It’s cloudy and cold in Seattle. The rest of the northern hemisphere is starting to grill, swim at the beach, and play in the sun. Here in Seattle we’re shivering (literally) under raincoats and fleece. It’s pouring. My space heater is running. Think rain, space needle, cold. It’s not always like this, though. And in the great hope that the clouds will clear and the ball of fire will reappear in the sky, I’ve been thinking about sunscreen and ways to prevent melanoma.

Every season we hear that cancer of the skin related to sun exposure (and tanning bed use) is rising, even in children. This post covers my thoughts, the off-the-cuff thoughts of 2 dermatologists and 1 environmental health expert/pediatrician. We’re all still learning. But we do know a few things that may help.

Although melanoma is rare in children, sun exposure is more dangerous for children than adults. Here’s why: the more sun exposure children have, the more moles they make in their first few decades. The more moles, the bigger the risk of a mole turning into a melanoma. So, here’s how to stop being scared of the sun and enjoy it safely. Sunscreen is what most parents reach for when they worry about the sun, yet when it comes to infants and toddlers, long sleeved UV suits, hats and sunglasses are far easier. And maybe cheaper depending on how many times you use them.

Sun and Sunscreen Basics:

  • When you sit in the sun, you get exposed to both UVA and UVB light. Think of UVB light as the light that Burns, and UVA light as the light that causes your skin to Age (wrinkle).
  • The SPF in your sunscreen only takes care of the UVB light. Most sunscreens now have notes like, “Avotriplex” or “Helioplex” that covers both UVB/UVA rays. You need sunscreen that covers both.
  • Sunscreen comes in many different SPF to prevent burning. Advertisers love to play the numbers game with you. For kids, I say choose 45 or 50 SPF. After you get above 45 or 50 SPF, the increasing numbers don’t make much of a difference. Don’t pay $10 extra for 70 SPF. Just reapply your 45 SPF like you should.
  • When I asked my friend Dr. Jill Weinstein, a dermatologist in Chicago, about chemicals in sunscreen she said, “Just make sure parents are choosing a sunscreen with a physical blocker, either zinc and/or titanium” and they will be making a safer choice. That way you avoid many of the chemicals that raise concern. This means, there are chemicals in sunscreen that work to protect your skin, and other ingredients like zinc and titanium that literally put a barrier between the sun and your skin. A barrier is safer. Remember those zinc noses on the lifeguards when you were growing up? They were onto something.
  • When it comes to buying sunscreen you have to be a ingredient hound. Really–to find the right sunscreen for kids, you have to look at the back of the bottle and look for zinc or titanium, Parsol 1789 (or avobenzone) and ensure it covers for both UVA/UVB rays.
  • Sunscreens are less effective when they expire. Really. So look at the expiration date on your sunscreen and get new sunscreen if it’s over the top.

My anatomy partner from medical school, Dr Ross Levy, is now a dermatologist and Mohs surgeon (and father of 3) who cuts out skin cancer every day. When I asked him about sunscreen use and children he said, “I don’t recommend specific products but rather tell people to look for ingredients. Broad spectrum UVA and B is key. Look for avobenzone (Parsol 1789) UVA blocker, Mexoryl (ecamsule) UVA blocker, titanium dioxide (UVA and B) and zinc oxide (UVA and B). A shot glass of sunscreen should be used for the body and apply at least every 2-3 hours. Anything over SPF 45 doesn’t make a difference and remember that is only a measure of UVB (burning protection). Even if its waterproof, it isn’t and needs to be re-applied. Also a must is the UV protection suits for kids (plus sunscreen) because from experience, good luck getting them to put on sunscreen on their entire body every 2 hours.”

Mama Doc’s Tips For Using Sunscreen On Children:

  • It’s not the brand or the SPF number that matters the most. What matters most is how you use sunscreen. If you can, apply sunscreen about 1/2 hour before your kids go outside. It is absorbed into the skin better this way.
  • Don’t trust the “sweatproof, waterproof” claims. Reapply sunscreen every 2 hours if your kids are playing actively, swimming, sweating. When you reapply, apply to areas that burn a lot: shoulders, back, chest, ears, nose and lips.
  • Those sunscreens marketed for kids may not be any safer than adult brands. Tear free may not be tear-free, either. So use caution around your baby’s or toddlers eyes. Using a hat will help!
  • Be an ingredient hound. Look for sunscreen with SPF 45 that covers both UVA/UVB. If you’re worried about chemical exposure, look for those that use “zinc” or “titanium” as the barrier for sunscreen.
  • Use A LOT of sunscreen. A shot glass size for a body. Even a little body like your child.
  • Avoid the most direct and most dangerous mid-day sun when you can. Keep kids out of the sun between 10am and 3-4pm. I know, this sounds crazy….just do the best you can. It’s something to know…
  • If you can, get a UV swim suit, a hat, and sunglasses to protect your kids. If it’s the norm and you start them early, the battles will be small. Kids will never think it’s funny to have a hat on in the sun if they have always done it that way.

This past week, The Environmental Working Group (EWG) urged the FDA to evaluate the safety of Vitamin A in sunscreen. The media got wind of the news and increased fear for many of us about ingredients in sunscreen. There have also been plenty of statements in the media regarding the safety of oxybenzone, parabens, vitamin A and other “nanomaterials” in sunscreen. The messages and rumors are scary but the data is fairly inconclusive, particularly when it comes to children. Meaning there is no perfect study that guides doctors in telling families if these claims are true. So best thing you can do if you are worried is use long sleeved clothing, UV-swim suits, hats and sunglasses. That way you’re truly minimizing the amount of sunscreen you have to apply to your child and the number of struggles you’ll have wrestling them down to get it on their bodies.

Another friend who is an environmental health expert and pediatrician confirmed this when I asked her about some of this news feed. She said, “From our end, we talk to a lot of parents whose children have extremely sensitive skin (i.e. irritant or allergic reactions) or who are just concerned about toxicity. We honestly tell them to use the breathable swimsuits that cover the entire body (they make these for children now) and just use sunscreen on face/neck to minimize both the harmful effects of sun exposures as well as of the sunscreens. Most parents say it is great and the people I know personally say their kids love the swimsuits.”

Go be off. Off into the sunshine, well armed with sunscreen and knowledge.