This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Results of a Randomized Controlled Trial

Robin Marks, MBBS, MPH; Peter A. Foley, MBBS, BMedSci; Damien Jolley, MSc(Stats), MSc(Epidemiol); Kenneth R. Knight, BSc(Hons), PhD; Josephine Harrison, BApplSci; Sandra C. Thompson, MBBS, MPH, PhD, BMedSci

Arch Dermatol. 1995;131(4):415-421.

Abstract
Background and Design
Studies published have suggested a possibility that regular use of sunscreen to prevent skin cancer may put the population, particularly elderly people, at risk of vitamin D deficiency. We aimed to determine whether regular use of sunscreens in the normal adult population, as recommended by public health authorities for the prevention of skin cancer, may put individuals at risk of vitamin D deficiency. A randomized double-blind control trial of the daily use of a broad-spectrum sunscreen (sun protection factor [SPF] 17) vs placebo cream over a summer period in Australia was conducted in 113 people aged 40 years and over, with sampling stratified by age. All participants had at least one solar keratosis. Serum samples taken at the beginning and at the end of the study were analyzed for 25-hydroxyvitamin D3 and 1,25-dihydroxyvitamin D3.

Results
Mean levels of 25-hydroxyvitamin D₃ rose significantly by the same amount in both groups over the period of the study (placebo, +12.8 mmol/L; sunscreen, + 11.8 mmol/L). Mean levels of 1,25-dihydroxyvitamin D₃ increased significantly in the pla- cebo group only (placebo, +10.8 pmol/L; sunscreen, +1.3 pmol/L), but for no subject in either group was the level of 1,25-dihydroxyvitamin D₃ outside the reference range either at the start or at the end of the study. There were no significant differences by age, sex, and skin type in the change in 25-hydroxyvitamin D₃ or 1,25-dihydroxyvitamin D₃ over the study period.

Conclusions
No person, including those aged 70 years and over, developed any vitamin D levels outside the normal reference range during the period of the study. The data suggest that over an Australian summer sufficient sunlight is received, probably through both the sunscreen itself and the lack of total skin cover at all times, to allow adequate vitamin D production in people who are recommended to use sunscreens regularly. More work is required to elucidate the relationship between 25-hydroxyvitamin D³ and 1,25-dihydroxyvitamin D³, particularly during the different seasons of the year.

(Arch Dermatol. 1995;131:415-421)

Author Affiliations
From the Departments of Dermatology (Drs Marks, Foley, and Thompson) and Chemical Pathology (Mr Knight), St Vincent's Hospital, University of Melbourne, Fitzroy, Victoria; Anti-Cancer Council of Victoria, Carlton (Dr Marks and Mr Jolley); Department of Chemical Pathology, Heidelberg (Victoria) Repatriation Hospital (Ms Harrison); and Health and Community Services Department, Melbourne, Victoria (Dr Thompson).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Editorial: Photoprotection: does it work?
Ilchyshyn et al.
Lupus 2008;17:705-707.
 

Vitamin D Deficiency in Children and Its Management: Review of Current Knowledge and Recommendations
Misra et al.
Pediatrics 2008;122:398-417.
ABSTRACT | FULL TEXT  

Sunlight exposure assessment: can we accurately assess vitamin D exposure from sunlight questionnaires?
McCarty
Am. J. Clin. Nutr. 2008;87:1097S-1101S.
ABSTRACT | FULL TEXT  

Point: Sunscreen Use Is a Safe and Effective Approach to Skin Cancer Prevention
Green and Williams
Cancer Epidemiol. Biomarkers Prev. 2007;16:1921-1922.
FULL TEXT  

Cutaneous Malignant Melanoma
Cummins et al.
Mayo Clin Proc. 2006;81:500-507.
ABSTRACT | FULL TEXT  

COMMENTARY: Nutritional Rickets in Georgia
Tomashek et al.
Pediatrics 2001;107:e45-e45.
ABSTRACT | FULL TEXT  

Sunlight and health
Marks et al.
BMJ 1999;319:1066-1066.
FULL TEXT  

Are we really dying for a tan?
Ness et al.
BMJ 1999;319:114-116.
FULL TEXT  

The Case for Sunscreens: A Review of Their Use in Preventing Actinic Damage and Neoplasia
Naylor and Farmer
Arch Dermatol 1997;133:1146-1154.
ABSTRACT  

Regular Use of Sunscreen on Vitamin D Levels
Holich et al.
Arch Dermatol 1995;131:1337-1338.
ABSTRACT  

Regular Use of Sunscreen on Vitamin D Levels-Reply
Marks
Arch Dermatol 1995;131:1338-1339.
ABSTRACT