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We humans have become a bit unnatural in our behaviour. Many thousands of years ago we evolved as a naked ape, standing upright on our specialised lower limbs, with weird feet that look pretty unlike our primate cousins’. We spent our brief lives wondering around the savannahs of Africa, with pigmented skin to protect us from being totally fried by the sun and stopping us getting skin cancer. Some humans migrated north wondering around the plains of Europe and Asia where darker skin was less important to stop us getting skin cancer and became a problem for another reason- sunlight was required for vitamin D because low vitamin D gives children the bendy-bone disease called rickets.
Vitamin D comes from two sources, diet and the effect of sunlight on the skin. We need vitamin D to keep our bones strong as we get older, and also to strengthen the immune system and reduce our chances of getting ill. We know that people with low vitamin D are much more likely to suffer serious bone fractures when they’re older. Primitive Homo sapiens mostly ate seeds and berries, with only occasional meat or fish- probably not enough to supply adequate vitamin D. But he or she did wonder around outside naked and only lived about 30 years.
These days we cover our bodies with clothes, spend most of our time inside, and generally protect ourselves from the sun. Our skin production of vitamin D is way lower than it could be and there is a huge epidemic of vitamin D deficiency. This includes the London Dermatologist, whose vitamin D was ‘in his boots’ as we doctors like to say. Now we could all start wearing budgie-smugglers and bikinis and hold clinics, job interviews, movie showings and luncheons in the local park. But the problem is because we now live until our 80s, if we did this, unfortunately our skin would just give out. Skin cancer is four times commoner now than it was 40 years ago, and is the commonest cancer in the world. Dermatologists are seeing way more sun damage, skin ageing and precancerous and cancerous skin change in their patients.
So what should we do? The answer is really simple. Replace vitamin D with diet and oral supplements. This can be done naturally with foods that are high in vitamin D such as liver and fish or perhaps even better fish oils or fish oil capsules. But probably the most reliable way is to take vitamin D capsules either 1000 international units a day, or if you are properly deficient, which can be checked with a simple blood test, 20,000 international units (one capsule) once a week. Health Education England now recommends every single adult in the UK should take 1000 international units of vitamin D from October to March, when skin production is really low.
So to protect your skin, that wonderful organ that keeps you hydrated, warm and protected from infection, combine vitamin D supplements with sensible sun protection. Do not burn and when you are on holiday try to come back as close as possible to the colour you were when you left. That’s right, most people need a frameshift of thought when it comes to skin health. As far as your skin is concerned there is no such thing as a healthy tan. Remember, your skin has to last you decades.
Oh and by the way, since taking the supplements, London Dermatologist is still pale and (slightly) interesting, but has normal vitamin D, and his achy knee has completely settled.
All the best
The London Dermatologist