Most parents know that sunscreen is as crucial for kids on a beach day as sun, sand and plastic shovels. But some still adhere to dated beliefs: The sun can cure acne; tanning booths prevent sunburns; and a solid base tan is healthy. All are untrue.
This month, Dr. Lewis First, chief of pediatrics at Vermont Children's Hospital at Fletcher Allen Health Care in Burlington, elaborates on the importance of protecting children's skin from sunburns, which can lead to dryness, premature aging and, ultimately, skin cancer. The good doctor lays it on thick — and often.
KIDS VT: Is there such a thing as a healthy tan?
LEWIS FIRST: No, there really isn't. Whether you tan naturally from the sun or use artificial tanning methods such as cosmetic skin pigmenters or tanning beds, you are still putting your skin at risk from the dangers of the ultraviolet rays that cause skin to turn darker. While the artificial tanning pigments are not felt to be damaging to the skin, it may make people less apt to take precautions in the sun, thinking their artificial tan is protective like sunscreen when it really isn't. You need vitamin D for healthy bone growth — and the sun's rays help produce it in the body. But that goal is better achieved through a diet containing ample vitamin D since the risks of too much sun outweigh the benefits of getting vitamin D that way.
KVT: Are kids with darker complexions still at risk of sunburns?
LF: Yes. Getting tan is simply a function of how many cells in your skin produce a pigment called melanin that absorbs the sun's rays. But it doesn't mean the sun's rays are not going to do further damage, causing the cosmetic as well as malignant dangers that can occur from sun exposure. One bad burn in an infant, toddler or child will more than double that child's chances of getting skin cancer as an adult. But any sunscreen product that's safe is going to reduce that original risk by 80 percent.
KVT: What sun protection factor do you recommend?
LF: Parents should be using a sunscreen rated at SPF 15 to 30. That means if your skin would normally take 15 minutes to tan or burn, with a sun protection factor of 15, theoretically it would take 15 times that — or 225 minutes — to get to the same level of burn. We do know that SPF 15 protects the skin from about 94 percent of the ultraviolet radiation, especially UVB rays, which are the ones that cause sunburns; with an SPF of 30, 97 percent. Once you surpass an SPF of 30, the value may not be that dramatic for the price.
KVT: When should kids apply sunscreen?
LF: Kids need to apply it 15 to 30 minutes before going outside in the sun, and then reapply it every one-and-a-half to two hours — as well as when they come out of the water. Even with products billed as "waterproof," there's controversy over how waterproof they really are.
KVT: How much should they use?
LF: A common mistake is that parents don't use enough . They should use at least an ounce of sunscreen or sunblock per application.
KVT: Does it matter if the sunscreen is a cream, lotion or spray?
LF: What really matters is the SPF number, the amount that's used and the frequency with which it's applied. Parents should know that some environmental groups are concerned about some of the chemicals used in these products. There are some simple products that parents can look for when picking a sunscreen or sunblock that certainly would reduce the risk of exposure to unnecessary chemicals.
KVT: Such as?
LF: Make sure your sunscreen is PABA-free. PABA has been shown to cause skin irritation and rashes. It's also been shown to produce free radicals, which are associated with cancers. Most sun products today are PABA-free. The other chemical to avoid is called benzophenone, more commonly known as oxybenzone. Basically, it has been associated in some laboratory studies to produce free radicals that can lead to cardiovascular disease and, possibly, cancer.
KVT: What about products that combine sunscreen with insect repellent?
LF: Insect repellents contain a chemical called DEET that, when used in excess, can cause significant neurological damage. Insect repellents should be applied no more than once every six hours. The problem is, when you reapply sunscreen every hour and a half, you can overdose on DEET, so I don't recommend combination sunscreen and repellent products.
KVT: What's the best treatment for a sunburn?
LF: Cool compresses, aloe vera lotion to reduce the redness and take the sting out and acetaminophen for the pain. But it's easier to prevent a burn than to treat one.
KVT: But sunscreen alone doesn't prevent skin cancer, isn't that right?
LF: That's correct. Between 10 a.m. and 4 p.m., when the sun's rays are the strongest and thus most dangerous, keep children out of the sun. Parents also need to remember that you don't need to be at the beach to get a sunburn. Kids can still get burned on a cool, cloudy day. Whether it's sunny or cloudy, all kids should be wearing sunscreen or sunblock. And they really need to cover up. If parents can't see their hand through the clothing fabric, it means there's a sun protection factor of at least 10. Light colors tend to absorb less of the sun's rays than dark colors. Kids should wear hats with brims, and even babies need UV-blocking sunglasses. The American Academy of Pediatrics also recommends using sunscreen on a baby's hands and face. But most babies should not be out in the sun at all.