Vitamin D: Is it Really Worth the Sun Damage?
AUTHOR: KARA HORACEK. AUGUST 2026
Growing up in LA, the subculture surrounding tanning and overexposure to sun during a high UV index was often justified not only with the aesthetics of a tan but with the claim that it was “healthy” because we as humans need Vitamin D. While, yes, Vitamin D does have a wide range of systemic effects within the body ranging from helping with skin barrier function to bone health, there are many ways to meet our daily recommended intake without baking on the beach.
The primary strategies for obtaining vitamin D without sun damage are oral supplementation and dietary intake from vitamin D–rich and fortified foods. In a 2022 paper, the American Academy of Dermatology stated there is no scientifically validated safe threshold of UV exposure that maximizes vitamin D synthesis without increasing skin cancer risk. Instead, the National Academy of Medicine recommends 600 IU/day for ages 1–70 and 800 IU/day for those over 70 years, with a tolerable upper intake level of 4,000 IU/day for the general adult population. An IU, or international unit, of Vitamin D is equivalent to 0.025 micrograms. The best natural food sources are oily fish (wild salmon ~600–1,000 IU per 3.5 oz, canned sardines ~300 IU), cod liver oil (~400–1,000 IU per teaspoon), and sun-dried shiitake mushrooms (~1,600 IU per 3.5 oz).
In addition to considerations for the general population, UV exposure and Vitamin D intake does not affect everyone equally. Research has shown that individuals with darker skin tones may be at increased risk for lower levels of vitamin D. Type V-VI skin can have 6× less cutaneous (skin surface) vitamin D production than pale skin under the same UV exposure. Routine sun protection is generally not recommended for this group but supplementation is often necessary regardless of sun habits. Contrastingly, for fair skin types I–II or those with personal/family history of skin cancer or immunosuppression, comprehensive photoprotection is essential, and vitamin D should come exclusively from supplementation.
On the topic of supplementation, what are vitamin D supplements and how do they differ? Vitamin D₃ (cholecalciferol) is the preferred supplement form, as it is ~40% more effective than vitamin D₂ (ergocalciferol) at raising and maintaining serum 25(OH)D levels. 25-hydroxy vitamin D, commonly shortened to 25(OH)D, is the primary circulating form of vitamin D in your blood and is the most accurate marker used to evaluate your body's total vitamin D status. Vitamin D₃ is available as tablets, softgel capsules, chewable tablets, liquid drops, and oral sprays — all are effective at raising 25(OH)D levels with no clinically significant difference between delivery methods. Daily, weekly, and monthly dosing schedules are equally effective at achieving target serum concentrations, so the schedule should be chosen based on what works for you!
Vitamin D is required for your health. In the US, the average daily vitamin D intake from food alone is roughly 200 IU (or 5 mcg) for men and 170 IU (or 4.2 mcg) for women. This is far below the recommended 600 IU. So, what do you do if you think you may be deficient? Mild vitamin D insufficiency is often asymptomatic, which is why it frequently goes undetected. However, the following symptoms should prompt evaluation:
Bone pain and tenderness — particularly symmetric low back pain, or throbbing pain elicited with pressure over the sternum or tibia.
Proximal muscle weakness — difficulty rising from a seated position, climbing stairs, or a waddling gait.
Recurrent fractures or fragility fractures — fractures from minimal trauma may indicate osteomalacia or osteoporosis related to vitamin D deficiency
Muscle aches and generalized fatigue — nonspecific but common in moderate-to-severe deficiency.
In addition, children with Vitamin D deficiencies can develop rickets, which presents with more distinctive findings: bowed legs, widened wrists/ankles, or delayed tooth eruption.
Even without symptoms, the following populations should have serum 25(OH)D tested, as they are at substantially higher risk for clinically significant deficiency:
Senior adults, especially with a history of falls or non-traumatic fractures
Individuals with obesity (BMI ≥30), as vitamin D gets pulled out of your blood and locked away inside fat cells
Patients with malabsorption syndromes (celiac disease, Crohn's disease, ulcerative colitis, cystic fibrosis) or post-bariatric surgery
Those with chronic kidney disease or hepatic failure, which impair vitamin D metabolism
Patients on medications that interfere with vitamin D (anticonvulsants, glucocorticoids, antiretrovirals, antifungals, cholestyramine)
Individuals with very limited sun exposure (homebound, institutionalized, fully covered clothing) or deeply pigmented skin at higher latitudes
Pregnant and lactating women
Patients with granulomatous diseases (sarcoidosis, tuberculosis) or certain lymphomas
If you or anyone close to you has displayed these symptoms or falls on the high risk list, consider asking your doctor for recommended treatment. We at Boutik Dermatology would be happy to assist you with learning how to best protect your health.
Summary:
Don’t think sun is the best way to get vitamin D! It can cause skin cancer! Eat fish with oils or supplement with D3. You need 600 IU of Vitamin D a day at LEAST. If you’re high risk, talk to a doctor. You need the Vitamin D.
