Aussie Gen Y’ers have slipped, slopped, slapped all their lives, thanks to a very successful public health campaign aimed at reducing skin cancer. Our pale generation, although less inclined to melanomas, are more likely to be Vitamin D deficient, which is linked to diseases such as osteoporosis. Not as widely noted is that lack of sun exposure in itself has been implicated in MS.

In this month’s JNNP, Zivadinov et al.1 report that sun exposure may have direct effects on MRI measures of neurodegeneration in MS, independent of vitamin D levels. Specifically, they found that increased summer sun exposure was associated with increased grey matter volume and whole brain volume.

Why is this?

Zivadinov’s group, from Buffalo, USA, postulate that this may be due to a possible immunomodulation effect from sun exposure itself.

It’s not the first study to have connected sunshine & immune diseases. Among others, an Australian study2 demonstrated that greater UV induced skin damage and higher vitamin D levels were associated with a decreased risk of the initial demyelinating event.

So where does that leave us?

Sun-bathing prescriptions – will you recommend your patients catch some rays?    How much is enough?

Do you encourage being SunSmart?

Are vitamin D supplements on the menu for your patients with MS?

Or do you feel the jury is still out on the links between the sun & immune mediated disease?

Would love to hear your thoughts and how you integrate these ideas into your day to day practice.

1 – Zivadinov R, Treu CN, Weinstock-Guttman B, et al. Interdependence and contributions of sun exposure and vitamin D to MRI measures in multiple sclerosis. J Neurol Neurosurg Psychiatry 2013;84:1075-1081. doi:10.1136/jnnp-2012-304661

2 – Lucas RM, Ponsonby AL, Dear K, et al. Sun exposure and vitamin D are independent risk factors for CNS demyelination. Neurology 2011;76:540–8.