Sunbathing and skin diseases - are we allowed to sunbathe if we suffer from psoriasis, acne, autoimmune diseases
Written by: Danijela Tadić
It is necessary to avoid contact with water contaminated with microorganisms for all skin conditions where the skin surface is exposed due to injuries or other chronic damage, where the protective layer of the skin has been removed, or the damage is in deeper layers of the skin, says dermatologist Dr. Jasmina Kozarev.
Moderate sun exposure with all precautions, and avoiding sunlight between 10 AM and 5 PM when UV indexes are highest, can benefit both healthy individuals and those suffering from certain skin conditions. After moderate and properly dosed sun exposure, 80% of patients with atopic dermatitis and fungal skin diseases reported improvement, while 40% of patients with psoriasis saw positive effects, according to some studies. Despite these benefits, moderate sun exposure is not recommended for everyone.
Sun Exposure and Atopic Dermatitis
Sun exposure is an excellent way to provide the body with vitamin D. A few minutes a day is sufficient; prolonged exposure is not necessary. Sunburn can even occur on cloudy days since 80% of UV rays pass through the clouds. Dermatologists emphasize that UV radiation damage is cumulative, meaning all sun exposure over a lifetime adds up and increases the risk of developing skin cancer in middle age. Research shows that a single sunburn with blisters during childhood or adolescence doubles the risk of melanoma, the deadliest form of skin cancer.
This is confirmed by Dr. Jasmina Kozarev, who states that moderate and timely sun exposure is beneficial, but excessive exposure during times of the day with the highest UV indexes is absolutely harmful.
“Moderate sun exposure is therapeutic due to its positive effects on vitamin D conversion and the skin’s natural microbiome. Atopic dermatitis is an immune-mediated skin disease that, in many patients, is accompanied by vitamin D deficiency and an imbalance in the skin's microbiome, leading to an increase in staphylococcal bacteria, which trigger hypersensitivity immune mechanisms similar to those seen in food allergies or sensitivities to outdoor allergens like pollen, dust, pet dander, and mold,” explains Dr. Kozarev.
Who Should Avoid Intense Sun Exposure?
When it comes to skin diseases and swimming in public pools, doctors advise caution.
“It is necessary to avoid contact with water contaminated with microorganisms for all skin conditions where the surface is exposed due to injuries or other chronic damage, where the protective layer of the skin is removed, or the damage is deeper in the skin layers. Excessive sun exposure disrupts the local immune response and increases skin hypersensitivity. Therefore, intense sun exposure is not recommended for individuals with autoimmune diseases, systemic lupus, scleroderma, and light-provoked rashes. For individuals with acne, sun exposure leads to thickening of the stratum corneum, the formation of keratin deposits in sebaceous gland ducts, which subsequently stimulates sebum secretion and worsens acne,” specifies Dr. Kozarev.
Dead Sea and Psoriasis
Sea water contains sodium, magnesium, calcium, potassium, and silicon. Experts point out that when we swim in the sea, the sea water penetrates the skin, making the trace minerals effective.
“Sea water is rich in minerals, and we consider waters with high concentrations of magnesium, such as the Dead Sea, especially beneficial. In conjunction with moderate sun exposure, there are significant positive effects for people with psoriasis,” emphasizes Dr. Kozarev.
Dr. Kozarev also explains that psoriasis is a chronic disease that can be controlled with therapeutic measures but cannot be fully cured.
“That’s why lifestyle changes, diet, supplementation, and sun exposure are part of the dermatological treatment, not just advice on medication. Today’s approach is individualized and based on clear evidence of treatment efficacy,” says Dr. Kozarev.
Sun exposure is therefore recommended up to the erythema dose limit.
Dr. Kozarev concludes that everyone must be careful not to get sunburned.
“Especially for those with psoriasis, introducing the skin into a new inflammatory state delays the therapeutic result. Sun exposure is recommended up to the erythema dose limit, which gradually shifts according to the skin's color change and the level of cumulative sun exposure. Sunscreens must be free of irritating and toxic substances, in appropriate formulations that won’t damage or dry out the skin barrier or cause occlusion,” says Dr. Kozarev.
The minimum erythema dose is determined as the time in seconds needed for red skin to appear on a specific skin type without protection, and the redness persists for 24 hours.
Good Sunscreen is Not Enough
To reduce the amount of chemicals in skincare products, Dr. Kozarev recommends using products with mineral filters in emollient and fluid bases.
“Don’t forget that sunscreen application delays the appearance of erythema on the skin. However, UV rays still have an effect if they are not screen-filtered. It’s advised not to rely only on sunscreen but to also use other physical skin protection methods with suitable clothing. A key segment of protection is a diet rich in natural antioxidants, which prevents excessive free radical formation in the skin, thus reducing inflammatory and other harmful effects of UV rays,” concludes Dr. Jasmina Kozarev.