As we approach the summer school holiday, I want to raise a topic that I think is often overlooked by parents. Living in Thailand means sun exposure is a daily fact of life for all of us. During school holidays, children spend a lot more time at the pool, the beach and outdoors in general. This makes it harder to be extra careful about sun exposure on a daily basis. Sunburns tend to sneak up on us. A little pink skin while playing in the sun can mean serious and painful sunburn 4-6 hours later. The first thing parents need to understand is that even a single serious sunburn (with blisters and skin peeling) during childhood or adolescence doubles the risk that your child will develop a melanoma, the most serious kind of skin cancer, later in life.
Other types of skin cancers, such as basal cell carcinoma and squamous cell carcinoma, are directly correlated with sun exposure over many years. In fact, the most common locations for these cancers are on sun-exposed areas like the face, ears and hands.
The lesson here is very simple; never allow your child to sunburn!
So, what to do?
First, infants should never be exposed to direct sunlight. Keep them fully shaded and covered at all times when outdoors. Sunscreen should not be applied to infants less than 6 months of age.
For all other children and adolescents, keep these tips in mind.
- The sun is most intense between 10am and 2pm. Play in the shade during these hours
- Never allow your child to tan their skin intentionally!
- Dress your child in loose fitting cotton clothing that covers arms, legs, chest and back
- Use wide brim hats anytime sun exposure will be prolonged
- Carry an umbrella- they are not just for the rain!
- Get in the habit of examining your child’s skin, head-to-toe, about once a month at bath time. If you notice conspicuous spots, changes in moles or other concerns, schedule an appointment with me
For sunscreen, there are some important new updates you should be aware of. First understand that sunscreen is not a magic bullet. Sunscreen is a compliment- not a substitute- for proper clothing, hats and staying out of the direct sunlight.
Sunscreen must be applied liberally and often. Use large “dollops” of sunscreen lotion and reapply it every 2 hours. This is really important. I understand sunscreen can be expensive, but it is too important to prevent sunburn to try to save money by using less. Many people just apply it once on their children before they go out and then forget about it. No matter what the label says, sunscreen must be reapplied often to provide adequate protection.
Pay close attention to the labels. The sunscreen you choose should provide protection against both UVA and UVB sunrays. Choose a sunscreen with a sun protection factor (SPF) of at least 15 and preferably 30. It is not clear if SPF numbers higher than 30 add additional benefit.
No matter what the label says, sunscreens are never “waterproof.” They may be water resistant, but they still must be reapplied every 40 to 80 minutes if your child gets in the water or is sweating a lot. Avoid sunscreens with vitamin A, retinol or retinyl palmitate or retinyl. These additives may increase sun sensitivity. Avoid sunscreens that include fragrances. They are unnecessary and increase the chances for an allergic reaction. Finally, avoid products with oxybenzone, a chemical that may disrupt your child’s hormones. I recommend products that use zinc oxide and titanium dioxide as active ingredients. Sometimes these products may leave a milky white film on the skin.
So what do you do if your child gets a sunburn?
If you see any sign of skin reddening on your child, get them out of the sun and start treatment right away! After a cool shower or bath, slather on a moisturizing cream or lotion to soothe the skin. Repeat this frequently to make peeling and flaking less noticeable. I suggest you use a lotion containing vitamin C and vitamin E as it may help limit skin damage (though studies have not proven that). Do not allow your child to scrub, pick or peel her skin or break blisters.
Sunburn draws fluid to the skin surface and away from the rest of the body. So encourage your child to drink extra water or juice for a couple of days and watch for signs of dehydration such as dry mouth, thirst, reduced urination, headache, dizziness and sleepiness. Come see me promptly if your child appears ill.
Give your child a dose of ibuprofen (an anti-inflammatory pain medicine) as soon as you see signs of sunburn and every 6 hours for the next 48 hours. This can reduce the swelling and redness and might prevent some long-term skin damage.
Most sunburn, even those that cause a few blisters, can be treated at home. However, if a blistering burn covers 20% or more of the body (a child’s whole back) or causes fevers or chills, please make an appointment to see me right away.
Remember, sun exposure speeds up the aging process with wrinkles and sunspots. I am sure that when they are in their 30s and 40s, your son or daughter will be grateful that you looked after their skin carefully when they were a child. By following these precautions, your child will have a wonderful and playful summer break without ever getting sunburn. Enjoy!