PhotoAny fair-skinned person hears it all the time from their dermatologist and family physician: too much sunlight can cause skin cancer. But now British dermatologists say that while that's true, too little sunlight isn't good either.

In fact, exposing the skin to sunlight may help to reduce blood pressure and thus cut the risk of heart attack and stroke, according to the study published in the Journal of Investigative Dermatology.

The research, carried out at the Universities of Southampton and Edinburgh, found that sunlight alters levels of nitric oxide in the skin and blood, reducing blood pressure.

"Nitric oxide, along with its breakdown products, known to be abundant in skin, is involved in the regulation of blood pressure. When exposed to sunlight, small amounts of nitric oxide are transferred from the skin to the circulation, lowering blood vessel tone; as blood pressure drops, so does the risk of heart attack and stroke," said Martin Feelisch, Professor of Experimental Medicine and Integrative Biology at the University of Southampton.

Good and bad effects

While limiting sunlight exposure is important to prevent skin cancer, the authors of the study, including Dr. Richard Weller of the University of Edinburgh, suggest that minimizing exposure may be disadvantageous by increasing the risk of cardiovascular disease.

Cardiovascular disease, often associated with high blood pressure, accounts for 30 per cent of deaths globally each year. Blood pressure and cardiovascular disease are known to vary according to season and latitude, with higher levels observed in winter and in countries further from the equator, where ultraviolet radiation from the sun is lower.

During the study, the skin of 24 healthy individuals was exposed to ultraviolet (UVA) light from tanning lamps for two sessions of 20 minutes each. In one session, the volunteers were exposed to both the UVA rays and the heat of the lamps. In another, the UV rays were blocked so that only the heat of the lamps affected the skin.

Dilates blood vessels

The results suggest that UVA exposure dilates blood vessels, significantly lowers blood pressure, and alters nitric oxide metabolite levels in the circulation, without changing vitamin D levels. Further experiments indicate that pre-formed stores of nitric oxide in the upper skin layers are involved in mediating these effects. The data are consistent with the seasonal variation of blood pressure and cardiovascular risk at temperate latitudes.

"These results are significant to the ongoing debate about potential health benefits of sunlight and the role of Vitamin D in this process. It may be an opportune time to reassess the risks and benefits of sunlight for human health and to take a fresh look at current public health advice," Professor Feelisch said. "Avoiding excess sunlight exposure is critical to prevent skin cancer, but not being exposed to it at all, out of fear or as a result of a certain lifestyle, could increase the risk of cardiovascular disease. Perhaps with the exception of bone health, the effects of oral vitamin D supplementation have been disappointing.

"We believe that nitric oxide from the skin is an important, so far overlooked contributor to cardiovascular health. In future studies we intend to test whether the effects hold true in a more chronic setting and identify new nutritional strategies targeted at maximizing the skin's ability to store nitric oxide and deliver it to the circulation more efficiently."

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