Sun Safety and Skin Cancer Awareness for Children

The American Academy of Dermatology recommends sunscreens that offer broad-spectrum protection, have an SPF of 30 or higher, and are water resistant to help protect the skin from sunburn and skin cancer.¹ Enough sunscreen should be applied to cover all the skin not protected by clothing; however, most people only apply 25% to 50% of the recommended amount.¹ When outdoors, sunscreen should be reapplied approximately every 2 hours, or as often as the label indicates.¹ For infants and toddlers, it is recommended to use pediatric sunscreens that have zinc oxide or titanium dioxide ingredients.¹

In this exclusive interview with The Dermatologist, we spoke with Amy Brodsky, MD, about the importance of sun protection and skin cancer risk awareness for children. Dr Brodsky is a board-certified dermatologist and the founder of Pediatric Sun Protection Foundation, Inc, and the Sun Hero program, which raises awareness of sun safety habits in childhood to reduce the risk of skin cancer.

The Dermatologist: What are your opinions on sun protection habits for children?

Dr Brodsky: Parents/guardians are the controlling factor for how much sunscreen is applied to their younger child and how often it is applied. Parents are mostly studious about this because they understand that most sun damage happens while you are younger, and then it can translate into skin cancer when you get older.

However, during puberty, older children often model themselves on kids their own age, or maybe a little bit older, like lifeguards. They may see that these lifeguards are not wearing sun-protective shirts while they are out in the sun. They may know people who are still portraying that being tan is cool. Although those mindsets are switching and changing slowly over time, children may be out there trying to lay in the sun and be tan. Experts are getting better at promoting sun protection, but the key age group that needs to change is teenagers, because not all of them are using sunscreen. They are starting to understand that they need it, but this is not necessarily translating into adoption. Or they may be using a spray sunscreen, which is inadequate. They may be spraying it in the wind instead of putting it on their skin, and they may not be applying 20 minutes before they are in the sun but putting it on while in the sun. Therefore, it is not working, and they get sunburns.

The Dermatologist: Regarding children with skin of color, do you think tinted sunscreen should be offered, and can it impact the effectiveness of sun protection?

Dr Brodsky: Tinted sunscreen should be offered. The sun does not discriminate who it shines on. Whatever color the skin is, people are still going outside and getting exposed to UV rays. People of color need to be educated that sun protection is important for them, too. Even though they have more pigment in their skin, it does not exclude them from getting skin cancer or even sun damage like brown spots and melasma.

Mineral sunscreens, which should be in a lotion or cream form, include zinc oxide, titanium dioxide, and iron oxide. For tinted sunscreens, iron oxide adds an extra level of protection across the whole UV spectrum, and it protects against blue light and infrared. The problem lies in the color of the tint. In the past decades, zinc was inelegant, and many people did not like it because it left a white residue. We have come a long way in micronizing zinc and coating the zinc so it does not look as white. The only downside is that it is hard to get off clothing, just like makeup.

The Dermatologist: Do you think visual aids can help children apply sunscreen effectively?

Dr Brodsky: Yes. In the Sun Hero program, we not only teach children why they need sunscreen, but we also teach them how to apply sunscreen and how much to apply. As an analogy, an egg worth of sunscreen is about 2 oz. That is how much sunscreen children should apply. And then we make sure they know to apply every 2 hours. Because the typical size bottle of sunscreen is 4 or 6 oz, it will be empty in a day if you apply 2 oz every 2 hours. So, we recommend SPF 100 sun-protective clothing as an easier solution.

The Dermatologist: Do you have any other insights you would like to share with your colleagues on sun safety for children?

Dr Brodsky: As part of the Sun Hero program, dermatologists, and soon pediatricians, go to their local schools and teach sun safety. Sun Hero kits are provided to children, which include sunscreen, sunglasses, UV indicator bracelets, and stickers. Almost 8200 children have been reached so far since the program was launched.

The children are gaining valuable knowledge. They are going home with their little swag bag and some cheat sheets or quizzes to educate their parents. Also, it is a good business strategy for dermatologists who are trying to grow their practice. Because in addition to the sunglasses and the sunscreen, there is a booklet to slip business cards in. It can also boost social media presence to post pictures with the children participating in the program. It shows involvement in the community, and it is teaching children something that they are going to need for a lifetime.

Reference
1. Sunscreen FAQs. American Academy of Dermatology. Accessed May 17, 2022. https://www.aad.org/public/everyday-care/sun-protection/shade-clothing-sunscreen/sunscreen-faqs