A Dermatologist’s Guide to Safe Fun in the Sun
With summer finally heating up, Annette Wagner, MD, an attending physician in Lurie Children’s Division of Dermatology, explains the effects of the sun on skin and answers some commonly asked questions about what sunscreens are best to use for infants and children.
Q: Is it safe for infants and toddlers to use sunscreen?
A: It is safe for infants from birth to use sunscreen as long as the sunscreen is chemical free. Chemical free sunscreens rely on two active ingredients: zinc oxide and titanium dioxide. Infants and young children should be protected with chemical free sunscreens only. The best way to find these is to just look at the active ingredients label on the sunscreen bottle or tube. ONLY those two ingredients will be listed there if the sunscreen is chemical free.
Q: What is the difference between infant/child sunscreen and adult?
A: There is really no difference between infant/child and adult sunscreens. Chemical free sunscreens can be used at all ages. Sometimes sunscreens labelled for babies have chemicals in them and perfumes. Don’t rely on the designation of “baby” to choose your sunscreen. Look on the label for the active ingredients and make sure there is no perfume or PABA for all ages. For adults, chemical sunscreens are good alternatives that are not as thick and more cosmetically elegant. Chemical containing sunscreens work on everyone but are not recommended for children or infants.
Q: What if a child is allergic to sunscreen? What are signs that a child is having a reaction to sunscreen?
A: Children are rarely allergic to chemical free sunscreen. If you are allergic to a sunscreen it will cause hives or immediate redness on the skin when it is applied. Many things produce facial redness including heat itself so what is often thought to be an allergy is not. There are also true allergies to the sun itself such as solar urticaria which can be attributed to the sunscreen that was applied incorrectly. In general, if you have a highly allergic child and you are concerned about an allergy to sunscreen, I would recommend chemical free sunscreens and that you apply the sunscreen to the inner arm before bed to look for an allergic contact dermatitis before applying the cream to the face. If your child is allergic, an itchy swollen rash will appear at the site of application, often quickly.
Q: What is the best SPF to look for when you are buying sunscreen?
A: A sunscreen with an SPF of 30 blocks about 96% of the more dangerous UVB light rays. Higher SPF options usually contain more chemicals and the additional benefits are very minimal. Look for sunscreens that contain physical blockers: titanium dioxide or zinc oxide. These are less harmful since they stay on the skin surface like clothing and do not get absorbed. They also block a wider spectrum of light, making them even more protective. Avoid sunscreen gimmicks, like sprays and sticks, or sunscreens that are perfumed. The best sunscreen is a cream in a bottle.
Q: What is the most effective way to apply sunscreen?
A: Sunscreen works most effectively if a thick layer is applied and allowed to sit on the skin surface for one to two minutes before being rubbed in. The sunscreen layer should be thick enough to completely cover the skin so no freckles are visible through it. Think of it like applying peanut butter to bread – if you can see the bread through the peanut butter you would put on more! After a minute has passed, rub the sunscreen down onto the lower face rather than laterally off of the cheeks. And remember to reapply if you are in the sun for more than two hours or swimming. Even waterproof sunscreens come off! Remember that hats and swim shirts, as well as other forms of sun protective clothing, are excellent ways to protect your children from the sun that do not rub off over time.
Q: Does sun exposure cause damage to skin?
A: Well, there’s no question that the sun will injure your skin if you go outside without the right protection. The sun produces energy; that energy is absorbed by your skin cells. The energy then causes breaks in your skin cells’ DNA, but your body has a repair mechanism that helps the skin heal. We recognize now that freckling, which is a form of sun injury on the skin, is not healthy. It’s a sign that the skin is not tolerating the sun’s harmful effects, and therefore injuring the DNA that make up those healthy cells.
Q: If I have darker skin, does that mean I cannot suffer sun damage?
A: Generally speaking, people with darker skin types typically produce eumelanin in their skin, while people with lighter skin types typically produce pheomelanin. The difference between those two is that pheomelanin is not protective as a barrier against the sun. However, if your skin produces eumelanin, which can act as a protective barrier against the sun, your skin becomes darker, or what you would call tan. That’s why the darker your skin pigment, the less likely you are to sunburn. That doesn’t mean that you don’t sunburn or that you don’t have to protect your skin from the sun – sun protection is still important for those with darker skin. It just means you are less likely to have problems than someone who doesn’t make eumelanin.
Q: Can staying out of the sun cause Vitamin D deficiency?
A: When you are in the sun, your skin actually produces Vitamin D, which is one of the sun’s most beneficial effects. However, you don’t have to rely on the sun to get Vitamin D. Food such as bread and milk are often supplemented with it, so a well-balanced diet would provide enough Vitamin D for a child or adolescent.
Q: If I wear sunscreen, will I still be able to get a tan?
A: It’s a myth that your skin will not develop pigment and will not darken if you’re wearing sunscreen. That process still happens. However, with the appropriate reapplication of sunscreen, you avoid most of the negative effects of overexposure. When you get sunburned, many of your skin cells are killed or are left with damaged DNA.
Q: Is sun damage that dangerous?
A: If you sunburn over and over again, you may be at an increased risk of skin cancers – basal cell carcinoma, squamous cell carcinoma and melanoma in particular. Melanoma is the most dangerous form of skin cancer. Even a melanoma that is just one millimeter in depth will kill 50% of the people that have it within five years.
Make an Appointment
Dr. Annette Wagner see patients at Lurie Children’s Outpatient Center at Westchester and Lurie Children’s Outpatient Center at Arlington Heights.
If you’d like to request an appointment with one of our specialists, call 1.800.543.7362 (1.800.KIDS DOC®).