According to the World Health Organisation, “Five to 15 minutes of casual sun exposure of hands, face and arms, two to three times a week during the summer months, is sufficient to keep your vitamin D levels high.” For countries such as Dubai that are close to the equator, the exposure time can be even less to meet your vitamin D requirements from sunlight.
Yet, here in the UAE, with its abundance of sun, almost 80 per cent of the population are vitamin D deficient. It means that many of us are not getting enough exposure to the sun or eating enough foods that contain the vitamins and nutrients our body needs.
Dr Anwar Al Hammadi, Consultant Dermatologist, DHA and President of the Emirates Dermatology Society, often finds a correlation between existing complaints and a vitamin D deficiency. The three main conditions he identifies are psoriasis, vitiligo and excessive hair loss.
People who suffer from psoriasis commonly start to see symptoms between the ages of 15 and 35 although between 10 and 15 per cent of patients develop the condition before the age of 10. The National Psoriasis Foundation says that the exact reasons for illness are unknown. “Although scientists do not know what exactly causes psoriasis, we do know that the immune system and genetics play major roles in its development. Usually, something triggers psoriasis to flare. The skin cells in people with psoriasis grow at an abnormally fast rate, which causes the buildup of psoriasis lesions.”
Psoriasis primarily effects people’s elbows, knees and scalp and can be identified by red, flaky plaques on the skin.
Vitiligo is a condition where the skin loses colour pigmentation, resulting in blotches of white on the skin. In many cases, Dr Al Hammadi finds that these patients also suffer from a lack of vitamin D.
For patients who report hair loss, Dr Al Hammadi also often finds a vitamin D deficiency, although it isn’t always the sole root cause of the issue. “When we replace the vitamin D, will their condition improve? Some of them, yes, but [for] the majority of them I would say, no, because it’s not usually the main cause.”
Often a lack of vitamin D can be evident in the appearance of a person’s skin. Their skin may be excessively pale or the patient may have dark patches underneath their eyes and show evidence of fatigue. Yet, these symptoms may not necessarily mean a patient is suffering from a shortage of vitamin D alone. “These symptoms may be linked to something else, such as an iron deficiency or anaemia.
“Many patients we treat have a combination of problems, where they are anaemic, they are living a healthy lifestyle and they are not eating properly,” says Dr Hammadi.
Each person requires different amounts of exposure to the sun to reach their required vitamin D levels, depending on factors such as their skin colour, diet and genetics. According to the UK’s National Health Service, “People with dark skin, such as those of African, African-Caribbean or south Asian origin, will need to spend longer in the sun to produce the same amount of vitamin D as someone with lighter skin.”
The Fitzpatrick scale categorises skin into six types. “Black skin is type six, where there is lots of melanin, which is a pigment that is produced by melanocytes, the pigmented cells,” says Dr Hammadi. “Melanin protects us from ultraviolet rays and skin cancers and gives the skin colour. If someone is dark and their skin is exposed to the sun for 30 minutes, someone with much paler skin is exposed to the skin for just ten minutes, may have more ultraviolet exposure.” Subsequently, incidents of dark-skinned people with vitamin D deficiency are more common here in the UAE and particularly among those who wear traditional dress, where the majority of their body is often covered.
Sun isn’t the only source of vitamin D though. In northern countries such as Denmark and Finland, where residents often live in long hours of darkness, supplements are added to foods and citizens are encouraged to take vitamin capsules. In some cases, people can also receive vitamin D injections, which work quicker than their digestive equivalents. In fact, supplements often may be more suitable for a patient than exposure to the sun. “For anyone with skin problems such as cancer, depigmentation, rosacea or lupus, I wouldn’t recommend exposure to the sun as the harm will outweigh the benefits,” explains Dr Al Hammadi.
While there are undoubted physiological and psychological benefits that come with exposure to the sun, even if you don’t have any genetic preposition of history of UV-related issues, overexposure can significantly increase the risk of contracting skin cancer.
“I would recommend a maximum of 20 to 30 minutes’ exposure to the sun in the early morning, or [just] before sunset,” says Dr Al Hammadi.
