It’s summer, and your kids are likely outside all.the.time. Swimming at the pool, running around in the neighborhood, playing at the park. And then there’s summer vacation, which, for most of us, includes a trip to the beach or lake. We know we should be applying sunscreen on our kids, but, how much? How often? Should we use a spray, lotion or stick? It’s overwhelming.
So we asked Dr. Kara Shah of Kenwood Dermatology to explain sunscreen, sun protection, SPF, and all things sun safety. How do we protect our kids from sun exposure, and what’s the easiest approach to sun protection?
Summer is in full swing in Cincinnati! While enjoying the hot, sunny days at the playground, the backyard, and the pool, remember to keep your kids (and yourself!) safe in the sun. Over time, sun exposure, including chronic, low-level exposure as well as intermittent, high intensity exposure contributes to the development of skin cancer, both melanoma and non-melanoma skin cancer, as well as wrinkling and other signs of aging.
Here are 10 tips for summer sun safety:
1. There is no such thing as a “healthy” suntan.
Tanning is a protective response to excess ultraviolet light exposure; by the time a tan develops, skin cells have already been exposed to damaging ultraviolet radiation (UVR). UVR is composed of UVA, UVB and UVC (but UVC doesn’t permeate the atmosphere).
Here’s a breakdown:
- UVA radiation is the predominant component of UV radiation. The full effects of UVA aren’t fully understood, but UVA exposure is known to contribute to the development of skin cancer and skin aging through damage to skin cells. UVA also contributes significantly to tanning and is the predominant UVR exposure in tanning beds. UVA exposure levels are relatively stable during daylight hours and throughout the year, and UVA passes through window glass.
- In contrast, UVB, which accounts for only about 5% of total UVR, contributes significantly to the adverse effects of UVR by causing acute DNA damage and inflammation, resulting in sunburn. UVB exposure levels vary throughout the day and throughout the year with significant geographic variability. Other adverse effects of UVR include apoptosis (programmed cell death) and immune suppression. Over time, the chronic effects of UVR include primarily carcinogenesis (both melanoma and non-melanoma skin cancers) and UV-induced skin aging.
UVR exposure results in immediate damage to DNA within skin cells, and new evidence suggests that ongoing damage may occur for several hours after exposure. If your child is still tanning significantly despite using sunscreen, you will need to consider additional sun safety interventions.
2. Chose the right sunscreen
The American Academy of Dermatology recommends that you choose a sunscreen with an SPF of 30 or greater, labeled “broad-spectrum,” and water-resistant (if you will be swimming or sweating).
All about SPF:
SPF measures the smallest UVR dose that results in skin erythema (redness) at 16-24 hours after UVR exposure. A sunscreen with an SPF of 15 filters out 93% of UVB radiation, a sunscreen with an SPF of 30 filters out 97% of the UVB radiation, while a sunscreen with an SPF of 50 filters out 98% of UVB radiation. Using a sunscreen with an SPF of 15 will theoretically allow you to stay out in the sun 15 times longer than without sunscreen use before your skin develops erythema (redness). In practical use, sunscreen should be frequently reapplied to ensure that enough sunscreen is continuously present.
3. Apply at the right time
Sunscreen containing chemical sunscreen agents (e.g. avobenzone) should be applied 30 minutes before sun exposure; those containing physical sunscreen agents (e.g. zinc oxide) may be applied immediately before sun exposure.
4. Apply the right amount of sunscreen!
Most people under-apply sunscreen by 50% or less of the recommended application amount and therefore do not achieve maximal sun protection, leaving them at risk for sunburn. For an average-sized adult, the recommended amount is at least one ounce. On that note; many experts agree that if sunscreen is applied correctly,there is no significant benefit to choosing a sunscreen rated higher than SPF 50.
Sunscreen should be re-applied at least every 2 hours, more often if swimming or sweating.
6. Choose the right type for your skin
Chemical or organic sunscreen agents include chemicals such as avobenzone, octinoxate, and oxybenzone. Physical, non-organic sunscreen agents include zinc oxide and titanium oxide, which are both broad spectrum agents. In short, look for the following information on your sunscreen label to ensure that you are choosing the right products:
- SPF of 15 (daily use) or SPF 30 (active use, such as swimming or sports or high-intensity exposure such as on vacation)
- Broad spectrum (protects against both UVA and UVB, which contribute to skin cancer and skin aging)
- Water-resistant for 40 or 80 minutes (if swimming or sweating)
Allergy to sunscreen is uncommon, in particular in children, and requires specialized evaluation. More commonly, some sunscreens may be irritating. If your child has sensitive skin, use of a sunscreen designed for sensitive skin may be helpful. These products typically are free from common, known irritants and contain zinc oxide without or without titanium dioxide as the active ingredients. Examples include Vanicream™ and Blue Lizard™ sunscreens.
7. Sunscreen doesn’t last forever!
Sunscreen products are tested for stability for up to three years, unless otherwise specified on the product container by an expiration date. If in doubt, throw it out!
8. Keep infants out of the sun.
Sunscreens are not tested in babies under 6 months of agents. These products are not inherently dangerous to younger infants, but it is best for young infants to be kept out of the sun or in a shaded, covered area.
9. Choose UPF clothing.
Sun-protective swimwear and other clothing is a great way to reduce reliance on sunscreen; clothing should be rated UPF (universal protection factor) 50; by comparison, a white T-shirt only affords a UPF of 2-4.
10. Timing is everything.
Remember the importance of other interventions to reduce sun exposure! Limit time in the sun between 10 a.m. and 4 p.m.; seek shade; and wear a broad-brimmed hat and sunglasses.
For more information, check out the Skin Cancer Foundation at www.skincancer.org.
Dr. Shah was previously the Director of Pediatric Dermatology at Cincinnati Children’s Hospital, and prior to relocating to Cincinnati, she was the Clinical Director of Pediatric Dermatology at the Children’s Hospital of Philadelphia. Motivated to provide more personalized and specialized dermatology services, she started Kenwood Dermatology in 2016, where she focuses on providing expert skin care to children, adolescents and young adults. While she enjoys caring for patients with a variety of skin concerns, her special interests include hemangioma and other birthmarks, melanocytic nevi (moles) and melanoma, psoriasis, acne, atopic dermatitis/eczema, hair and nail disorders, and genetic skin diseases.
Among her many achievements, she was recognized by Cincinnati Magazine as a Top Doctor in 2016.
Dr. Shah serves on the medical advisory boards for the Foundation for Ichthyosis and Related Skin Types and the National Psoriasis Foundation. She is also on the Scientific Advisory Council for Naevus Global and is a Councilor for the International Society for Pediatric Wound Care. Dr. Shah is board-certified in General Pediatrics, General Dermatology, and Pediatric Dermatology.