QDoes use of sunscreen and sun protective measures lead to vitamin D deficiency?

Recent data from multiple studies have shown that sun protection is a negligible factor in vitamin D levels. In one study, use of sun protection factor 50 and higher was shown to block cutaneous vitamin D production, but this had negligible effect on circulating 25-OH vitamin D levels.¹  Wearing appropriate amounts of sunscreen with high SPF was shown to improve, not lower, vitamin D synthesis during a week-long sun holiday. ²  A study of the National Health and Nutrition Examination Survey (NHANES) did not show any connection between sunscreen use and sun protective behaviors and decreased bone mineral density or osteoporotic bone fractures. ³

Educate your patients about sun protection and explain that there is no data to suggest that wearing sunscreen makes us vitamin D deficient.  In fact, low body weight, sedentary lifestyles, and poor diets likely contribute to more osteoporosis and bone fractures than wearing sunscreen.  Encourage patients to get exercise and wear sunscreen for healthy bones. 

References:

1. Libon  F, Courtois  J, Le Goff  C,  et al.  Sunscreens block cutaneous vitamin D production with only a minimal effect on circulating 25-hydroxyvitamin D.   Arch Osteoporos. 2017;12(1):66. doi:10.1007/s11657-017-0361-0
2. Young  AR, Narbutt  J, Harrison  GI,  et al.  Optimal sunscreen use, during a sun holiday with a very high ultraviolet index, allows vitamin D synthesis without sunburn.   Br J Dermatol. 2019;181(5):1052-1062. doi:10.1111/bjd.17888
3. Afarideh M, Sartori-Valinotti JC, Tollefson MM. Association of sun-protective behaviors with bone mineral density and osteoporotic bone fractures in US adults. JAMA Dermatol. 2021;157(12):1437–1446. doi:10.1001/jamadermatol.2021.4143