Teaching Kids Healthy Skin Habits Early Prevents Skin Damage and Skin Cancer Later in Life
Sun protection in children is of paramount importance. Early skin type evaluation and an understanding of the unique nature of early skin creates a harbinger of preventive health strategies. Like vaccines and well visits, sun protective strategies and protocols can assist children (and their parents) develop a life time of healthy habits that extend well being.
Most (90%) of skin changes are associated with sun exposure. Infants and children are at increased risk, due to to their vulnerable skin. Physiologic risks include lower levels of protective melanin, a thinner stratum cornermen and a higher surface to body mass ratio. This information suggests that photo damage may begin as early as the first summer of an infants birth. Whether it is intense intermittent exposure to UV radiation or chronic UV exposure, both contribute to the causes of melanoma. In fact, early exposure can also cause acquired melanocytic nevi which may be an early marker for melanoma.
Estimates are that 95% of all melanomas and 99% of non-melanoma skin cancers may result from excess UV exposure. Additionally, UV exposure is the only known modifiable risk factor for skin cancer. Current estimates suggest that 25% of lifetime sun exposure occurs before age 18. Sun habits and behaviors in children, and/or the sun protection (SPF) that they choose to use, may be more important than the same habits, behaviors and SPF protection for adults.
Sun exposure rates may also be changing (increasing) due to the growth of indoor and electronic recreational activity. The data is not clear as to whether these intermittent exposures, which are reportedly related to an increase in skin cancer, are necessarily safer.
In North America, young children historically have had a great deal of sun exposure, with time spent outdoors ranging from 2.5 to 3.0 hours daily. European studies have shown that children age 3 and age 12-14 spend more than 15 hours a week in a swimsuit outside. Australian studies have suggested that as many as two-thirds of secondary school children, ages 11-17, experience a summer time sun burn and North America adolescents have reported an even higher incidence of sun burn. Studies asking parents about their infants have reported that over half had a sunburn.
Sun Protection Behaviors and Habits Can be Instilled in Multiple Ways for Children
The American Academy of Dermatology does not recommend topical sunscreen for infants under 6 months old. Therefore, other options must be used. For example, avoiding direct mid day sun. Mid day sun can be defined as direct sun exposure at high noon, but ultimately should be expanded to the hours of 10 am to 4 pm during peak UV index months. These months are currently between April and September.
If exposure is necessary, for infants over 6 months and for children, seeking shade and using broad spectrum sun protection would be the next step. Broad spectrum sun protection is any topical sun protection with an SPF (sun protection factor) of 30 or higher. Broad spectrum defined, is a product that protects against Ultraviolet A (UVA) rays and Ultraviolet B rays (UVB). Multiple forms of SPF sun protection are available (creams, lotions, gels, sprays, powders). These products should be used in copious amounts to insure adequate protection with reapplication occurring every 1 to 2 hours during activities such as swimming or sweating.
Hats, clothing (rash guard or swim shirts) are also vital to the practice of sun protection. These types of products are designated as UPF (ultraviolet protection factor) and consist of materials including polyester, cotton and bamboo. These products have distinct advantages including a uniform application of protection and the ability to provide protection during rigorous activities; especially swimming. Finally, routine eye protection/sunglasses for children mitigate risks to eyelids and help to prevent cataract and macular degeneration.
Daycare Centers and Schools Tend to Have Few Policies When it Comes to Sun Protection for Children
Only 36% of child care centers and schools surveyed in North America had more than half of their outdoor play areas shaded. Hats were observed on children in only 19% of centers, protective clothing and sunglasses were almost never observed and 56% of centers had sun protection policies. Australian primary schools have more intensive policies, but practice of these polices was more intermittent. Wide spread variability between written policy and behavior was also noted.
The use of sun protection products in schools can also be limited. Recent controversies have erupted about the teachers having the authority to apply sunscreen to their students without pre-approval from parents regarding the type of sunscreen used. A recent Wall Street Journal article highlights the concern about applying sunscreen to children due to the FDA’s label of sunscreen as an over-the counter-medication. Multiple states have passed an override allowing children to carry their own sunscreen to school. However, this is a slow, arduous challenge.
Sun Protection for Infants and Children Can be Addressed in Stages
First – protect, with a sun protection product daily.
The use of a sun protect product is similar to any other product considered to provide health benefits. Meaning, the product can be used daily without exception, to create a healthy habit and to create a decreased risk of any skin related risk due to the sun. For infants under six months, the best current recommendation is sun avoidance.
Second – thoughtful planning for avoiding mid day sun during outside activities.
Not all activities can be avoided, but with diminished intermittent exposure, especially erratic exposures, a decrease in risk will be noted. This includes sunburns and acquired melanocytic nevi. With outdoor exposures, especially water related, UPF clothing is an excellent option to provide a uniform opportunity to prevent over exposure of large, often unreachable body parts. The back, arms and legs require significant sun protection products often reapplied to enhance coverage. While social stigmas may prevent large scale adoption, these products provide significant advantages over the traditional sun protection products. Advantages include ease of use and minimal to no degradation by UV rays or water. Risk of allergy is also avoided with UPF clothing, as 19% of adults have experienced an adverse reaction to sunscreen creams, lotions, gels, sprays, powders; most commonly a contact allergy.
Healthy Sun Habits and Behaviors in Children Start with Parents
Educating children early about how to they think about sun exposure is critical. Helping them to be proactive with their own health depends on the examples set by parents and care givers themselves. Leading by example instills healthy sun habits and behaviors in children.
The BurŪV Skin Fitness Tracker is an extremely helpful tool for keeping sun exposure in check. With gentle reminders to reapply sunscreen and alerts to move out of the sun when maximum UV exposure has been reached, the BurŪV Skin Fitness Tracker can be a wonderful tool for creating healthy sun habits and behaviors for every member of the family.