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Here comes the sun

Sunday, April 22, 2018
By Jane S. Bellet, MD, for KidsFirst
girl swimming

Sun safety
Spring is finally here! As the days become longer and we enjoy spending more time outdoors, how can you protect your child from the harmful effects of ultraviolet (UV) exposure?

The primary reason for decreasing sun exposure is to prevent skin cancer.

Sun exposure in young children increases their risk of developing melanoma and other types of skin cancer at some point in their lives. Sunburns are even worse for increasing skin cancer risk. If that information doesn’t faze your teenager, try this: sun exposed skin becomes wrinkly and ages much earlier than would happen otherwise.

Avoiding sun exposure is the best measure. Go outside when the sun is low on the horizon (this means that shadows are long and there will be less exposure). This means earlier in the morning and later in the afternoon. Try to avoid being outside between 10am-2pm. This is when the sun’s rays are the strongest. Even on cloudy days, there can be significant UV ray exposure, so do not forget to protect your child.

Seek shade. This can be under trees if playing outside, under an umbrella or tent at the beach, or under a shade structure if the playground or pool has one.

Clothing: think long sleeves, hats, and sunglasses
Choose clothing carefully. Get a broad brimmed hat for your child—start as an infant and it will become second nature. Wear one yourself so that you are modeling good behavior. 

Long sleeved “rash guard” type shirts are great choices when outdoors, since then you don’t have to reapply sunscreen to the areas covered by the shirt. There are many brands of clothing that have Ultraviolet Protection Factor (UPF) embedded in them—these types of fabric help block the UV rays, as most “normal” fabrics allow UV rays to pass through them. Regular clothing styles as well as swimwear are available so that your child can be protected all the time when outside. There are even full body UPF swimsuits that cover from neck to ankle.

These are just a few companies that sell UPF types of clothing. Many others do as well.

A tighter weave of fabric can help to block some UV rays (hold your regular clothes up to the light and see if light is filtering through). Another option is to wash regular clothes with a product called “SunGuard” that imparts UPF to clothing for up to 6 washes.

Sunglasses are important to protect the eyes and children can start to wear them in the first year of life.

Sun exposure in young children increases their risk of developing melanoma and other types of skin cancer at some point in their lives.

Sunscreen is the very last resort in terms of sun protection. For areas of the body that are not covered by clothing, sunscreen can help to protect them.  Use a product that is water resistant (no sunscreen is truly waterproof) and at least SPF 30 or higher. Make sure to use enough: 2 ounces (the amount in a shot glass) to cover the entire body of a large child or teenager.

Do not forget the ears or the feet, when applying sunscreen. Apply 30-60 minutes before heading outdoors, and then reapply at least every 1-2 hours as well as every time your child gets out of the water, if swimming. There are many different brands of sunscreen, as well as different components that provide the protection. These active components are divided into “physical” blockers and “chemical” blockers. “Physical” blockers are thought to be the safest for children, as they are not absorbed by the skin. These include zinc oxide and titanium dioxide. They can be used on very young infants if they cannot avoid sun exposure. The American Academy of Pediatrics recommends: “For babies younger than 6 months: Use sunscreen on small areas of the body, such as the face, if protective clothing and shade are not available.” Plain zinc oxide can be found in the diaper rash section of creams at the store—this is very good for the face since it will not sting if your child rubs their eyes after touching it. You can buy these in fun colors that older children may enjoy using on their face.

For older children and teenagers, they may prefer to use a “chemical” blocker, as these rub in without leaving a white residue. The American Academy of Dermatology has issued the following statement regarding the safety of oxybenzone, one of the common chemical blockers: “This is one of the few ingredients in sunscreen that effectively protects our skin from harmful UVA and UVB rays. Approved by the FDA in 1978. No data shows that oxybenzone causes hormonal problems in humans. No data shows that oxybenzone causes any significant health problems. FDA approved for use by people 6 months of age and older.”

Don’t forget the lips—use a lip balm with at least SPF 15.

For children that have long hair, put their hair into a ponytail without a part when going swimming, otherwise you will need to apply sunscreen to the part.

Spray sunscreens seem easy; however, some people will burn if they are not applied properly. Stick sunscreens are usually chemical blockers, and are easy to use for reapplication on the face.

Once your children are protected from the sun, they can get outside and enjoy their outdoor activities!

Jane S. Bellet, MD, FAAD, is an associate professor of pediatrics and dermatology in the Duke School of Medicine in Durham, NC.



Related Resources

CDC - Sun Safety - Skin Cancer
[Centers for Disease Control and Prevention]

Sun Safety

Be Safe in the Sun
[American Cancer Society]

“KidsFirst” is a blog, hosted by the Duke Department of Pediatrics, that provides high quality information to families on a wide range of important child health topics.