I am writing this blog seven weeks into the COVID-19 lock-down in Berlin. It’s the end of April and despite beautiful weather many of us spend most of the time indoors. Simultaneously, I started receiving messages from you about your skin being drier than normal, including several atopic dermatitis outbreaks. Coincident? I don’t think so.
A plant-based nutrition coach Kerstin Obermoser from Berlin’s iss bewusst (@issbewusst) has agreed to help me solve this riddle. We met in a park and kept a safe distance of 1,5m throughout our conversation.
NHL: Kerstin, thank you for meeting me here. We are one of the lucky ones to be able to spend some time outside today. Tell me, do you think being locked indoors can have something to do with developing skin problems?
Kerstin: Yes, lack of sun exposure is the main cause of vitamin D deficiency, which has a profound effect on the condition of our skin, from dryness to aging. Vitamin D is a very important vitamin in our body. It influences many organs like our bones and muscles and is key to our immune system.
NHL: Given that vitamin D is so important to our skin and body, why don’t we hear more about it?
Kerstin: That’s true, we should be talking about it more. Not many people know that it is vitamin D that helps to stabilise the lipid layer of our skin, keeping the skin moisturised and improving its elasticity. A strong skin barrier also means that the skin is less sensitive and not so easily irritated.
NHL: You mentioned before that vitamin D plays a role in our immune system response. Can this be translated to the immune response within our skin?
Kerstin: Yes, absolutely. Vitamin D activates the immune system to fight off skin infections. It also promotes quicker wound healing.
NHL: I am especially fascinated with the photo protective properties of vitamin D. It turns out that the very substance, which is created during sun exposure (i.e. vitamin D) also protect us from the damage this exposure can cause. Vitamin D has the ability to reduce the UV-related DNA damage and cell death, while simultaneously increasing the time until skin burn.
Kerstin: That is indeed fascinating. It also makes so much sense. We tend to burn easier just after winter, than we do mid-summer. It seem logical, that we develop a higher sun exposure tolerance as the blood levels of vitamin D rise. Moreover, vitamin D plays a role in preventing skin aging, as it is an anti-oxidant and a free radical scavenger. It helps reduce the appearance of lines and wrinkles.
NHL: We briefly mentioned it already, but what are the actual sources of vitamin D?
Kerstin: About 20% of what we need comes from our diet, but the vast majority (80%) is produced during sun exposure. Therefore it’s so important to consciously build in sunbathing time into our day, but this can be difficult, especially now.
NHL: Exactly. How easy is it to become vitamin D deficient? Are there factors, which influence it?
Kerstin: It is very easy. In fact the Nationale Verzehrsstudie II estimates that about 80-90% of all Germans are deficient. The further north you live on the planet the more at risk you are, but also elderly individuals or people with a darker skin tone have a harder job to produce vitamin D. Factors like clothing and lifestyle will also influence the degree of our sun exposure. Air pollution too can inhibit the radiation reaching our skin. Increasingly, however, the deficiency is driven by our misbelief that we should avoid unprotected sun exposure at all cost and always use sunscreen.
NHL: I want to take a moment here to list some of the skin conditions, which have an association with vitamin D deficiency: skin cancer, psoriasis, ichthyosis, atopic dermatitis, acne, hair loss and photodermatoses. This is a scary list. Can you give us some tips on how to safely get some vitamin D into our system?
Kerstin: I am going to base this advice on an average white person living in a climate similar to Germany. This advice will have to be adjusted accordingly for individuals living on different latitudes and with different skin tones. You want to get 10-15 min of unprotected (i.e. no sunscreen) sun exposure between the time of 10 AM and 3 PM a day. Make sure that at least one third of your body is exposed, e.g. arms and legs. Because the production of vitamin D is induced by UVB radiation, it is only when there’s enough of it, that sunbathing will have an effect. Usually the conditions are only right between the months of April and October. Check your weather app and make sure the UV index is at least 3.
NHL: What about the other 5 months of the year? How do we make sure we get enough vitamin D then?
Kerstin: It is worth mentioning that vitamin D is fat soluble, which means that your body can store it within your own fat cells. When sun exposing during the sunny months you will in fact build up some reserves for the winter, but they won’t carry you all the way through. Also people over 65 and pregnant or breast feeding women need more vitamin D. Unfortunately diet alone does not provide enough of it, therefore supplementation is a good option.
NHL: What are the most important things we need to know about supplementing vitamin D?
Kerstin: I recommend a daily dose of 1.500-2000 IU of vitamin D. For pregnant or breast feeding women and elderly individuals the dose should be higher. The D3 variation is more valuable to our bodies than the D2. If you take supplements in the form of a tablet, remember to take them with fats, to help your body absorb it. You may also want to reach for a supplement combining vitamin D with magnesium and vitamin K2, as both of these nutrients help in activating vitamin D. Before reaching for the supplements, however, I’d recommend visiting your GP, to make sure that supplementation won’t cause problems with any other underlying conditions, especially if you’re taking blood thinning medication.
NHL: Kerstin, I have a feeling that my skin has improved just by the virtue of learning so much about vitamin D. Thank you for talking to me today!
Kerstin: It was my pleasure. If you have any further questions you can always email on firstname.lastname@example.org