A Dermatologist’s Guide to Safe Fun in the Sun

With summer finally heating up, your family may be spending more time outdoors and exposed to the sun’s rays. Between packing bags and getting everyone out the door, sunscreen is easy to forget. A recent survey of Illinois parents found only 42% always apply sunscreen before their kids head outside in summer, and just 1 in 5 remember to reapply every two hours like they should.

But a few simple habits can make sun safety stick — and protect your kid's skin for years to come. Annette Wagner, MD, an attending physician in Lurie Children’s Division of Dermatology, offers guidance on sun safety for kids and adults and answers some frequently asked questions, including children’s sunscreen recommendations.

Sun Protection by Age

Sun protection looks a little different at every age, but the goal is always the same: building healthy habits early that last a lifetime. Because sun damage accumulates over years, starting smart sun protection in childhood is one of the best investments you can make in your child's long-term health. The American Academy of Pediatrics outlines strategies for families based on their children’s ages:

• Infants under 6 months have skin too sensitive for sunscreen and should be protected with alternatives. Keep them out of direct sunlight. Use shade, clothing and hats, and if needed, apply minimal sunscreen to small areas like face and hands.
• For all children above 6 months, reapply sunscreen every two hours and follow the instructions to ensure children are protected throughout the day.
• For older children, apply enough sunscreen — about one ounce for full-body coverage. Avoid sunscreen gimmicks, like sprays and sticks, or sunscreens that are perfumed; the best sunscreen is a cream in a bottle.

When it comes to sun protection, it’s essential to start young and stay consistent, as sun damage can have long-term effects, including premature aging and skin cancer.

Children are rarely allergic to chemical-free sunscreens, but if you child is it will cause hives or immediate redness on the skin when applied. Keep in mind that many things produce redness including heat itself or incorrectly applied sunscreen. However, if you have a highly allergic child, first apply a chemical-free sunscreen to the inner arm before bed to look for an allergic reaction like an itchy, swollen rash.

How and When to Apply Sunscreen

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. After a minute has passed, rub the sunscreen down onto the lower face rather than laterally off the cheeks.

Sunscreen should be applied daily, but reapplication is even more important if in the sun more than two hours, swimming or sweating. Even waterproof sunscreens come off! Set a phone reminder or alarm to stay on top of the day. Remember that hats, sunglasses 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: What is the best SPF to look for when you are buying sunscreen?

A: Look for SPF 30+, broad-spectrum, and water-resistant. Higher SPF options usually contain more chemicals and the additional benefits are very minimal. Bonus points for zinc oxide or titanium dioxide as the active ingredients — they offer great protection and are gentler on skin. The best sunscreen is a cream in a bottle. 

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.

Learn more about pediatric dermatology