Children sustain high levels of skin DNA photodamage, with a modest increase of serum 25-hydroxyvitamin D₃, after a summer holiday in Northern Europe

Abstract

Careful consideration must be given to the health outcomes of childhood solar exposure, and a much better understanding of the risk-benefit relationships of such exposure is required. Rigorous photoprotection is necessary for children, even in Northern Europe.

Sunscreen photoprotection and vitamin D status

“…Laboratory and modelling studies have shown that serum 25(OH)D can be increased with repeated suberythemal UVR exposure; such doses can be as low as four exposures of 0·375 SED over 24% BSA . A study of Polish children, who did apply sunscreen, on holiday by the Baltic Sea showed that daily borderline erythemal exposure results in a highly significant increase of serum 25(OH)D 3 . These studies suggest that vitamin D synthesis occurs with low UVR doses and therefore sufficient UVR may be transmitted through a sunscreen for vitamin D synthesis.…”

Vitamin D Update

“…These findings were attributed to the fact that high UVA sunscreen allows transmission of more UVB than low UVA sunscreen. Another very important study on sun exposure and vitamin D levels followed Polish children over 12 days at a Baltic Sea summer camp [31]. Relatively low daily UV radiation doses resulted in a modest but significant improvement in 25(OH)D (24%) but a very much greater increase in CPD (1162%).…”

Impact of high latitude, urban living and ethnicity on 25-hydroxyvitamin D status: A need for multidisciplinary action?

“…However many skin experts suggest that all sun exposure is detrimental, even very short exposures, due to the cumulative effects of radiation exposure to the skin. One recent study suggested increased skin damage in children after exposing skin to the sun on holiday in Northern Europe [81], but this study has been criticised as the children were exposed to 6-7 hours of sun a day, which is far greater than that needed for adequate vitamin D synthesis, and use of sunscreen after an initial short period of unprotected skin exposure around noon would have reduced the skin damage but still have the benefit of producing vitamin D (commentary by Webb [82]. The subjects were also relatively vitamin D sufficient so would not be expected to make large gains in vitamin D status [82].…”