|SSM Cardinal Glennon Children's Medical Center|
We all need some sun exposure — it's the top source of vitamin D, which helps our bodies absorb calcium for stronger, healthier bones.
But it doesn't take much time in the sun for most people to get the vitamin D they need. And repeated unprotected exposure to the sun's ultraviolet (UV) rays can cause skin damage, eye damage, immune system suppression, and skin cancer. Even people in their twenties can develop skin cancer.
Most kids get much of their lifetime sun exposure before age 18, so it's important for parents to teach them how to enjoy fun in the sun safely. Taking the right precautions can greatly reduce your child's chance of developing skin cancer.
Facts About Sun Exposure
The sun radiates light to the earth, and part of that light consists of invisible UV rays. When these rays reach the skin, they cause tanning, burning, and other skin damage.
Sunlight contains three types of ultraviolet rays: UVA, UVB, and UVC:
What's important is to protect your family from exposure to UVA and UVB, the rays that cause skin damage.
Melanin: The Body's First Line of Defense
UV rays react with a chemical called melanin that's found in skin. Melanin is the first defense against the sun because it absorbs dangerous UV rays before they do serious skin damage.
Melanin is found in different concentrations and colors, resulting in different skin colors. The lighter someone's natural skin color, the less melanin it has to absorb UV rays and protect itself. The darker a person's natural skin color, the more melanin it has to protect itself. (But both dark- and light-skinned kids need protection from UV rays because any tanning or burning causes skin damage.)
Also, anyone with a fair complexion — lighter skin and eye color — is more likely to have freckles because there's less melanin in the skin. Although freckles are harmless, being outside in the sun may help cause them or make them darker.
As the melanin increases in response to sun exposure, the skin tans. But even that "healthy" tan may be a sign of sun damage. The risk of damage increases with the amount and intensity of exposure. Those who are regularly exposed to the sun (such as farmers, boaters, and sunbathers) are at much greater risk. A sunburn develops when the amount of UV exposure is greater than what can be protected against by the skin's melanin.
Unprotected sun exposure is even more dangerous for kids with:
You should be especially careful about sun protection if your child has one or more of these high-risk factors.
Also, not all sunlight is "equal" in UV concentration. The intensity of the sun's rays depends upon the time of year, as well as the altitude and latitude of your location. UV rays are strongest during summer. Remember that the timing of this season varies by location; if you travel to a foreign country during its summer season, you'll need to pack or buy the strongest sun protection you can find.
Extra protection is also required near the equator, where the sun is strongest, and at high altitudes, where the air and cloud cover are thinner, allowing more damaging UV rays to get through the atmosphere. Even during winter months, if your family goes skiing in the mountains, be sure to apply plenty of sunscreen; UV rays reflect off both snow and water, increasing the probability of sunburn.
With these precautions, kids can safely play in the sun.
Avoid the Strongest Rays of the Day
First, seek shade when the sun is at its highest overhead and therefore strongest (usually from 10 a.m. to 4 p.m. in the northern hemisphere). If kids are in the sun during this time, be sure to apply and reapply protective sunscreen — even if they're just playing in the backyard. Most sun damage occurs as a result of incidental exposure during day-to-day activities, not from being at the beach.
Even on cloudy, cool, or overcast days, UV rays travel through the clouds and reflect off sand, water, and even concrete. Clouds and pollution don't filter out UV rays, and they can give a false sense of protection. This "invisible sun" can cause unexpected sunburn and skin damage. Often, kids are unaware that they're developing a sunburn on cooler or windy days because the temperature or breeze keeps skin feeling cool on the surface.
Make sure your kids don't use tanning beds at any time, even to "prepare" for a trip to a warm climate. Both UVA and UVA/UVB tanning beds produce sunburn. And there is an increased risk of melanoma in people who have used tanning beds before the age of 35.
One of the best ways to protect your family from the sun is to cover up and shield skin from UV rays. Be sure that clothes will screen out harmful UV rays by placing your hand inside the garments and making sure you can't see it through them.
Because infants have thinner skin and underdeveloped melanin, their skin burns more easily than that of older kids. The best protection for babies under 6 months of age is shade, so they should be kept out of the sun whenever possible. If your baby must be in the sun, dress him or her in clothing that covers the body, including hats with wide brims to shadow the face. Use an umbrella to create shade. If your baby is younger than 6 months old and still has small areas of skin (like the face) exposed, you can use a tiny amount of sunscreen with a minimum SPF (sun protection factor) of 15 on those areas.
Even older kids need to escape the sun. For all-day outdoor affairs, bring along a wide umbrella or a pop-up tent to play in. If it's not too hot outside and won't make kids even more uncomfortable, have them wear light long-sleeved shirts and/or long pants. Before heading to the beach or park, call ahead to find out if certain areas offer rentals of umbrellas, tents, and other sun-protective gear.
Use Sunscreen Consistently
With all the options available (organic or mineral? water-resistant or sweat-resistant? lotion or spray?), choosing a sunscreen for your kids can be tricky. But what matters most is the degree of protection it provides from UV rays.
Look for SPF numbers on the labels of sunscreens. Select an SPF of 30 or higher to prevent sunburn and tanning, both of which are signs of skin damage. Choose a sunscreen that protects against UVA and UVB rays (usually labeled as a "broad-spectrum" sunscreen).
Sunscreen sprays are convenient but should be used with caution. For starters, sprays are easy to breathe in, which can irritate the lungs. Some sprays also are flammable, so you need to avoid sparks or flames when applying them and wearing them. And, sprays make it hard to tell if you have applied enough sunscreen, which increases the risk of sunburn.
Other things to consider:
For sunscreen to do its job, it must be applied correctly. So be sure to:
Every child needs sun protection. The American Academy of Dermatology (AAD) recommends that all kids — regardless of their skin tone — wear sunscreen with an SPF of 30 or higher. Although dark skin has more protective melanin and tans more easily than it burns, tanning is a sign of sun damage. Dark-skinned kids also can get painful sunburns.
Use Protective Eyewear for Kids
Sun exposure damages the eyes as well as the skin. Even 1 day in the sun can result in a burned cornea (the outermost, clear membrane layer of the eye). Cumulative exposure can lead to cataracts (clouding of the eye lens, which leads to blurred vision) later in life. The best way to protect eyes is to wear sunglasses.
Not all sunglasses provide the same level of ultraviolet protection; darkened plastic or glass lenses without special UV filters just trick the eyes into a false sense of safety. Purchase sunglasses with labels ensuring that they provide 100% UV protection.
But not all kids enjoy wearing sunglasses, especially the first few times. To encourage them to wear them, let kids select a style they like — many manufacturers make fun, multicolored frames or ones embossed with cartoon characters.
And don't forget that kids want to be like grown-ups. If you wear sunglasses regularly, your kids may be willing to follow your example. Providing sunglasses early in childhood will encourage the habit of wearing them in the future.
Some medications increase the skin's sensitivity to UV rays. As a result, even kids with skin that tends not to burn easily can develop a severe sunburn in just minutes when taking certain medications. Fair-skinned kids, of course, are even more at risk.
Ask your doctor or pharmacist if any prescription (especially antibiotics and acne medications) and over-the-counter (OTC) medications your child is taking can increase sun sensitivity. If so, always take extra sun precautions. The best protection is simply covering up or staying indoors; even sunscreen can't always protect skin from sun sensitivity caused by medications.
If Your Child Gets a Sunburn
A sunburn can sneak up on kids, especially after a long day at the beach or park. Often, they seem fine during the day but then gradually develop an "after-burn" later that evening that can be painful and hot and even make them feel sick.
When kids get sunburned, they usually experience pain and a sensation of heat — symptoms that tend to get worse several hours after sun exposure. Some also get chills. Because the sun has dried their skin, it can become itchy and tight. Sunburned skin begins to peel about a week after the sunburn. Encourage your child not to scratch or peel off loose skin because skin underneath the sunburn is vulnerable to infection.
If your child does get a sunburn, these tips may help:
If the sunburn is severe and blisters develop, call your doctor. Until you can see your doctor, tell your child not to scratch, pop, or squeeze the blisters, which can get infected and cause scarring. Keep your child out of the sun until the sunburn is healed. Any further sun exposure will only make the burn worse and increase pain.
Be Sun Safe Yourself
Don't forget: Be a good role model by consistently using sunscreen of SPF 30 or greater, wearing sunglasses, and limiting your time in the sun. Doing so not only reduces your risk of sun damage — it also teaches your kids good sun sense.
Reviewed by: Rupal Christine Gupta, MD