Fun in the Sun: Summer Sun Safety

Summer is time for fun in the sun, but children’s skin also needs to be protected from the damaging effects of the sun’s rays.  Scientists currently believe that many skin cancers are caused by ultraviolet radiation from sun exposure, especially sunburns, and that cancer can be prevented by reducing sun exposure and sunburns (though this is yet to be proven). Melanoma is on the rise and is being seen at younger ages. About 80% of a person’s lifetime sun exposure occurs during childhood, and many experts believe that the majority of the sun damage that leads to the cancer occurs during this time. Furthermore, sunburns in childhood have been shown to increase the risk of melanoma. Melanoma may be an adult disease that is preventable in childhood!

Sun exposure also causes other skin damage that appears later in life as wrinkles, leathery skin, and other skin changes. Protection from the damaging ultraviolet radiation of the sun is especially important in children who are fair skinned, have blond or red hair, or have a history or a family history of skin cancer.  Children should have fun in the sun, but must be wise and vigilant about it and take the proper precautions.

While dermatologists are fond of saying these days that there is no such thing as a safe tan, sun safety should be balanced with common sense. Children need to play outside, and we all need sunlight to make vitamin D.  Children should certainly stay away from tanning beds, and should probably not intentionally try to get a tan. They should definitely not get sunburned; besides increasing the risk of cancer, it is simply not healthy to burn the skin. It also hurts. But there may not be as much concern about children getting some naturally darker skin from playing outside during the summer. Like most things in life, it should be in moderation. How should you protect your children while letting them enjoy the great outdoors?

The best protection from the sun is not sunscreen use, but the following:

  • Stay in the shade whenever possible.
  • Wear clothes that cover the skin, hats, and sunglasses (to protect the eyes). Tighter weave is better (hold it up and see how much light you can see through it).
  • Stay inside during peak ultraviolet radiation hours, from 10 am to 2 pm.

Sunscreens

  • Sunlight contains two types of ultraviolet radiation (A & B) that cause sunburns and skin damage leading to cancer. The SPF rating refers to UVB protection, which causes sunburns; however, UVA is a concern for skin damage and cancer. The best sunscreens protect against both types of ultraviolet radiation.
  • Choose a sunscreen that says “broad-spectrum”, which means both UVA and UVB protection (this is a new FDA requirement in 2012).
  • Use at least SPF 15; 30-50 is preferred.  But don’t go over 60 (too many chemicals with little added benefit).
  • Sunscreens can have the effect of making people stay in the sun longer without burning from UVB radiation, actually increasing sun exposure, especially to UVA radiation.
  • Choose a water-resistant sunscreen. The FDA also changed regulations in 2012 to stop claims of being water or sweat proof. Sunscreens are not waterproof and all must be reapplied regularly.
  • The safest and most effective sunscreens contain zinc oxide or titanium dioxide. These have not been as popular because they stay somewhat visible on the skin; however, new technology makes the particles very small and lessens this problem significantly. Avoid nanoscale zinc and titanium oxides, however, in any spray or powder form.
  • Sunscreens with avobenzone are also safe and effective.
  • Try to avoid oxybenzone in children (it interferes with hormones in body) and retinyl palmitate (which may increase risk of birth defects in pregnant women, plus other effects) if possible.
  • Avoid sunscreens with added insect repellant.
  • Avoid sprays and powders in children, and all ages around the face. Inhaling the chemicals may be harmful. Spray the sunscreen on hand and rub on your child if you must use them.

General Tips for applying/using sunscreen for all ages

  • Apply at least 20 minutes before going out and use recommended amounts.
  • Choose a sunscreen with an SPF rating of 30-50 and broad-spectrum protection.
  • Reapply after 2 hours or after swimming or sweating (even water-resistant sunscreens should be reapplied).
  • Avoid the brightest times whenever possible, from 10 am to 2 pm.
  • Sunscreen should be worn even on cloudy days.
  • Water, sand and snow reflect the sun’s damaging rays and increase exposure to ultraviolet radiation.

Children under 6 months of age

  • Children this age should be in the shade as much as possible to avoid exposing their delicate skin to the sun’s rays.  They can be dressed in lightweight long pants and long-sleeve shirts.  A hat should also be worn.  They can be kept under umbrellas, tents, canopies, etc. to protect them from the sun (but be sure they remain cool and don’t get overheated).  Be aware that sand and snow reflect the sun’s rays and can increase sun damage and sunburn.
  • Experts used to recommend not using any sunscreen at this age; however, there is no evidence of harm, and the benefits are now thought to outweigh the risks of sun exposure.  A small amount may be applied to the face, scalp, and back of the hands if these areas cannot be protected.  An SPF of at least 15 and preferably 30 is recommended.  You should wash off any residue after coming inside. Don’t let your child put sunscreen in his or her mouth.

Toddlers and Children

  • Minimizing exposure is still recommended.  Shade is the first line of defense.
  • Children should wear sunglasses when old enough in order to avoid eye damage.
  • Hats should be worn whenever possible as well.

Teenagers

  • The same guidelines for children apply to teenagers as well.
  • Be sure enough sunscreen is used – at least 1 oz per application.
  • Teens (and adults) should be discouraged from getting tans.  There is no such thing as a safe tan, especially one from a tanning bed.

Quick Suncreen Guide

More resources

References

Ultraviolet Radiation: A Hazard to Children and Adolescents. Council on Environmental Health and Section on Dermatology. Pediatrics Mar 2011, 127 (3) 588-597; DOI: 10.1542/peds.2010-3501