Sunscreen and Skin Cancer
A few minutes of daily sun exposure is important as a source of vitamin D, which helps the body absorb calcium to make bones strong. Too much sun, however, can damage skin, eyes and the immune system, as well as cause painful sunburns. Prolonged sun exposure may cause wrinkling, skin toughening, freckling and skin cancers. And most lifetime sun damage occurs in childhood.
The Danger of UV Rays
There are three types of ultraviolet rays emitted by the sun: UVA, UVB and UVC. UVA rays cause skin wrinkling and cancer, such as melanoma. Tans from UVA rays do not protect the skin from further sun damage. UVB rays cause sunburns and cataracts, and damage the immune system. Severe UVB sunburns in children may also lead to melanoma. UVC rays are most dangerous, but are blocked by the ozone layer and don’t reach the earth.
Melanin is the body’s defense mechanism against sun exposure. Unprotected sun exposure is more dangerous for children with very fair skin and hair, a family history of skin cancer, or moles on their or their parents’ skin, but all children need sun protection regardless of skin color or other risk factors.
The intensity of sun exposure varies by season, altitude and latitude. Extra protection is needed at higher altitudes, in regions closer to the equator and during the summer. The strongest UV rays are usually from 10 a.m. to 4 p.m, and cool temperatures and clouds do not filter out UV rays. Reflective surfaces, such as water, sand, snow and concrete can increase sun-exposure intensity, as can certain medications, including some antibiotics and acne medications. Talk to your doctor or pharmacist about whether a child’s medication may increase sun sensitivity.
Covering up is the best defense from the sun. Encourage children to wear hats, sunglasses and clothing with a tight weave. To test clothing, place your hands inside clothing to make sure you can’t see through. Hats should have at least a 3-inch brim.
Always use sunscreen with at least a SPF 15 rating. Make sure the sunscreen is broad-spectrum, screening out UVA and UVB, and pick a sunscreen that is waterproof. A new system is now in place that rates UVA protection. One star is the lowest and four stars is the highest protection available over the counter.
Protecting infant skin is essential because children under 6 months have the least melanin and can easily sunburn. Children under 6 months should be kept out of direct sunlight. Sunscreen should not be used because sweat glands are impaired, and they are at increased risk of complications of prolonged heat exposure.
Be sure to apply sunscreen to a small area and watch for a reaction prior to applying all over. If sunscreen causes an irritation, stop using it immediately and try a different brand, a sunscreen stick, or one with titanium dioxide or zinc oxide. If a rash develops, call your pediatrician.
Make sure to cover all exposed areas and rub it in well. Don’t forget ears, behind the knees and feet. Sunscreen should be applied at least 30 minutes prior to going outdoors in order to be absorbed by the skin. Then apply sunscreen again every two hours, as well as after swimming or sweating.
In addition to skin protection, it is important to protect eyes. Unprotected sun exposure can burn the cornea, the outer membrane of the eye, and longterm exposure may cause cataracts. Sunglasses that block out 99-100 percent UV rays are the best protection. Let kids help select a style they will like wearing, and consider a pair with an elastic headband that will stay on while they play.
When Sunburn Occurs
Sunburns can occur within six to 12 hours, and are at their worst within 24 hours. If skin is red and tender, treat with cool compresses and aloe gel followed by moisturizer cream. Give acetaminophen or ibuprofen for pain. If blisters appear and the child has fever, chills, headache or a general feeling of illness, call your pediatrician. Severe burns need immediate medical attention.
Set an Example
Parents should model healthy behavior by applying and re-applying sunscreen, wearing sunglasses and protective clothing, and explaining the risk of unprotected sun exposure to their children.
Dr. Marinca is a pediatric resident at Levine Children’s Hospital. Dr. Neuspiel is a general pediatrician at Myers Park Pediatrics and is director of ambulatory pediatrics at Levine Children’s Hospital.