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These days, the sun is often viewed almost exclusively as a risk. From a dermatological perspective, that view is too one-sided.
When it comes to the sun, there are two camps. Some never leave the house without sunscreen and see a threat in every ray of sunlight. Others lie carelessly in the midday sun until their skin turns red. Both are wrong. My position can be summed up in two words: common sense.
Sunlight lifts our mood, can have antidepressant effects, and promotes serotonin production. I know hardly anyone who isn't glad when the sun comes out. Then there is vitamin D. The crucial first step of its synthesis takes place in the skin – under the influence of UVB radiation. As a source of vitamin D, sunlight plays an important biological role. But it also carries its risks.
Every tan begins with damage. UV radiation puts the DNA in our cells under stress. The skin responds by producing melanin, a pigment that acts as a natural protective filter. A tan is therefore not a sign of health, but a protective response. How serious the damage is depends greatly on skin type. Fair, sun-sensitive people carry a higher long-term risk – for skin cancer as well as for premature skin ageing. It is important to understand: the damage occurs long before any redness appears. Reddened skin is not an early warning signal. It is a late sign of damage.
The takeaway is not fear of the sun, but moderation. Those who understand and respect their skin's natural tolerance to sun exposure can enjoy the benefits of sunlight without causing unnecessary damage. Clothing, sunscreen and sensible behaviour are wise forms of protection. Panic is not. And this is where it gets interesting: there is growing evidence that not only too much sun can be problematic, but also too little. People in sunny Brisbane, for example, live longer on average than those in far less sunny Edinburgh – even though skin cancer is considerably more common in Brisbane. This is exactly why the sun should not be viewed solely through the dermatologist's lens. The skin is just one organ among many. What matters is the whole person. That is OneHealth.
It is what most people think of first when the subject of sun comes up – and hardly any topic is accompanied by so much fear. Yet this is exactly where a sober perspective helps. Non-melanoma skin cancer is indeed the most common form of cancer worldwide. The cause is almost always the same: too much sun over too many years for fair skin, which by nature has little to no inherent protection. And yet hysteria is not warranted. In mortality statistics, skin cancer ranks relatively low, and with regular check-ups it is, in the vast majority of cases, easily treatable. One word matters most: early. Any new or changing spot on the skin should be examined by a dermatologist – for the trained eye, skin cancer is usually relatively easy to recognise.
The sun is not an enemy. But it is not a harmless friend either. It is a powerful biological force that should be understood and respected, not feared. For healthy people, the sun is, on balance, a positive force. Its benefits far outweigh its risks – provided you know what you're doing. I write about this in more detail in Chapter 5 – "Tan Carefully" – of my book How to Look Better: 10 Maximen für eine schöne Haut und ein besseres Leben. It is the longest chapter in the book – because hardly any subject is as misunderstood as the sun.