With summer just around the corner, sun safety and protection is incredibly important. Suntans are generally associated with good health and beauty. The sun, however, can cause a lot of damage. The first 20 years of life are the most important time to avoid excess sun exposure. Most skin cancers develop because of sun exposure the first 20 years of life. Skin cancer is becoming a more common cancer. In the early 1900’s there was a 1 in 1500 risk of developing skin cancer. Now the risk is 1 in 87 people. This is all due to the outdoor lifestyle and tanning without adequate sun protection.
Children are at the highest risk for sun damage because they spend a lot more time outdoors than adults. 80% of a person’s sun exposure comes within the first 20 years of life. Children’s skin is comparatively thin with less protective melanin than adults, increasing their risk of sun damage. Because of this, it is important to know your child’s risk for sun damage so that you can provide adequate protection.
Because of the risks of sun damage, it is important to be prepared for the summer sun. The sun emits radiation called ultraviolet A, B, and C (UVA, UVB, and UVC). UVA is constant throughout the day, which causes most of the damage to the skin. UVB peaks between 10 am-4 pm and causes mostly redness or tanning, UVC is absorbed by the ozone layer. Sunscreen SPF takes only UVB into consideration. SPF addresses how long a person can stay in the sun without damage with sunscreen applied compared to without sunscreen. For example if it takes 15 minutes to burn without sunscreen, then SPF 4 will provide 1 hour of protection before burning. It is important to apply sunscreen and to use the correct SPF.
Sunscreens come in two types, physical and chemical. The physical sunscreens completely block the sun’s radiation, however, they are very difficult to apply. These include zinc oxide or titanium oxide. People will apply these to a particularly prone area of the body such as the nose. Chemical sunscreens are much more common. They absorb the sun’s rays and disperse it to a more harmless form. These include para-aminobenzoic acid (PABA) Octyl methoxycinnamate and many others. PABA is an excellent block for the UVB radiation, which causes most of the damage. Unfortunately, about 4% of the population is allergic to this. This would be my first choice if there is no allergic reaction. Allergic reactions include redness and itching.
Sunscreens should be applied 30-45 minutes before sun exposure and should be reapplied every 2 hours, sooner if there is swimming or heavy perspiration. Sunscreen with an SPF of 15 will block about 95% of all radiation. An SPF of 30 will block about 97% of all radiation so sunscreen higher than 15 SPF won’t generally give any more protection. The frequent application is more important than the SPF once you are up to 15 SPF.
Although the use of sunscreen is very important, other safety measures must be considered. First, children under the age of 6 months should not need sunscreen because they should not be in direct sunlight. The FDA recommends against sunscreen in the first 6 months of life for this very reason. We don’t want to get a false sense of security. Baby’s skin is just too thin and too prone to injury to be in direct sunlight. Use hats, umbrellas, and avoid direct sunlight in that age group. Most people either don’t use sunscreen at all or they don’t reapply it enough. Studies show that almost 50% of all children use no sunscreen at all and less than 10% reapply the sunscreen after 2 hours. You have to use the sunscreen for it to work. Also, clothing type can be very important. If the clothing does not block the sun, then sunscreen should be applied beneath the clothing. For example a typical white cotton T-shirt provides an SPF of around 7. The more tightly wound the fabric, the better the protection. Sunglasses should block both UVA and UVB. The darkness of the lens does not equate to the ultraviolet protection. Make sure the glasses are labeled for UVA and UVB protection.
Helpful hints:
- Limit your child’s exposure to the sun, especially between the hours of 10 am and 4 pm.
- Have your child wear protective clothing such as a hat, long sleeved shirt, and long pants in a tightly woven fabric.
- Avoid sunscreens in children younger than 6 months of age. Instead use protective clothing and an umbrella.
- Use sunscreens from May through September.
- Apply sunscreen daily. Use SPF 15 and make sure it provides protection for both UVA and UVB radiation. Use the sunscreen 30-45 minutes before sun exposure and reapply every 2 hours.
- Use sunglasses that protect both UVA and UVB radiation.
- Use more protection at higher altitudes. Every 1000 feet increases exposure 5%.
- Cloudy days can be dangerous. 80% of radiation can get through the clouds. Be sure to use sunscreen on cloudy days as well.
- Do not use tanning beds.
- Examine your child’s skin for burns or moles. See your physician if there are new moles or changes in the size or borders of existing moles.
Treatment for sunburns is limited. Sunburns usually occur 2-4 hours after the damage has been done and the peak of pain is 24 hours after exposure. Redness without blistering is a first-degree burn and redness with blistering is a second-degree burn. Advil, Motrin, or Tylenol can be used. Hydrocortisone cream 1% or moisturizing creams can relieve some of the pain. Wet compresses or cool baths with 2 oz of baking soda added can also provide some extra relief. It is important to drink plenty of fluids and stay out of the sun. Do not use Vasoline or butter on sunburns. They prevent heat and sweat from escaping through the skin and they are difficult to remove. If a blister breaks, remove the dead skin with a pair of fine scissors and apply an antibacterial ointment twice a day for three days. If there is fever or if your child acts sick, call your physician.
Written by Dr. Michael Bornstein, who has over 28 years of experience as a pediatrician.
Disclaimer: The contents of this article, including text and images, are for informational purposes only and do not constitute a medical service. Always seek the advice of a physician or other qualified health professional for medical advice, diagnosis, and treatment.
FOLLOW US