Rebuttal to Outside Magazine’s Piece “Is Sunscreen the New Margarine?”

This is my rebuttal to an article called “Is Sunscreen the New Margarine?”, by Rowan Jacobsen. You can find here on Outside Magazine.

6 Reasons Why You Should “Junk” this Article Now

Outside Magazine, in my opinion, you’ve just done significant harm to your readers, some of whom will believe this piece, which reads with a conspiratorial tone. I have been a 30+ year outdoor exerciser (running, cycling, hiking, open water swimming, skiing) and happen to be a dermatologist. There are a lot of skews or misinterpretations of data in this piece. Below are the main ones.
For starters, can we all agree that moderation and common sense in almost everything is good thing? No dermatologist is telling their patients to go live in caves. And no dermatologist is telling patients, “Don’t go outside, you might die.” (Did Dr. Weller actually attribute this to dermatologists or was it the author who did?)

1. High Blood Pressure

The author says that, “It is already well established that rates of high blood pressure, heart disease, stroke, and overall mortality all rise the farther you get from the sunny equator,”. Below is the World Health Organization (WHO) data documenting the opposite of this statement. https://www.worldlifeexpectancy.com/cause-of-death/hypertension/by-country/
If the sun was a major deterrent of high blood pressure, the sunniest countries would have the lowest rates of hypertension. Clearly not the case as demonstrated in the table above. You can Google a similar table for heart disease. Nutrition, physical activity, a healthy BMI, smoking, and access to health care, are significantly more important.

2. Melanoma Skin Cancer

Melanoma is the potentially fatal form of skin cancer. It is clearly sun related because worldwide the highest rates are in the sunniest areas who have the most lighter skinned people living in them – like Australia. It is the second most common cancer for young adults aged 15-29. The American Cancer Society estimates there will be approximately 7,500 deaths from melanoma in the U.S. alone in 2019.

3. Basal Cell Skin Cancer

It’s true that usually basal cell carcinoma won’t kill you. But who wants the disfigurement, discomfort, and time commitment of multiple surgeries? Especially when most of these cancers occur on the face, neck, and chest. There were 4.3 million cases diagnosed in the U.S. last year.

4. Vitamin D

Yes, there is a lot we don’t know about vitamin D. Ongoing research should help us. But remember, for thousands of years those in northern, cloudy climates have been supplementing vitamin D with food. Oily fish like salmon, herring, cod liver oil, etc. have high amounts of vitamin D. Some vegetables contain it as well. If supplements make you nervous, just eat your vitamin D in food. That may be better anyway.

5. Skin Cancer Risks

This author fails to address risk groups in a balanced way. Darker skin types have less risk for skin cancer and lighter ones more. We’ve all known this for years. Many patients with darker skin use sunscreen not to prevent skin cancer, but to keep from developing uneven skin pigment. And the fact is that everyone could lay out nude in Boston for 6 hours in the winter, and still not make much vitamin D. The sun just isn’t strong enough that time of year because we are too far from the Equator.

6. Sunbathing

Could it be that sunbathers have slightly lower blood pressure because in general they are a younger, more fit, lower BMI group than non sunbathers? Maybe they are more “chill?” Many of us find sunbathing incredibly boring. When trying to support his contention that sunbathers live longer, this was the link the author quoted http://www.ncbi.nlm.nih.gov/pubmed/26992108 . After reading this study, instead of just looking at the abstract, you find that they only looked at sun exposure, age, smoking, education, marital status, and disposable income as co-factors. What about BMI, nutrition, diabetes, exercise, access to health care, etc. as significant factors for mortality? These are all factors which have a much stronger effect on mortality than level of sun exposure does. In fact, the Outside article addresses skin cancer only halfway through, giving the prominent position to hypertension and heart health, which are much more dubiously linked to sun exposure. So we are asked to believe that sun exposure has a serious effect on heart health, but that vitamin D doesn’t necessarily play a part in that. This leaves no currently scientific pathway for us to understand the heart health/ sun exposure connection, which leaves me skeptical.

While research is still ongoing, I for one will be outside with my hat or helmet and sunscreen on, eating fish, and taking vitamin D.

For full disclosure, I have no financial ties or interests in any companies that make sunscreen.

Hope this helps,

Dr. Brandith Irwin
Founder, SkinTour
Director, Madison Skin & Laser Center
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Dr. Brandith Irwin, MD

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Hi, I’m Dr. Irwin. I believe that consumers deserve a medically trained and unbiased skin care advocate.

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