Is sunlight exposure beneficial when feeling unwell?

From the Guidelines

Exposure to sunlight is not recommended when feeling sick, especially for individuals with certain medical conditions, due to the risk of photosensitivity and other adverse effects. When considering the impact of sunlight on health, particularly in the context of feeling unwell, it's crucial to weigh the potential benefits against the risks. While moderate sunlight exposure can have benefits such as improving mood, regulating sleep patterns, and boosting vitamin D production, which supports immune function 1, the risks associated with photosensitivity and other conditions must be prioritized.

For individuals with systemic lupus erythematosus (SLE), photoprotection is advised to prevent flares, as ultraviolet (UV) radiation is a known triggering factor for cutaneous and systemic lupus flares 1. This recommendation is based on experimental studies showing that broad-spectrum sunscreens can prevent cutaneous lesions on photo-provocation. Therefore, people with SLE should avoid direct sun exposure, especially during days with high UV index, and use protective measures such as hats, sunglasses, long-sleeved shirts and pants, and broad-spectrum sunscreen.

Given the potential for adverse effects, especially in vulnerable populations, the most prudent approach is to avoid direct sun exposure when feeling unwell, particularly if you have conditions like SLE, porphyria, or are undergoing chemotherapy. If sun exposure is unavoidable, protecting the skin with SPF 30+ sunscreen is essential to prevent sunburn, which could further stress the body. The latest guidelines and research, such as those from the EULAR recommendations for the non-pharmacological management of systemic lupus erythematosus and systemic sclerosis 1, emphasize the importance of photoprotection and cautious sun exposure, especially for individuals with specific health conditions.

From the Research

Benefits of Sunlight Exposure

• Sunlight exposure is beneficial for increasing vitamin D levels in the body, which is essential for maintaining a healthy immune system 2.
• Vitamin D deficiency has been linked to various health conditions, including psoriasis, type 1 diabetes, multiple sclerosis, rheumatoid arthritis, tuberculosis, sepsis, respiratory infection, and COVID-19 2.
• Sensible sunlight exposure is recommended to maintain serum 25-hydroxyvitamin D levels at least 30 ng/mL (75 nmol/L), and preferably at 40-60 ng/mL (100-150 nmol/L) for optimal overall health benefits 2.

Vitamin D Status and Sunlight Exposure

• Photosensitive patients are at high risk of year-round low vitamin D status due to their photoprotective measures, which limit their sunlight exposure 3.
• Behavioral factors, such as lower weekend ultraviolet B doses, smaller skin surface area exposure, and greater sunscreen use, contribute to lower vitamin D levels in photosensitive patients compared to healthy individuals 3.
• Supplementation and summer surface area exposure can predict summer peak and winter trough vitamin D levels, highlighting the importance of balancing sunlight exposure and supplementation 3.

Health Benefits of Vitamin D

• Vitamin D supplementation has been shown to reduce COVID-19 severity and risk of mechanical ventilation, as well as improve symptoms in patients with atopic dermatitis and major depression 4.
• Moderate levels of vitamin D may reduce the risk of falls, while higher doses may increase fall risk, emphasizing the need for personalized vitamin D recommendations 4.
• Emerging evidence suggests that vitamin D supplementation may be helpful in patients with prediabetes, fibromyalgia, and other conditions, although more research is needed to determine optimal dosing standards and timing 4, 5.

Recommendations for Vitamin D Intake

• Daily supplementation with 2000 IU/day (50 mcg/day) of vitamin D3 can help raise serum 25-hydroxyvitamin D levels above 30 ng/mL, reducing disease and mortality risks 5.
• A daily dose between 4000 and 6000 IU of vitamin D3 may provide greater protection against many adverse health outcomes, although individual needs may vary 5.