Thursday, February 11, 2016

Just the right amount of sun

Should all kids avoid the sun, all the time? As the days grow longer and warmer and as summer approaches, it's a question parents wonder about.

Just the right amount of sun

As the days grow longer and warmer and as summer approaches, parents wonder about how much sun exposure is right for their children. (AP Photo/John Minchillo)
As the days grow longer and warmer and as summer approaches, parents wonder about how much sun exposure is right for their children. (AP Photo/John Minchillo)

Not every kid or teen needs the same “prescription” when it comes to sun exposure.

One of my patients, a 15-year-old girl, was a self-described tanning bed "addict." Too much sunlight ages the skin and makes it leathery. And, indeed, her skin was like shoe leather. Even more worrisome: Overexposure was tripling her risk for skin cancer. She needed to avoid tanning beds and be careful outdoors, too.

Should all kids avoid the sun, all the time? As the days grow longer and warmer and as summer approaches, it’s a question parents wonder about. Different doctors have different perspectives. A dermatologist who sees deadly melanoma skin cancers and precancers daily will warn “keep a baby under 6 months completely out of the sun.”  But a primary care pediatrician who sees jaundiced infants (improved by sunlight) and toddlers with rickets (caused by a combination of little or no sun exposure and a diet low in vitamin D) will tell parents children need 15 to 30 minutes of facial exposure to sunlight daily. 

What’s best for your child? I believe a little sunlight is good — but not too much. I have had fair-skinned young patients end up in a burn unit with second-degree burns when they fell asleep in the sun. Even dark-skinned individuals are at risk. I have had African-American patients get severe sun poisoning, too.

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The CDC suggests children should avoid being outdoors at midday and seek the shade as much as possible

  • Cover up children with tightly woven cloth – loose weaves let UV light through.
  • Have children wear floppy hats. I know this doesn’t always work. Personally, my children would never wear hats and still don’t. And I didn’t wear hats until I went bald and the sunburn came too easily. Good suggestions are nice only if one actually does them!
  • Encourage little ones to wear sunglasses, but only Polarized sunglasses actually block UVA and UVB. Children also lose sunglasses in about 8 seconds, so buy on price.
  • Apply sunscreen.

There are two types of sun protection:

Sun blocks (with ingredients like zinc oxide and titanium dioxide — the white stuff the beach lifeguard puts on his/her nose) are very safe because they do not react with the skin.  And they work immediately (no waiting!).

Sun screens work by chemically interacting with the UV light. They come in many strengths, but an SPF over 30 buys very little added protection. The problem with sun screens? They have to be on the skin for 30 minutes before they reach maximum protection. And they contain active chemicals which can cause allergic skin reactions. (To check your child, dab a little bit of the sunscreen on her skin the day before you need it and make sure there is no reaction.) Children’s sunscreen is not much different from adult sunscreen so the extra expense probably is not worthwhile. What is: Reapply as directed after swimming, when your child is sweaty or at least every 2 to 3 hours.

Gary Emmett, M.D., is director of hospital pediatrics at Thomas Jefferson University Hospital.

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The Healthy Kids blog is your window into the latest news, research and advice around children's health. Learn more about our growing list of contributors here.

If you have questions about your child's health, ask them here.

Anna Nguyen Healthy Kids blog Editor
Sarah Levin Allen, Ph.D., CBIS Assistant Professor of Psychology at Philadelphia College of Osteopathic Medicine
Stephen Aronoff, M.D., M.B.A. Chair of the Department of Pediatrics at Temple University Hospital
Peter Bidey, D.O. Medical Director of Family Medicine at Philadelphia College of Osteopathic Medicine
Christopher C. Chang, MD, PhD, MBA, FAAAAI, FACAAI Associate Professor of Medicine in division of Rheumatology, Allergy and Clinical Immunology at UC Davis
Katherine K. Dahlsgaard, Ph.D. Lead Psychologist of The Anxiety Behaviors Clinic at Children's Hospital of Philadelphia
Gary A. Emmett, M.D., F.A.A.P Director of Hospital Pediatrics at TJU Hospital & Pediatrics Professor at Thomas Jefferson Univ.
Magee DeFelice, M.D. Chief of Allergy and Immunology at Nemours/Alfred I. duPont Hospital for Children
Hazel Guinto-Ocampo, M.D. Chief of Pediatric Emergency Services at Nemours duPont Pediatrics/Bryn Mawr Hospital
Rima Himelstein, M.D. Adolescent Medicine Specialist at Crozer-Keystone Health System
Jessica Kendorski, PhD, NCSP, BCBA-D Associate Professor in School Psychology/Applied Behavior Analysis at Philadelphia College of Osteopathic Medicine
Anita Kulick President & CEO, Educating Communities for Parenting
Janet Rosenzweig, MS, PhD, MPA VP for Programs & Research for Prevent Child Abuse America
Beth Wallace Smith, R.D. Registered Dietitian at Children's Hospital of Philadelphia
Emiliano Tatar, M.D. Pediatrician at Einstein Healthcare Network Roxborough Plaza
Jeanette Trella, Pharm.D Managing Director at The Poison Control Center at CHOP
W. Douglas Tynan, Ph.D., ABPP Director of Integrated Health Care for American Psychological Association
Flaura Koplin Winston, M.D., Ph.D. Scientific Director of the Children’s Hospital of Philadelphia’s Center for Injury Research and Prevention
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