Photoprotection and the Vitamin D Status of the Elderly

The preliminary study published in this issue of theArchivesby Matsuoka et al1addresses the question of whether the long-term use of sunscreens by the elderly will result in poor vitamin D status. Comparing two adult populations, one that used ap-aminobenzoic acid (PABA)-containing sunscreen with one that did not use sunscreen, these investigators found significantly lower levels of serum 25-hydroxyvitamin D (25-OH-D) in the group that used sunscreen. In our zeal to protect patients from the undesirable effects of sunlight, we encourage our fairskinned patients to apply sunscreen liberally and avoid the sun.2Patients with fair skin, actinic damage, or a history of skin cancer are particularly encouraged to apply a sunscreen with a sun protection factor (SPF) of 15 or higher. Recently, tretinoin (Retin-A) has been advocated to reverse photoaging.3,4These patients avoid the sun to minimize further photodamage. Because tretinoin use increases