The Sun Will Come Out Tomorrow, and the Next Day…
Many of us are taken aback by the media attention given to an overly-tanned mother accused of bringing her young child into a tanning bed. We also read about a push to ban children from tanning in salons in some states.1 I see a much bigger problem in my pediatric practice and that is the exposure to natural ultraviolet (UV) rays in kids who are playing outdoors during the spring and summer.
When the song “The Sun Will Come Out Tomorrow” was popular, there was little concern about the risks of sun exposure. When I was a kid, I didn’t use sunscreen (I also didn’t use a seat belt or wear a bike helmet). I had my share of sunburns and did my share of lying in the sun with the intention to get tan. Unlike use of tanning beds, we cannot legally ban time in the sun. However, we can educate ourselves and our patients about the risks and stress the need for sun protection. When we know better, we do better.
This time of year, pediatricians will see a patient for one medical reason, but then notice peeling, pink skin on the nose, facial cheeks, and shoulders—the tell-tale signs of a sunburn. Usually, the child isn’t brought in for sunburn treatment, nor does the parent or child even mention it at the visit. When I see the obvious skin findings during the physical examination, I’ll say something like, “Oh, I see you have a sunburn.” Typically, there is little concern expressed back to me. Perhaps these parents assume that it’s a fact of life that kids will have a sunburn. But we all know that sunburns are nearly fully preventable.
In addition to educating parents about the usual list of sun-protection measures (use sunscreen, re-apply it every few hours, stay out of the sun at midday, wear protective clothing, etc), we should be promoting the use of these measures as daily habits, just like tooth brushing. A simple measure that costs nothing and can protect the often-sunburned shoulders is the recommendation to keep children in their shirts at all times when playing or swimming outdoors.
Some areas of the country require the use of sun-protection measures every day of the year. The recommendation is to use broad-spectrum sunscreens—those that block UV “A” rays, which cause “A”ging, and UV “B” rays, which cause “B”urning. The potential prevention of cancer is a big plus to using these agents too.
Helpful information for the clinician about sunscreen ingredients can be found in an article by Draelos.2 To find an effective sunscreen, parents can look for ingredients that end in the letters “one” or “ate.” Despite the promotion of the use of sunscreen and other sun-protection measures, children are still sunburned every day. The biggest obstacle to protecting children from the sun is probably the cost of sun care products and the hassle of using those products. Encouraging the use of the least expensive sunscreens can lead to more liberal use of these skin-saving products.
Sure we can support a ban that prohibits children from tanning in salons. However, most of our time should be spent on providing practical advice on how to protect kids from the giant hot yellow ball in the sky that will be coming out tomorrow and the next day and so on.
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