Sun exposure, sunscreen, and skin health: skin cancer, vitamin D, & more (AMA 61 sneak peek)

View show notes here: bit.ly/4crxcth
Become a member to receive exclusive content: peterattiamd.com/subscribe/
Sign up to receive Peter's email newsletter: peterattiamd.com/newsletter/
In this “Ask Me Anything” (AMA) episode, Peter delves into two topics that have generated a lot of questions over the years: skin cancer & sunscreen. He begins by exploring the basics of UV radiation, discussing its effects on vitamin D conversion, photoaging, & its role in skin cancer. He examines various skin types, discussing their implications for sun exposure & vitamin D levels, as well as how to determine where you fall on the skin type scale. He then delves into the various types of skin cancer, with a particular emphasis on melanoma, exploring its complex relationship with UV exposure & other contributing risk factors. Additionally, he covers tanning beds, the importance of early skin cancer detection through regular skin checks, & the often confusing topic of sunscreen. He explains how sunscreen affects UV radiation & skin cancer risk, what SPF levels to choose, the differences between organic & mineral sunscreens, & what to consider when selecting the best sunscreen for your needs.
In this sneak peek, we discuss:
00:11 - The impact of UV radiation on the skin
02:38 - Understanding solar UV: from the electromagnetic spectrum to skin health
07:12 - The role of sunlight in vitamin D production
08:45 - Factors contributing to vitamin D deficiency: insufficient UV exposure, magnesium levels, & more
11:22 - Sun exposure needs for different skin types, & the limitations of current studies in defining vitamin D deficiency
15:10 - The effects of excessive UV exposure: sunburn, photoaging, & risk of skin cancer
17:40 - Types of skin cancer & associations with UV exposure
In the full episode, we also discuss:
-The complex relationship between melanoma & UV exposure;
-Why UV exposure alone doesn’t necessarily explain the risk for melanoma;
-Other risk factors for melanoma;
-Tanning beds & skin cancer risk;
-Balancing sun exposure: benefits and risks [38:15];
-Tattoos and sun exposure;
-The importance of regular skin checks, dermatologists, and emerging technologies showing promise for early detection of cancer;
-Self-skin checks: what to look for;
-Prevalence of skin cancer and the importance of early detection [49:30];
-Summary of the major risk factors for melanoma;
-The role of sunscreen in reducing skin cancer risk;
-How sunscreen works, the differences between chemical and mineral sunscreens, an explanation of SPF, and more;
-How to determine the appropriate sunscreen SPF to use based on the UV index;
-Choosing the right sunscreen for your individual needs;
-The impact of water and perspiration on sunscreen effectiveness;
-Chemical vs. mineral sunscreens: safety concerns and recommendations;
-Concerns about hormone effects from chemical sunscreens;
-Sunscreen summary: skin types, key considerations, recommended brands, and more;
-More.
--------
About:
The Peter Attia Drive is a deep-dive podcast focusing on maximizing longevity, and all that goes into that from physical to cognitive to emotional health. With over 90 million episodes downloaded, it features topics including exercise, nutritional biochemistry, cardiovascular disease, Alzheimer’s disease, cancer, mental health, and much more.
Peter Attia is the founder of Early Medical, a medical practice that applies the principles of Medicine 3.0 to patients with the goal of lengthening their lifespan and simultaneously improving their healthspan.
Learn more: peterattiamd.com
Connect with Peter on:
Facebook: bit.ly/PeterAttiaMDFB
Twitter: bit.ly/PeterAttiaMDTW
Instagram: bit.ly/PeterAttiaMDIG
Subscribe to The Drive:
Apple Podcast: bit.ly/TheDriveApplePodcasts
Overcast: bit.ly/TheDriveOvercast
Spotify: bit.ly/TheDriveSpotify
Google Podcasts: bit.ly/TheDriveGoogle
Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional healthcare services, including the giving of medical advice. No doctor-patient relationship is formed. The use of this information and the materials linked to this podcast is at the user's own risk. The content on this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they have, and they should seek the assistance of their healthcare professionals for any such conditions. I take conflicts of interest very seriously. For all of my disclosures and the companies I invest in or advise, please visit my website where I keep an up-to-date and active list of such companies. For a full list of our registered and unregistered trademarks, trade names, and service marks, please review our Terms of Use: peterattiamd.com/terms-of-use/

[@kaylaharrop7639]

For those here for sunburn vs sunscreen in cancer prevention, he does not answer it in this video Lab range vit D 30-100ng/ml Considered deficient under 30ng/ml, however there is endless research that shows optimal range is 60-80ng/ml

[@jjjames6894]

Finally been long awaiting this one thank u

[@johntim3491]

Light v Sound. Hearing around corners is due to the multi-directional Propagation of Sound by Molecular Collision. Sound doesn't travel through Vacuums. Nothing to do with Wavelength difference v Light (which does travels through vacuums as a packet of energy .. Photons).

[@bobbybrown1258]

Yes it does..it's diffraction and everything to do with the wavelength. The wavelength of audible sounds match the gaps that are around is in every day life and therefore diffract readily and spread out. We can get light to diffract by passing it through very small gaps, no matter that it is a wave that does not need a material to propogate. Equally we can get sound to travel in relatively straight lines by making it quite high frequency . Source, physics teacher

[@angelapolly1]

I wish I could attend a college and have Dr. Attia as my professor for every subject. He has such a gift for teaching.

[@TheSarah730]

Great topic!

[@jackloughridge7617]

Hold on. Isn’t that picture of the truck driver actually anatoli burgorski? The russian man who has a almost fatal radiation accident on the left side of his face?

[@max_955]

Not sure, but google shows that picture when searching for him.

[@Kwaku1337]

Looks like it 😮

[@Angelthedog]

A good article summarizing English studies on the effect of sun exposure is "Is Sunscreen the New Margerine." It concluded that much more sun exposure than is generally recommended has significant health benefits. The study conceded that more sun exposure results in more skin cancer, but decreased the chances of dying from it. The author also noted some studies concluded that Vitamin D taken in pill form seemed to be less beneficial than Vitamin D gained through sun exposure. He speculated that perhaps Vitamin D wasn't really the beneficial thing, but only a marker for sun exposure.

[@jmass4207]

I read the article and the NO hypothesis is interesting but I’m far from convinced. A lot of D research is flawed because they don’t give people enough. They need to start establishing a vitamin D status based on bloodwork rather than offering some amount. I’d also be curious about controlling for exercise, pro social behavior, and other benefits of outdoor exposure see: nature bathing as well as circadian aspects of seasonal fluctuation. Dr. Weller claims sunscreen is capable of blocking the harmful effects of UV and allowing the good, but I haven’t been able to see any details. It seems odd to me that that is possible. And regardless of all this, could the NO benefits still be replicated with a supplement like l-citrulline without the need for skin-damaging sun exposure?

[@HendersonHinchfinch]

Thats an odd conclusion they came to. Vitamin D is a crucial hormone for humans that regulates so many processes in the body. It is synthesized by the sun, but to say the benefits are more directly from sun exposure than vitamin D is a bit ignorant, no offense to the author

[@ItsChilly-WearMittens]

Note that only about 9,000 people die each year in the US from skin cancer (compare hundreds of thousands from heart disease or cancer), and much of that is due to serious sunburns decades in the past. Seems likely that careful sun exposure along with annual dermatologist checkups will do more good than harm. Look into the benefits of red light and other visible frequencies.

[@BODYCOACHable]

pubmed.ncbi.nlm.nih.gov/26992108/

[@kjkernSerendipity]

Interesting comments. I recently heard about wearing sunglasses or not influenced how your body responds to the sunlight. The premise was unshielded eyes get signals from the sun and the body protects the skin from a burn and aids in vitamin d conversion.

[@rouensk]

Peter, just to correct your reasoning about microwaves: Microwave oven is not harmless because the wavelength is longer than visible light, but because microwave oven is shielded, so the radiation do not escape it. You wouldn't want to stand next to unshielded 1000W microwave emitter same way as you stand next to your microwave (just as you don't want to look at 1000W visible light LED).

[@Crepitom]

Is it really? Wifi doesn’t work properly anymore on my phone when the microwave is on and I’m in the kitchen

[@jedinxf7]

​@@Crepitommostly.

[@Ghanzo]

Radio waves can kill with a high enough amplitude. Energy is transmitted as amplitude and frequency, not just frequency

[@randomhominid9816]

Right. Microwave radiation can cook you just like the food you put in a microwave cooker.

[@DerFlotteReiter]

Yes, it's a Faraday cage what keeps the microwaves away from escaping. Without it your flesh would get heated the same as the food gets heated inside the microwave.

[@notagain1952]

Microwave ovens are designed to shake/resonate the water molecule so if the shielding is missing, distance is a safety measure.

[@georgeb8637]

I am sure the premium version of this video is amazing, however I am disappointed that I have to find out at the end of the video. Also, we are only answering if to use sunscreen or not, that information should be provided. If people want to get a deeper scientific dive, maybe then it’s a premium offering 🙃

[@richardfricke6806]

Anyone who watched the whole video- does Peter talk about benefits of the Sun outside of vitamin D? I feel like this is the missing piece when most people discuss sunlight. Its basically reduced to weigh your odds of vitamin D vs skin cancer. But Medcram’s video + many others have shown that vitamin D supplementation does not replace the benefits of healthy sun exposure

[@rickzalewski2728]

UVA for nitric oxide. UVB for "vitamin" D. And those are the only 2 things science understands. There's possibly a 1000 benefited that we just don't understand yet. How long in the history of humans have we been using sunscreen? Do animals get skin cancer? Trust "the" science.

[@rickzalewski2728]

The medical consensus is melanin levels determines how much you tan/burn with sun exposure. However, as a northern European i used to burn easily when i consumed a plant based diet, high in seed oils in my 20s. Now in the last 8 years, since turning meat based with zero seed oils and only animal sourced fats I don't burn. Living in Toronto i always have to start with a fresh tan each year.

[@hvallejog]

Great video. Thank you. There seems to be a typo in the lower left graph (and perhaps the presentation). Ultraviolet light spans from 10 nm to 400 nm. Right?

[@beverleyroberts1025]

Really interesting stuff! I've been saying this for years about the sun. We've evolved on this planet and everything on it needs sunlight. Ive been living in Spain for many years and have never applied sunscreen once. And I walk four miles everyday. If I'm being really honest, my skin still looks pretty good. Many be we'll even find that sunlight is beneficial for the skin and is anti aging ☀️! 🌸🦋

[@user-no7rx1cz7z]

Bio Allgäu’s Moor-Creme is now my favorite part of my nighttime skincare routine for intense moisturization.

[@susancarpenter4434]

A few years ago I found out I had basal cell skin cancer. My dermatologist put me on a supplement called Heliocare. Anyone else use it or heard anything about it? I’m a crossing guard so I’m outside for some time in the sun.

[@gotem1725]

I know it sounds crazy but I’ve always thought what came first; sunscreen or skin cancer? Does your diet impact your causation for skin cancer such as processed foods, processed sugars and high omega 6 content, more than the sun?

[@Cathy-xi8cb]

You don't sound old enough to remember life before sunscreen. It wasn't pretty. If people lived long enough and didn't die of infectious disease or cardiac issues, they had chunks (yes, chunks) of their skin removed due to skin cancer. I treated elderly people in the 1980's who had partial noses. Sometimes it was melanoma and they would die. Not always. And these were folks who ate real food most of their life, because processed food did not exist in the 1920's and 30's when they were young.

[@softballbryan]

@@Cathy-xi8cbyeah but the amount of skin cancers have skyrocketed…. I wonder if there’s more at play here than sun alone…

[@dawnkeckley7502]

@@Cathy-xi8cbI agree. It was vaguely around when I was growing up, but my parents never introduced it to me. My mom always said sunscreen made her burn. It turns out, we are both allergic to some of the ingredients in chemical sunscreens. By the time I was 18, I started using sunscreen myself. Prior to that, I had several sunburns and one terrible one on my back, and that’s where the first skin cancer on me showed up.

[@Cathy-xi8cb]

@@softballbryan In science we know that if you don't look for a problem, it appears that it doesn't exist. There was no such thing as being screened for skin cancer in the 1980s. Only 40 years ago. And the less people die of one thing, they live long enough to contract/develop and die of something else. If you die of a heart attack at 46, you didn't get skin cancer at 67.

[@nichtsistkostenlos6565]

​@@softballbryan The technology in identifying, and treating skin cancer early as well as categorization has improved drastically in the past 30 years. So, the "amount of skin cancers" increasing isn't about actual incidence rates it's about screening, identification, and technological improvements in the field.

[@IonutLaceanu]

On soundwaves: Light waves are electromagnetic waves that travel through a vacuum at the speed of light. They do not require a medium to propagate and can travel through empty space. Sound waves, on the other hand, are mechanical waves that require a medium (such as air, water, or solids) to travel. Sound waves propagate by compressing and rarefying the medium they travel through. They're fundamentally different, way beyond their wavelength. That's also why you can "hear around corners". I love your videos, but here you lost me a bit.

[@diablominero]

I've dealt with UV-C. Lots of your listeners probably have. UV-C is generated by arc welding and germicidal lamps, and can penetrate a few meters of air.

[@helios4425]

I know these are observational facts but would love people's opinions on them. 1. Epidemiological studies show that less sun exposure= higher all causs mortality. 2. Highest skin cancer rates are in countries of light skin people aka european and american. But exposure is least amount because of winter. 3. I think there is a huge difference between tanning and sun burn. One builds protection and other damages the skin. Aside from aging, does tanning really protective?

[@helios4425]

@@missioncodez so I guess the body producing Melanin has no protective benefits ? Such absorbing ultraviolet radiation?

[@careyjamesmajeski3203]

⁠@@missioncodezthat doesn’t make any sense to me. What are the reasons you believe this? A tan is an increase in base-level melanin content. Base level Melanin content differs on an individual basis. Differences in base-level melanin content do not constitute damage. So a tan doesn’t constitute damage. From your perspective, What are the problems with this argument?

[@nrs_207]

@@careyjamesmajeski3203frequent tanning is damaging to your skin and leads to higher rates of skin cancer. It might look good aesthetically but it’ll age your skin faster and look worse when you’re older

[@missb3964]

Where is the full episode?

[@minimumtrade]

Interesting discussion. We defo need sunscreen here down under, but many are also short the D. There is a local company named Solar D that produces a patented UVA sunscreen while allowing a UVB pass through of a tight nm range for your Vit D.

[@bellelacroix5938]

Really?

[@bengalgardening2407]

Interesting, especially you mention Mg crucial for body to utillize vit D. I thought for body to intake/use VitD properly intake should be with VitK2 (~50umgK2/1000vitD). Thats also one ofthe reason, respectful brands sell them together or mention it.

[@joerockhead7246]

i was just diagnosed with it. up next, mohs

[@dawnkeckley7502]

My second skin cancer required Moh’s. The dermatologist did such a great job stitching it up.

[@Krunch2020]

It’s not deadly. Don’t worry about it.

[@joerockhead7246]

@@Krunch2020 thank you

[@sassysandie2865]

It’s a rip off surgery. 6:07

[@sassysandie2865]

It’s a rip off surgery that is not necessary.

[@jfriedman028]

when is the full episode posted?

[@EzEzEz369]

I believe you have to pay for his premium content for full videos

[@jfriedman028]

@@EzEzEz369 I did before posting that. I ended up finding an audio version on Spotify but no video version

[@EzEzEz369]

@jfriedman028 oh sweet, good to know. I don't visit Spotify much. 🙏

[@nikosogamias]

so for aesthetic to not get wrinkles what do we do. obviously not get burned. but does that mean we can stay out in sun all day? just dont get burnt? or whats the limit.

[@Johnny-P-Good]

I live in the Caribbean. In order to get wrinkles or damage your skin, you have to daily be exposed to the sun for hours. People at risk are the ones that work outside, like construction workers, police, etc. But getting 10-20min of sun exposure 3 or 4 times per week will not cause damage to your skin. If you wanna be extra careful (specially in the tropics), avoid the sun at peak hours (10am to 3pm). Before 10am and after 3pm you will be fine. And if you are extra pale, take it at 8am or after 5pm (the UV index has to be below 3; check it in your Iphone in the weather app)

[@imemailingmybrother]

Sunscreen face lotion

[@amoeba8888]

stay inside and cover your windows, when you go outside dress with long clothes preferably made of synthetic materials like polyester with dark colors and use sunscreen on exposed areas

[@imemailingmybrother]

Wear sunscreen face lotion

[@Aetherius88]

UVA which penetrates glass / windows gradually leads to wrinkles and skin aging. Even if you stand in the shade you get UVA exposure. So wear sunscreen or sun protective attire and don't spend too much time near windows unless those windows are designed to block UVA

[@kennycarmody3d]

I am not sure about this one, when dermatologists talk about the sun is bad. Let’s talk about POMC, Sunlight and Mitochandria Health!

[@trimih]

So what should we do

[@Krunch2020]

Sunbathe at noon for 15 minutes on each side. Then put on a hat or go inside.

[@fhowland]

17:00 Glass blocks UVB rays but not UVA

[@bogse]

17:15 i amused Peter doesnt know that windows have zero effect preventing getting age by sunlight. The fact is that if you re in a space where you can see clearly, its bright enough, and that brightness isnt coming from manmade light or fire then your skin is aging all the time since sun. If if you sit in your home all your life but sunlight is getting to the house you will age faster unless you use high enough SPF every single day when there is sun meaning in very north or south there is barely any sunlight at winter and then sunscreen is not needed. Also clouds dont prevent you getting older unless clouds are so dark that its almost night dark which barely ever happens. All in all remember this: If its bright enough by sunlight to see well any part that is not protected by clothes or sunscreen will age faster, starting at the day you were born.

[@danieldaniels5034]

That's why people need to put uv protective film on their windows

[@Krunch2020]

Bogie has some old school windows!

[@bogse]

@@Krunch2020 You can ask that from any dermatologist.

[@vetruviamFlan]

OMFG 😂😂😂 BAHAHAHAHHAHAHAHAHAHAHAHAHAH!!!!

[@pleinaire8698]

Please leave the diagram on the screen longer.. what you are talking about Will make more sense. Thanks

[@cabolynn]

I'm grateful to have been a student of Jack Kruse's, learning the truth and never fearing the sun. I am a stickler however, of artificial blue light, which most have no idea is causing skin cancer.

[@dawnkeckley7502]

The first skin cancer I ever got was on my lower back. The only time that area had ever been exposed to UV light was when I was a pre-teen and teenager, but specifically I had one sunburn that was so bad I ended up with blisters on my back. By the time I was 18, I had stopped wearing a bathing suit and stopped doing things like waterskiing. I now help my husband with landscaping, and while I don’t fear the sun, I respect that if I don’t wear sunscreen, I will burn terribly. I’m very pale with red hair genes. I think it’s a different matter entirely when your job depends on being in the sun. These days, quite frankly. Unless your job is outside or you practice something like long-distance running, the majority of your hours are spent inside a building. I am an example of a person who didn’t practice sunbathing consistently, and after I turned 18, I was much more determined with my sunscreen application, and I’m routinely pegged for being ten years younger than my actual age of 52. Friends of mine who did sunbathe have very wrinkled skin now.

[@BadMannerKorea]

You’re grateful to listen to a guy telling people to not use sunscreen when the general consensus and the evidence says to use sunscreen? Yeah, just don’t think so

[@cabolynn]

@@BadMannerKorea , All I can tell you, is to do some in depth research. Jack is a very well researched Neurosurgeon and he helped me turn a very serious health problem around, using the sun. The very best to you!

[@BadMannerKorea]

@@cabolynn I don’t need to do any research on a guy that tells people not to use sunscreen lol. The scientific consensus is crystal clear, and you should use sunscreen. There’s always outliers who believe and claim radical things, and that’s what he is and that’s what he’s doing.

[@BadMannerKorea]

@@cabolynn Ps a few hours ago Andrew Huberman uploaded a video and guess what he said? The general consensus, particularly of mineral sunscreen, is that it’s safe and you should wear it.

[@menezes23]

How is it possible that UV radiation causes the truck driver’s injury if glass absorbs UV radiation?

[@Monicalala]

Because all UVA rays pass glass.

[@theandybee3050]

Peter - why must you be so greedy? Do you not already make millions off of your practice? Why must the most important part of this discussion, cancer risk, be behind a paywall? Do you really need the money? Do you care about the general public enough to give us this information free of cost considering it could save lives and you have no need of anything?

[@MrRjj4321]

UV-C has been making down to earth for some time now... research it...

[@NickMarshallMusic]

Jack Kruse going to roast you again on this one lol!

[@matthewirwin1112]

no one should be scared of that idiot

[@robriste]

Tru$t the $cience

[@kirkbarley4999]

Why does host’s video bounce with his head motion. Disconcerting…

[@lotfibouhedjeur]

Motion to drop the nice guy.

[@esgee3829]

he had surgery to remove eye bags? i thought rapamycin was supposed to cure that

[@TonyBabarino]

Huh…you would think a physician would HELP people for free on KZbin…I mean, doctors make 100’s of thousands $$$/yr already. Many of us don’t have the money for deeper help. Interesting.

[@seanknox7321]

He gives a shit ton away for free. And doctors per hour make garbage money.

[@srsr28]

Huh...maybe try thinking or finding out to maybe know what you're talking about before you complain and make a dumb comment. There are hours upon hours of free content offered and it becomes ad free if pay a monthly sub. Grow up

[@sassysandie2865]

If he is working he should get paid. Do you work for free?

[@skygreen5939]

Oof, that physics review needs some work 😬 I see others pointing out a couple of the issues. might be best to stay in the medical lane

[@BODYCOACHable]

Never miss another sunrise!! No toxic sunscreen , no sunglasses and build a solar callus.

[@BadMannerKorea]

No where in that video did he say to not use sunscreen or sunglasses. In fact, every single thing you said was never mentioned....

[@BODYCOACHable]

@@BadMannerKorea I know and there is good science showing why but he ignores it!

[@BadMannerKorea]

​@@BODYCOACHable Has it ever occurred to you that the reason he ignores it is because what you're saying is pseudoscience? I'm sure he delves into the risks of chemical sunscreens, but to claim or imply all sunscreen is toxic is not true at all. Your comment is just nonsense.

[@scottiechapman8351]

​@@BODYCOACHableThen show us the links to your "good science". How about just one good systematic review with meta analysis of the benefits of no sun protection outweighing the risks? You can post a link to those publications here. I won't hold my breath.

[@dawnkeckley7502]

There are many mineral sunscreens that work very well. No wearing sunglasses? You obviously don’t have blue eyes. I couldn’t see to drive without them.

[@ExcellentHealth]

I believe Dr. Jack Kruse has more than one disagreement with this video.

[@Regna4824]

I clicked on this just to see how many things he mentions that Kruse is going to blast him for. I know it's not really Jack's style but I would love to see an educational "reaction" style video to this where he responds to the points he disagrees with Attia on. Would be entertaining at the very least.

[@EzEzEz369]

I.e.?

[@dravrahamrosenzweig]

where is the full version for God's sake ?

[@scottiechapman8351]

It is only available to subscribers who pay.

[@dawnkeckley7502]

It’s an AMA. The full version is only offered to subscribers. Listen to the end of the video, and he explains.