AAD letter to the Atlantic in response to “Against Sunscreen Absolutism”

American Academy of Dermatology President Seemal R. Desai, MD, FAAD
Letter to the editor originally submitted to the Atlantic on May 17, 2024

ROSEMONT, Ill. (Nov. 8, 2024) — On behalf of the American Academy of Dermatology and its 21,000 members, I am writing to express serious concerns about your recent article, “Against Sunscreen Absolutism.” This article contains misleading information that may discourage the public from using sun protection, thereby increasing their risk of skin cancer.

Skin cancer is the most common cancer in the U.S. It is estimated that one in five Americans will develop skin cancer in their lifetime and nearly 20 Americans die from melanoma, the deadliest form of skin cancer, every day.

Scientific research shows that unprotected exposure to ultraviolet rays is a major risk factor for skin cancer. Since exposure to the sun’s harmful UV rays is the most preventable risk factor, it’s important that everyone protect their skin from the sun. To effectively do so, the Academy recommends that people seek shade when appropriate, wear sun-protective clothing, including a lightweight and long-sleeved shirt, pants, a wide-brimmed hat and sunglasses, and apply a broad-spectrum, water-resistant sunscreen with an SPF of 30 or higher to all skin not covered by clothing. Importantly, it should be noted that the Academy’s position on sunscreen was misrepresented in this article. While we say, "You should apply sunscreen every day to skin not covered by clothing if you will be outside," we do not recommend that “everyone but infants wear sunscreen every day, regardless of the weather.”

The truth is that there is no level of sun exposure that enables the body to produce ample vitamin D without increasing the risk of skin cancer. While vitamin D is crucial for bone health, there isn't enough evidence to support its impact on reducing the occurrence of other diseases such as certain cancers, neurological conditions, infectious illnesses, autoimmune disorders, or cardiovascular issues. The National Academy of Medicine, formerly the Institute of Medicine (IOM), concluded that the evidence linking vitamin D status to health benefits beyond bone health was inconsistent, lacked conclusive proof of causality, and was insufficient to determine nutritional requirements. The Academy supports advancing research and continuously evaluates its positions according to the latest scientific evidence.

Your article references a 2011 clinical trial that found vitamin D supplementation noted “no benefits whatsoever had been found for any of the health conditions that the study tracked.” The author’s conclusion drawn from this study is misleading. The study showed that vitamin D supplements did not protect people against a number of diseases, but the study was not designed to address whether vitamin D obtained from sun exposure would have protected against the development of these diseases.

AAD member dermatologists see the effects of skin cancer every day, and UV exposure is the most preventable skin cancer risk factor. And while we acknowledge the dangers of unprotected sun exposure, we don't want the public to feel intimidated by the sun or limit their outdoor activities. Our aim is to encourage the public to embrace outdoor activities responsibly, with the appropriate precautions in mind, and we are concerned that your article is discouraging them from doing so.

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Shelby Homiston, shomiston@aad.org

Rhys Saunders, rsaunders@aad.org

About the AAD

Headquartered in Rosemont, Ill., the American Academy of Dermatology, founded in 1938, is the largest, most influential and most representative of all dermatologic associations. With a membership of more than 21,000 physicians worldwide, the AAD is committed to advancing the diagnosis and medical, surgical, and cosmetic treatment of the skin, hair, and nails; advocating high standards in clinical practice, education and research in dermatology; and supporting and enhancing patient care because skin, hair, and nail conditions can have a serious impact on your health and well-being. For more information, contact the AAD at (888) 462-DERM (3376) or aad.org. Follow @AADskin on Facebook, Pinterest, and YouTube and @AADskin1 on Instagram.

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AAD letter to the Atlantic in response to “Against Sunscreen Absolutism”

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