. Ultraviolet radiation: sun exposure, tanning beds, and vitamin D levels. What you need to know and how to decrease the risk of skin cancer. J Am Osteopath Assoc. 2003 Aug;103(8):371-5.
[PMID: 12956250]
Main article: Antifungal agents
Because of the effect of light on the skin, Marshall ProtocolA curative medical treatment for chronic inflammatory disease. Based on the Marshall Pathogenesis. (MP) patients who exhibit photosensitivityAbnormal sensitivity to sunlight and bright lights. Also referred to as "sun flare" or "light flare." must protect their skin from exposure to natural light.
MP patients should wear dark clothing outdoors, because dark, dense fabric blocks all types of light better than white fabric, which lets some light through. Darker, thicker clothing stops all light energy from falling on the skin. That is the goal. The thin, light-colored fabrics that are supposed to stop UV should not be used. Outdoor attire should include shirt with a high collar and long sleeves, trousers or a long skirt, socks and shoes, a wide-brimmed hat and gloves.
Sunscreen use should not be seen as a replacement for sun avoidance measures, but only as a tool that sometimes helps when used in conjunction with sun avoidance measures.
The only sunscreen ingredients which appear to offer a significant level of protection from vitamin D production and sun flare symptoms in Th1 patients are zinc oxide, Helioplex, and titanium dioxide.
Joyce Waterhouse, PhD has produced a review of the various types of sunscreen. A summary of that review is reproduced below.
Sunscreens containing zinc oxide appear to work as well or better than ketoconazole cream for blocking sun sensitivity symptoms. Zinc oxide containing sunscreens appear to be more effective when they contain a higher percentage of zinc oxide: 16-25% vs. 3-10%. It should be remembered, though, that even a high percent of zinc oxide sunscreen only blocks a percentage of light radiation, so the longer the skin is exposed, the less effective it is. If one is exposed to light for more than a few hours, it becomes completely ineffective.
Zinc oxide is recommended for MP patients over ketoconazole cream because it inhibits both 25-DThe vitamin D metabolite widely (and erroneously) considered best indicator of vitamin D "deficiency." Inactivates the Vitamin D Nuclear Receptor. Produced by hydroxylation of vitamin D3 in the liver. and 1,25-DPrimary biologically active vitamin D hormone. Activates the vitamin D nuclear receptor. Produced by hydroxylation of 25-D. Also known as 1,25-dihydroxycholecalciferol, 1,25-hydroxyvitamin D and calcitirol. production, whereas ketoconazole cream only affects the conversion of 25-D to 1,25-D. Ketoconazole also is likely to interfere with the VDRThe Vitamin D Receptor. A nuclear receptor located throughout the body that plays a key role in the innate immune response. and becomes ineffective in dealing with Stage 5 reactions to light.
Neutrogena products with Helioplex offer some protection, but it only lasts for about 90 minutes after each application, whereas zinc oxide products work until the sunscreen is washed off.
Main article: Antifungal agents
Related article: Skin protection
Ketoconazole cream, sometimes referred to as “K-cream,” is a topical cream or shampoo that may reduce sun flare or light-driven immunopathology. Although ketoconazole cream was once recommended to MP patients, the recommendation that patients routinely use K-cream has been withdrawn. Like the other antifungals, ketoconazole cream may inhibit bacteria die-off, especially in the skin areas where it has the highest concentration.
Patients for whom light sensitivity is a problem should consider zinc oxide as an alternative for preventing moderate symptoms associated with sun exposure that cannot be avoided. For some of the most severely sun sensitive, ketoconazole cream or shampoo seems to work better for preventing or reducing sun flare symptoms, but for others, zinc oxide (not an anti-fungal) seems to work better. Both may have inhibitory effects on the immune response.
Several researchers have concluded that even when throughly applied and regularly used, sunscreen has a limited effect in slowing vitamin D production:
Several large prospective studies have shown that vitamin D deficiency does not result from regular sunscreen use.
W.L. Scarlett 1)
Vitamin D levels are not significantly affected by regular use of a sunscreen.
F.J. Moloney, et al. 2)
Clinically prescribed sunscreen creams (sun protection factor 15) caused a minor decrease in 25-hydroxyvitamin D levels, which did not induce secondary hyperparathyroidism or an increment in bone biological markers.
J. Farrerons, et al. 3)
One research team, studying patients with xeroderma pigmentosum (XP), a genetic disorder in which patients are unable to repair damage caused by ultraviolet light, found that vitamin D levels are maintained even when patients practice at least six years of rigorous photoprotection and not supplementing with vitamin D. More importantly, the researchers also concluded that the clinical manifestations of vitamin D “deficiency” were absent.
The patients all wore protective clothing and sunscreens when outdoors. Estimated mean vitamin D intake was normal. The mean values of serum 25-OHD were low normal, but 1,25-(OH)2D, calcium, ionized calcium and parathyroid hormone levels were normal…. Despite rigorous sun protection normal vitamin D levels can be maintained in ambulatory patients with XP.
R.B. Sallitto, et al. 4)
Rooms inhabited most will need dark curtain material or some other covering that will block virtually all visible, infrared and ultraviolet light. Miniblinds or vertical blinds on windows are typically not enough protection.
Redi-Shades - We found a great product at Lowes (or Home Depot) to put under shades or curtains. It is inexpensive, easy to install and does the trick. It comes in two sizes: 36“ wide or 48” wide, both are 72“ long. It can be cut down to a smaller width easily. We taped it to the bedroom window top and bottom and it blocks quite a bit of light. Since I rarely go thru the rest of my house we just keep the rest at a minimum amount of light.
Delray, MarshallProtocol.com
I found I needed to get the room darker than I could with mini-blinds. My solution was to get some blackout curtain backing fabric to use to make temporary curtains. I found the fabric at the Jo-Ann Fabrics store. My husband cut the fabric to size to fit over 4 large picture windows we have in our living room. We also put it up over the bedroom windows. My mother-in-law helped out by sewing small curtain rings onto the upper corners of the fabric. We put some small nails up at the upper corners of the windows. This way we can hang the curtains up but still easily take them down, for instance in the evening after it is dark. I like to look out at the city lights then and it helps ease the sense of claustrophobia from having the blinds closed all day long. This has been a great solution for me.
Catlady, MarshallProtocol.com
My daughter bought these really cool brown leather curtains for her livingroom at Penny's. Really total blackout and a rather modern look for her, so we are both happy. So when I visit, no more sun issue.
Melinda, MarshallProtocol.com
I purchased 15 packages of black vinyl opaque shower curtains from Walmart and will be nailing them to the windows today! My husband, Tom and the plants will have the guest room as a retreat. Heavy Duty Commercial Grade Black Vinyl Shower Curtain or Liner. We did a few of the windows today and they worked out beautifully. Hopefully, they will also help with some of the heating costs as well.
DianeC, MarshallProtocol.com