Monday, May 26, 2008

Sun Safety (2 of 2)

By: Steven Dowshen, MD

Use Sunscreen Consistently

There are lots of good sunscreens available for kids, including formulations for sensitive skin, brands with fun scents like watermelon, long-lasting waterproof and sweat-proof versions, and easy-application varieties in spray bottles.

What matters most in a sunscreen is the degree of protection from UV rays it provides. When faced with the overwhelming sea of sunscreen choices at drugstores, concentrate on the SPF (Sun Protection Factor) numbers on the labels.

The SPF number tells you how much longer you can stay in the sun without burning if you apply the sunscreen, which acts as a "block" to the sun's rays (hence the term sunblock). For example, if your child would burn after 20 minutes of sun exposure, applying a sunscreen with an SPF of 15 gives him or her 15 times the protection.

For kids age 6 months and older, select an SPF of 15 or higher to prevent both sunburn and tanning. Choose a sunscreen that states on the label that it protects against both UVA and UVB rays (referred to as "broad-spectrum" sunscreen). To avoid possible skin allergy, avoid sunscreens with PABA, and if your child has sensitive skin, look for a product with the active ingredient titanium dioxide (a chemical-free block).

For sunscreen to do its job, it must be applied correctly. Be sure to:

  • Use sunscreen whenever your child will be in the sun.
  • Apply sunscreen about 30 minutes before going outside so that a good layer of protection can form. Don't forget about lips, hands, ears, feet, shoulders, and behind the neck. Lift up bathing suit straps and apply sunscreen underneath them (in case the straps shift as your child moves).
  • Don't try to stretch out a bottle of sunscreen; as a guide, apply the sunscreen generously.
  • Reapply sunscreen often, approximately every 2 to 3 hours, as recommended by the American Academy of Dermatology. Reapply after your child is sweating or swimming.
  • Apply a waterproof sunscreen if your child will be around water or will go swimming. Water reflects and intensifies the sun's rays, so kids need protection that lasts. Waterproof sunscreens may last up to 80 minutes in the water, and some are also sweat- and rub-proof. But, regardless of the waterproof label, be sure to reapply sunscreen when kids come out of the water.

Keep in mind that every child needs extra sun protection. The American Academy of Dermatology recommends that all children - regardless of their skin tone - wear sunscreen with an SPF of 15 or higher. Although dark skin has more protective melanin and tans more easily than it burns, remember that tanning is also a sign of sun damage. Dark-skinned children can also develop painful sunburns.

Purchase Protective Eyewear for Kids

Sun exposure damages the eyes as well as the skin. Even 1 day in the sun can result in a burned cornea (the outermost, clear membrane layer of the eye). Cumulative exposure can lead to cataracts later in life (clouding of the eye lens, which results in blindness). The best way to protect eyes is to wear sunglasses.

Not all sunglasses provide the same level of ultraviolet protection; darkened plastic or glass lenses without special UV filters just trick the eyes into a false sense of safety. Purchase sunglasses with labels ensuring that they provide 100% UV protection.

But not all children enjoy wearing sunglasses, especially the first few times. To encourage kids, let them select a style they particularly like; many manufacturers make fun, multicolored glass frames or frames embossed with cartoon characters. And don't forget that kids want to be like grown-ups. If you wear sunglasses regularly, your kids may be willing to follow your example.

Ask About Your Child's Medication

Some medications increase the skin's sensitivity to UV rays. As a result, even kids with skin that tends not to burn easily can develop a severe sunburn in just minutes when taking certain medications. Fair-skinned children, of course, are even more vulnerable. Ask your doctor or pharmacist if the prescription (especially antibiotics and acne medications) and over-the-counter medications your child is taking can increase sun sensitivity. If so, always take extra sun precautions. The best protection is simply covering up or staying indoors; even sunscreen can't always protect skin from sun sensitivity caused by medications.

What to Do if Your Child Gets a Sunburn

A sunburn can sneak up on your child, especially after a long day at the beach or park. Often, kids seem fine during the day, but then gradually develop an "afterburn" later that evening that can be painful and hot and can even make them feel sick. The best way to take care of your child is to treat the symptoms and prevent further problems.

When children get sunburned, they usually experience pain and a sensation of heat - symptoms that tend to become more severe several hours after sun exposure. Some children also develop chills. Because the sun has dried their skin, it can become itchy and tight. Burned skin typically begins to peel about a week after the sunburn. Encourage your child not to scratch or peel off loose skin because skin underneath the sunburn is vulnerable to infection.

If your child does get a sunburn, the following tips may help you make him or her more comfortable:

  • Keep your child in the shade until the sunburn is healed. Any additional sun exposure will only increase the severity of the burn and increase pain.
  • Have your child take a cool (not cold) bath, or gently apply cool, wet compresses to the skin to help alleviate pain and heat.
  • Apply pure aloe vera gel (available in most pharmacies or taken directly from within the leaves of the plant) to any sunburned areas. It's excellent for relieving sunburn pain and helping skin heal quicker.
  • Give your child a pain reliever like acetaminophen or ibuprofen and spray on over-the-counter "after-sun" pain relievers. (Do not, however, give aspirin to children or teens.)
  • Apply topical moisturizing cream to rehydrate the skin and help reduce swelling. For the most severely burned areas, apply a thin layer of 1% hydrocortisone cream. (Do not use petroleum-based products, because they prevent excess heat and sweat from escaping. Also, avoid first-aid products that contain benzocaine, which may cause skin irritation or allergy.)

If the sunburn is severe and blisters develop, call your doctor. Until you can see your child's doctor, tell your child not to scratch, pop, or squeeze the blisters, which can become easily infected and can result in scarring.

What About Heat-Related Illnesses?

Heat-related illnesses such as heat syncope (fainting from heat), heat exhaustion, and heat stroke are far more serious than a sunburn. These conditions occur when kids become overheated and dehydrated, and in many cases, are accompanied by sunburn.

Call your child's doctor if:

  • your child has an unexplained fever higher than 102 degrees Fahrenheit (38.9 degrees Celsius)
  • the sunburned skin looks infected
  • your child has trouble looking at light (This may indicate a sunburn of the eye's cornea.)

Contact your child's doctor for immediate assistance if your child has:

  • nausea
  • vomiting
  • fainting
  • delirium (seems temporarily mentally confused)
  • diarrhea

· Be Sun Safe Yourself

· Being a good role model by wearing sunscreen and limiting your time in the sun not only reduces your risk of becoming sunburned, it reduces your child's risk, too. By using a variety of sun protection measures, such as keeping your child indoors during peak hours and encouraging your child to wear hats, sunglasses, and long-sleeved shirts, as well as using sunscreen, you can decrease your child's exposure to the damaging effects of the sun.

Updated and reviewed by: Steven Dowshen, MD

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