Summer is coming :) For anyone out there already dealing with skin damage and/or basal cell carcinoma, will you change your sun exposure habits, wear sunscreen or avoid the sun altogether and just supplement D?
At 39 years old, I have already had three BCCs removed from my back along with several other skin issues from sun exposure. I used to have a tanning bed and spent many hours sunbathing outdoors as well. I have had sunburns in my life (Scottish descent, brown hair/eyes, naturally pale with freckles but I do tan well with measured exposure). My dermatologist of course thinks any sun exposure is certain death and wants me to never walk outdoors again in my life without full sleeves/pants/hat and SPF of 1,000,000 slathered all over my body. Okay I am sure you can tell by my attitude that I am really not happy about decreasing my sun exposure.
Being paleo now for a year and supplementing with Vit D all winter (very low fructose and PUFA), I do not burn until I have been exposed outdoors for 45 minutes (used to be about 15 minutes). So I am thinking that nature knows best and that even for sun-damaged people like me it is okay to be in the sun for a little less than the amount of time it takes to turn pink. I'm planning on 1 hour of outdoor sun measured over the course of a week in a bathing suit or shorts, wearing a hat with SPF 30 on my face, neck and chest. No tanning beds. I would like to get more time in the sun than that, but there is such conflicting information out there that I guess I will be a little more cautious than I prefer and re-evaluate next year after examination by the derm.
To tell the truth this has been on my mind a LOT lately. At age 19 I was diagnosed with a malignant in situ melanoma. On one hand, in the years since I've been faithfully to see a dermatologist on a 6 month (or even more frequent) schedule to check for moles and abnormalities. I was always lauded enthusiastically - "I see you've done a great job staying out of the sun!" they'd exclaim.
ETA: I'm a northern European mutt, generally Germanic and British Isles origin, exceedingly fair skin, coppery hair, light blue eyes, classic melanoma phenotype profiling. Redheads in my family, and melanoma has shown up in the family tree, so it would seem that it is all but predestined by heredity.
Yet now? I'm slowly coming around to the idea that being a total hermit during the summer until twilight hours may not be the best for me or my family inasmuch as our vitamin D deficiencies may contribute to other health problems long term.
Even in a recent podcast Robb Wolf seemed slightly reticent to tell a melanoma survivor to go whole hog on sun exposure; he generally recommended very moderate exposure, just a bit at a time.
My current take (though it's always changing) is to not worry about 20 minutes here, 30 minutes there of sun, and only do high SPF sunscreen on myself and my girls if we'll be out at least an hour.
I'm just sort of dreading the dermatologist's admonition the next time I head into the office (which will be August or September) - in terms of me looking potentially less than my baseline shade of ghastly.
Any melanoma survivors out there reading this thread? How are you planning to do sun exposure (if any) this summer?
Good for you for standing up to your doctor!
That's very interesting about the vitamin D. Is there any scientific evidence that this helps, or are we still pioneering?
I haven't ever had melanoma, though I figure I am at high risk. I suspect I am genetically unable to tan (Scots/Irish/English mix), but my burn rate also seems to have gone down since I started ZC. I'm still hoping I can tan a bit eventually, just for the protection it provides.
I've started oiling myself with coconut oil, because some places suggest it mitigates burns, although I can find no hard evidence, and also CW says oils actually intensify the sun. I've already been burned mildly so far this Spring, but it's so mild, that it almost doesn't seem to me like a burn -- just pinker skin that stays whitish for a few seconds when pressed, but it doesn't last long or cause discomfort.
I'm also trying to get frequent exposure. I live at high altitude, though, and the sun can be very intense.
I do tend to shield my face, because sun triggers my rosacea. Sometimes I'll even put sunscreen on this area.
I think one important point to remember is that you don't live where your ancestors did. Houston in Texas is on about the same latitude as Cario in Egypt. If your ancestors were Egyption instead of Scottish you would be unlikely to have pale skin and freckles and would be at a lower risk of sun damage. It may not be "natural" for you to be able to spend long periods in the Texan sun without accumulating skin damage whatever your diet. Pale skin is a trake-off between reduced protection and maximising reduced sun exposure.
I live in Scotland and getting enough sun exposure for a sun tan is often not easy and it is rarely warm enough to be outside in a bathing suit :)
If you are fair skinned with freckles the amount of time it takes to produce vitamin D is quite short. 15 minutes may produce as much as you are going to make in a place like Texas. Spending a long time in the sun is unlikely to bring any additional benefits and will only acculate extra damage. Just because you are not burning does not mean damage is not occuring.
If you have already had three basal cell carcinomas it suggests that you are rather vunerable to sun damage. I would be cautious about extended sun exposure beyond what you need to get some vitamin D. You could get your brief sun exposure and then cover up and wear hat etc.
20 min a day half naked--10 min a side--makes enough Vit D naturally. I know one person who has been doing this for a year...who used to have to visit the dermatologist every 3 months to have lots of the BCCs frozen off. Now he has a nice tan and no BCC. It seems either supplementation or 20 min a day eliminates the BCCs.
Because I am very vain in regards to my skin, I do protect fairly meticulously with high PPD european sunscreen containing both tinosorbs. Last summer, I made some exceptions to that rule and would, midday, in a bikini, get sun exposure "both sides" to the point just before a burn would occur. At first this was about 25 minutes each side (in atlanta) but as the summer wore on it could be as much as 1h45m each side (in michigan at the beach). On days I didn't get midday exposure as described above, I would take my normal 6,000 IU per day which is an amount that for me, with daily intake, results in levels of 65 ng/mL. And I've tested many many times over the last 7 years.
Oddly enough, even with probably 4-5 days exposure plus supplementation as outline above, my D level FELL 18 points over the course of 3 months.
Just always test, test and retest.
With a very low PUFA/fructose diet that is rich in zinc, plants and with optimal serum levels of vitamin D, personal, my concern regarding skin cell abnormalities (and cancer) would be very low.