Protect Your Most Important Assets
With warm temperatures and extended daylight hours, most children are anxious to be outside. With the right precautions, children can safely play in the sun. An estimated 80 percent of all sunlight damage occurs before the age of 18, underscoring the importance of beginning protective practices in childhood. In tiny infants the best protection is avoidance of exposure. As a practical matter, children under the age of six months should not be involved in the kind of outdoor activity for which sunscreens are intended. By six months of age, babies are likely to be outdoors for longer periods, and a more aggressive strategy is needed.
I instruct patients to apply sunscreens over all potentially exposed skin,not just specific spots. The higher the SPF number, the better the protection. Use the highest number you can find. Ideally, a thick layer should be applied half an hour before sun exposure, but it is never too late to use sunscreen. New studies show that many sunscreens start to lose some effectiveness after 2 hours. Reapplication is necessary every few hours or after intense activity, sweating or immersion in water.
Beach umbrellas and clothing can give a child additional protection from the sun. Long-sleeved shirts of a tightly woven fabric and broad-brimmed hats should be worn. Fair-skinned individuals can sunburn under some thin clothing.
It is also important to keep your child out of the sun from 10:000 a.m. to 3:00 p.m. and to avoid places with highly reflective surfaces, such as sand and water. Parents must remember that heat and brightness are not indicators of ultraviolet intensity. (It is hotter on August 15 than it is on April 15, but the UV light is equivalent.) In addition, rays are transmitted through clouds, and sunscreen should not be forgotten on cloudy days.
The fact that children rarely get skin cancers should not dissuade a parent from having a child examined if there is the slightest cause for suspicion. Parents must be alert to changes in moles and spots on the skin that look unusual or do not heal. Any spot on the skin that changes size, shape, color or bleeds should be brought to the attention of your dermatologist. Similarly, children who have a large number of moles or a family history of melanoma must be checked regularly by a dermatologist as well as by the parents. Several studies show that sunburns may cause normal moles to become precancerous or lead to melanoma. Therefore, children with a family history of melanoma or abnormal moles should be especially careful about overexposure to the sun.
A life free of skin cancer is the goal. Exposure to ultraviolet radiation occurs whenever one is outdoors, and skin damage is not limited to the beach. Therefore, sunscreen should be used not only for such recreational activities as swimming, but also for such outside chores as mowing the lawn. As an educated parent, you can play an important role in improving the health of all children.
John J. Jones, M.D.
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