Dr. Bob: Our children are outside all of the time in the summer. Whether it’s the backyard pool, the neighborhood pool or the beach, they are out there with just their bathing suits on. I worry about sun exposure and its effect on their skin. What can I do to protect them from long term effects of sun exposure?
Answer: You are right to be concerned. When I grew up, no one seemed to worry about that. I got sunburn to the point of peeling several times, and I remember other folks purposely putting stuff on their skin to “enhance” their exposure and get a dark tan. We now know that was not a good idea. The risk of skin cancer over your lifetime increases with your exposure to the sun. Squamous cell cancer, basal cell carcinoma and melanoma are the main offenders. All adults who were “sun worshippers” as children or young adults should be monitored closely by themselves (self-skin inspection) and by their health professional.
We want to encourage outdoor activity but let’s be sure to protect our children –
- General rules of protection
- Loose comfortable clothing; clothes with a tight weave tend to provide more protection
- A hat with a broad brim is helpful to protect the face, the ears and the back of the neck
- Limit sun exposure during the hottest times of the day, typically 10 AM-4 PM.
- Sunglasses with UV protection built in will help protect the eyes
- Infants under 6 months should definitely not be in the direct sun and even older infants need protection and time limits for being outside on hot days
- Sunscreen use
- Always use sunscreen for your children; even deeply pigmented children are at risk for sunburn and later skin cancer
- Most skin doctors recommend that a sunscreen with SPF (sun protection factor) 30-50 is sufficient; it is not proven that SPF over 50 actually provides more protection
- Be sure that the product protects against both UVA and UVB (ultraviolet light rays A and B); interestingly UVA tends to be linked to skin aging and UVB to sunburn
- Apply generously to all exposed areas; apply 15-30 minutes before exposure to allow for absorption; reapply every 2 hours
- Remember that UV rays can still penetrate cloud cover so you can still get significant sun exposure and even sunburn on a cloudy day
- Infants also need sunscreen for their few exposed areas; apply with care so as to avoid the eyes and/or where they can lick it off of their skin
When outside, especially on a hot day, be sure that your children are adequately hydrated. They can be lulled into a false sense of security and not drink enough fluids. Even when the summer comes to a close and fall approaches, sun exposure is still significant and children need protection.
In the event that a sunburn does occur, be sure to keep your children out of the sun until the skin is healed. Cool compresses and pain medication might help. Check with your doctor about medicated lotions. (My mother lathered me with Noxzema, and it helped the symptoms because of the cooling qualities, not because of any specific medicinal qualities). If there are any signs of scalding or blisters, check with your pediatrician and your child should probably be seen to check for any potential infections or for more advanced care of the sunburn. I have seen some whoppers of sunburn during my career.
Dr. Saul is Professor of Pediatrics (Emeritus) at Prisma Health and his website is www.mychildrenschildren.com. Contact Dr. Bob at askdrbobsaul@gmail.com with more questions.