure. The Landmark Swedish Study: A famous 20-year prospective study of 29,518 women — known as the Melanoma in Southern Sweden (MISS) cohort found that all-cause mortality was inversely related to sun exposure. Researchers concluded that women who actively sunbathed and had tanned skin had a lower risk of death from cardiovascular disease (CVD) and non-cancer related chronic illnesses compared to sun-avoiders.
How big was this risk reduction?
For women in low-sun exposure regions, avoiding the sun entirely was a risk factor for death of a similar magnitude to smoking cigarettes. Sun-avoiders had a life expectancy 0.6 to 2.1 years shorter than those with the highest sun exposure.
Researchers emphasize that the benefits are driven by controlled sun exposure, not the tan itself. The systemic health benefits seen in women who spend time in the sun include:
- Cardiovascular Health Benefits: Sun exposed women had overall lower blood pressure and reduced risk of blood clots and stroke. Sunlight triggers the skin to release nitric oxide into the bloodstream, which dilates blood vessels.
- Metabolic Health: Lower incidence of metabolic issues such as Type 2 diabetes. UV rays improve insulin sensitivity and modulate systemic inflammation.
- Optimal Vitamin D Levels: UVB rays interact with cholesterol in the skin to produce Vitamin D, crucial for bone and immune health. Note that clinical trials of oral Vitamin D pills fail to replicate these systemic benefits. This indicates that sunlight produces independent, non-vitamin compounds in the skin that pills cannot mimic.
Studies draw a strict line between how a person gets a tan. A study tracking Swedish women published in Cancer Epidemiology, Biomarkers & Prevention found that while natural solar UV exposure was associated with reduced mortality, artificial UV exposure (tanning beds) was strictly linked to increased overall mortality and cancer risk. Tanning beds deliver highly concentrated UVA radiation without the balanced benefits of natural sunlight.
What does this mean about sun avoidance vs sun embracing?
The modern medical consensus is moving away from absolute sun avoidance toward sensible, non-burning sun exposure. You can get the health benefits of the sun without damaging your skin or seeking a dark tan. Of course a dark tan is relative. Most individuals can synthesize ample nitric oxide and Vitamin D within 15 minutes (for lighter skinned individuals) or 30 minutes (darker skin types) of daily midday sun exposure on skin WITHOUT applied sunscreen — well before the skin burns or changes color.
Where do we go from here?
Well I don’t know about you, but I’m going to the tennis court sans goopy sunscreen. A tastefully thick layer on the face and neck for anti-aging protection but otherwise – I’m going to bask in the vitamin D boosting, heart disease reducing, all cause mortality drop of a sun filled afternoon!
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Ready for the legal disclaimer? Information offered here is for educational purposes only and does not constitute medical advice. As with any health recommendations, please contact your doctor to be sure any changes you wish to consider are safe for you!
Mental Health Hormones Doctor Anita Sadaty Share The Health board certified gynecologist New York Functional Medicine NY Women’s Wellness