Sunshine Health Foundation
What Should I Do?
Updated: Oct 3, 2022
The first thing everyone should do is get a vitamin D test. This is a standard blood test that you should be able to get from your health provider. You can also buy a home test on the internet (google “home vitamin d test”). The science today indicates that 30 ng/mL (nanograms per milliliter) is sufficient. You should note, however, that humans today that are still living a pastoral outdoor lifestyle have 46 ng/mL, so perhaps something greater than 30 ng/mL might be beneficial.
If you have 30 ng/mL or more, you are probably OK. 30% of all Americans are in this category. You probably don’t need any more sun exposure than what you are currently getting.
If you have less than 30 ng/mL, you are in trouble. 70% of Americans are in this category. The further you are below 30 ng/mL, the more trouble you are in. In addition to spending more time outside, you may also need some deliberate sunbathing.
If you are pregnant or planning to be pregnant it is especially important for you to have at least 30 ng/mL. Click HERE for Special Message to Women Who are Pregnant or Planning to Become Pregnant.
All humans evolved under the sun. Everyone developed just the right amount of melanin in their skin to perfectly balance the risks of sun exposure (sun burns and skin cancer) against the benefits of sun exposure (all the benefits described on this website). The sun’s rays are strongest at the equator and get progressively weaker the closer you get to the North Pole or the South Pole). Melanin, which is produced in the skin by sun exposure, absorbs some the photons from the sun. The more melanin you have in your skin, the more photons are absorbed by your skin.
So, people who evolved near the equator have lots of melanin in their skins to deal with the powerful equatorial sun (absorbing enough of the sun’s rays to protect against sunburn and skin cancer, but not too much to block the beneficial effects of sunlight) and people who evolved at higher latitudes have lesser amounts of melanin in their skins to absorb just enough of the sun’s rays to maintain the balance between the risks and benefits of sun exposure. Melanin makes the skin darker, so people with larger amounts of melanin in their skins have darker skins and people with smaller amounts of melanin in their skins have lighter skins.
This is why when white people were moved from Britain (latitude 50-59) to Australia (latitude 15-35) they got a lot of skin cancer and when black people were moved from central Africa (latitude 0) to the United States (latitude 30-45) they had no worries about skin cancer but suffer more of the ill effects of insufficient sun exposure than their white counterparts.
The reasons why 70% of Americans (including millions of people with white skins) have insufficient sun exposure include the migration of the workforce from outdoor work to indoor work, the increased indoor attractions of air conditioning, television, video games and the internet, and the tragic incorrect sun avoidance advice from government health agencies and the healthcare community in general. These problems affect Americans of all skin colors, but Americans with darker skins suffer additionally from fact that the amount of melanin in their skins is ill suited for the high latitudes of the United States. That is why, while 70% of all Americans suffer from insufficient sun exposure, that breaks down by skin color to 62% of White Americans and 95% of Black Americans
The amount of additional sun exposure you need and the best method for getting it depend on how far your vitamin D test is below 30 ng/mL and the color of your skin. Keep in mind the importance of avoiding sunburns and the fact that the benefits of sun exposure come mostly between the hours of 10 a.m. and 2 p.m. when sunlight is the most powerful. The best time to get your sun exposure is at “solar noon” when the sun is highest in the sky since this is when sunlight is most powerful. It is better to get your dose of sun exposure in a short amount of time from powerful sunlight than in a longer amount of time from weaker sunlight. Dose equals power multiplied by time.
Always wait at least 24 hours between deliberate sun exposures to give your skin time to adapt.
Your body has a warning system that you should pay close attention to. If your skin turns just a little bit red 24 hours after your sun exposure, this is called erythema and it is a warning that you are getting too much sun, so wait for the redness to disappear before getting any more sun exposure and lower the amount of your sun exposure the next time below the amount that led to the erythema, and then make sure again that your skin has not turned the least bit red after 24 hours. It takes about twice as much sun exposure to get a sunburn as it does to get erythema, so erythema is a good warning sign.
The different colors of people’s skins have been standardized in the so-called Fitzpatrick Skin Types.
Type 1. If you have Type 1 skin, your vitamin D level is very likely to be above 30 ng/mL because the lighter your skin is the easier it is to manufacture vitamin D from the sun. If you are below 30 ng/mL, you are going to have to be very careful in getting your sun exposure in order to avoid burning. You should be able to get enough sun exposure to get your level up to 30 ng/mL by just spending a little more time outside. If that doesn’t work and you think you need some deliberate sun exposure, walk out in the direct sunlight at mid-day for for 5 minutes with arms and/or legs exposed and then wait 24 hours to see if you get erythema. If you don’t, do 10 minutes the next day and then gradually and very carefully increase your time in the sun making sure all the time that you don’t get erythema, much less get burned. You should never sunbathe. With red hair and very light skin you are at higher risk for sunburn and therefore melanoma than other people. But don’t get so scared of sun exposure that you fail to maintain your serum 25(OH)D level at 30 ng/mL or higher – the overall risk of melanoma is low, with about 110,000 cases estimated for 2022 in the U.S. out of a population of 333,000,000.
Type 6. If you have type 6 skin and your vitamin D level is a lot less than 30 ng/mL, you are probably going to have to do some sunbathing (perhaps a lot of sunbathing) to get the sun exposure you need to get your level up to 30 ng/mL. Persons concerned about getting too much sun on their faces can simply wear a hat or cover their faces with a white towel. The health benefits of sun exposure are proportional to the area of the body exposed to the sun, so covering your face is OK if most of the rest of the body is exposed. You get the most out of your time in the sun by sunbathing at solar noon with your exposed skin perpendicular to the sun’s rays. Solar noon is when the sun is highest in the sky and most powerful. You can find out what time of day this occurs in your location by googling “solar noon in [your location].” It is unlikely (but not impossible) for persons with Type 6 skin to get burned. You can probably start out with one hour of deliberate sun exposure, and check to see if that starts any skin reddening 24 hours later, and then increase your time from there.
To check on how you are doing, get a vitamin D test from time to time. At latitude 35 degrees (Washington, D.C. is 39 degrees, Atlanta is 34 degrees, Dallas is 33 degrees and Los Angeles is 34 degrees), most Black Americans should be able to increase their 25(OH)D levels to 30 ng/mL during the months of March to September with less than an hour of sun exposure daily (more is required at higher latitudes and less is required at lower latitudes). Fortunately, Black Americans are unlikely to get skin cancer, since the higher melanin level in their skins that makes it harder for them to get the health benefits from sun exposure also gives them more protection against skin cancer.
Types 2-5. You are in between 1 and 6, and your sun exposure should be in between what is best for 1 and 6. Start with just a little deliberate sun exposure (10-15 minutes) in short sleeves and shorts and gradually build up, making sure to avoid sunburn. Resort to sunbathing only if necessary to get your vitamin D level up to 30 ng/mL. If you develop a tan, you can spend more time in the sun without burning. The darker your tan is, the more protection it gives you against sunburn. Click HERE for SPF of a Tan.
Needless to say, when you are getting the sun exposure you need for good health, don’t put sunscreen or anything else on your skin. But, be super careful and always remember that for all people of all skin types, it is critically important to avoid getting sunburned.
With regard to all of the above, remember that
We are not medical doctors.
We are not medical doctors. Our statements above and elsewhere on this website are our opinions of the current state of the science on sun exposure and human health and are not intended to be medical advice, should not be viewed by you as medical advice, and are not medical advice. You should consult your medical doctor before obtaining sun exposure. The Sunshine Health Foundation specifically disclaims all responsibility for any liability, loss or risk, personal or otherwise, which is incurred as a consequence, directly or indirectly, of the use and/or application of the above or any other contents of this website.