Sunscreen and 25-Hydroxyvitamin D Levels: Friends or Foes? A Systematic Review and Meta-Analysis.

OBJECTIVE

To evaluate the impact of sunscreen use on 25-hydroxyvitamin D (25(OH)D) levels, addressing conflicting findings from observational and interventional studies.

METHODS

Potentially eligible studies were identified from the PubMed/MEDLINE, Scopus, and Web of Science databases from inception to November 2024, utilizing a search strategy incorporating terms related to "sunscreen" and "vitamin D." The studies eligible addressed the questions define based on the Population, Intervention, Comparator, Outcome framework: What are 25(OH)D levels in patients exposing to sun applying or not sunscreen? This review followed Preferred Reported Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality assessment and the risk of bias were analyzed using Quality Assessment of Diagnostic Accuracy Studies version 2.

RESULTS

We included 22 studies in the qualitative synthesis, and 7 in the quantitative one, encompassing a total of 9470 participants. In vitro studies consistently showed that sunscreen blocks UV-B radiation, crucial for vitamin D3 production, while population-based studies reported mixed findings. Some studies linked sunscreen use to lower 25(OH)D levels, particularly in individuals with limited sun exposure, while others observed no significant impact. Meta-analysis showed that the adoption of sunscreen is associated to a reduction of 25(OH)D serum concentration (standardized mean difference = -2 ng/mL, 95% confidence interval -3, -1) with a not important heterogeneity across studies (I-square = 37%, P = .15).

CONCLUSION

The existing evidence supports that sunscreen can impair vitamin D3 synthesis, and as a result decrease serum 25(OH)D levels, but further research is necessary to determine the broader health implications and guide public health recommendations.