Sunscreens

Did you ever wonder how you would possibly choose the correct sunscreen for your child when there are more than 40 different products staring you in the face? What does SPF really mean anyway, and how often should it be reapplied?

The following points will help you decide which sunscreen product is right for your child.

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What does sunscreen do?

Sunscreens are considered to be drugs by the Food and Drug Administration (FDA) because they are used to prevent health problems like sunburn and skin damage.. Sunscreens can also prevent freckling. Also, studies show that just one severe sunburn during childhood or the teenage years can double the chances of skin cancer in adulthood, and that using sunscreens during childhood can help prevent this. [back to top]

What is an SPF?

SPF stands for "Sun Protection Factor" which is used as an estimate of how long you can stay in the sun without getting a sunburn. An SPF can range from 2 to 50 and is listed on the product label. Here is an example of how SPF works: If it normally takes your skin 10 minutes to turn red in the sun without any sunscreen, then a product with an SPF=2 would give you 20 minutes in the sun before you turned red (2 x 10 minutes= 20 minutes). If you used a product with an SPF=30, then you would be protected for 300 minutes (30 x 10 minutes= 300 minutes). Of course, no one really knows exactly how many minutes it takes before they turn red, so SPF is used as a way to compare the protection provided by different products. In order for the sunscreen to continue working, it must be reapplied as recommended on the label. Most skin doctors recommend an SPF of 15 or more for all skin types, and an SPF of 30 to 45 for children since they are outside a lot.  [back to top]

Types of Ultraviolet Radiation (UVB and UVA)

There are two different types of sunlight rays that affect the skin; UVB and UVB. UVB rays are responsible for sunburn, wrinkling of skin, as well as other damage to the surface including the kind that can lead to skin cancer. UVA rays reach deeper into the skin cause damage to lower layers of skin and blood vessels and weaken the structure of the skin.  [back to top]

Types of Sunscreens:

 

Chemical

Some sunscreens contain ingredients (chemicals) that prevent skin from becoming sunburned. These chemicals actually absorb some of the sun's harmful rays and help prevent damage to the skin. Some people are allergic to certain chemicals in sunscreen products (PABA esters) and should choose a sunscreens of a different type. Also, people that are sensitive to the sun after taking any medication, could have the same reaction in the sun after using a PABA containing sunscreen and should talk to their pharmacist before selecting one.

The chemicals in sunscreen products are not always effective against all types of UV rays. Some are effective for just UVA and some are effective against both UVA and UVB. Read the package label to determine which sunscreen product protects against which type of light. One chemical, salicylate, which is a weak sunscreen and does not stay on the skin well, should not be used in children. Also, salicylate can be absorbed through the skin, which is another reason it should not be used in children.  [back to top]

Physical

Physical sunscreens (zinc oxide and titanium dioxide) form a barrier between the sun's radiation and your skin. The thicker they are applied, the more effective they are. Physical sunscreens scatter or reflect the rays instead of absorbing them. They are used most often on small areas of the body that are always exposed to the sun such as the nose, lips, and ears and appear as a white or colored substances. Lifeguards often apply these products on over-exposed body parts. Disadvantages of these products include staining of clothing and blocking the pores on the skin, so these products should not be used over large areas of the body.  [back to top]

Broad-Spectrum (UVB and UVA)

Products that block UVB and UVA radiation are sometimes referred to as "broad-spectrum" sunscreens. Most contain a minimum of two chemical and/or physical sunscreen ingredients.  [back to top]

Water-Resistant vs. Waterproof

How well a sunscreen will work also depends on its ability to stay on your child's skin. Sunscreens are available as a cream, an oil, or a gel. Oil-based products tend to have lower SPF values, but stay on quite well. Creams and gels have higher SPF values, but need to be reapplied because of their tendency to wash and rub off. When a product claims to be "water-resistant" it will retain its sun protection for at least 40 minutes in water. "Waterproof" means the product retains its sun protection for 80 minutes in water.  [back to top]

Special Considerations for Children:

Children Under 6 months of age

Infants that are under 6 months of age have delicate skin and can absorb more of the chemicals in sunscreen products. Also, their kidneys and livers are not fully developed so if they do absorb the chemicals, they can't eliminate them. For these reasons, the FDA does not recommend using a sunscreen on infants less than 6 months of age. Instead, you should protect your infant from exposure to the sun by covering them with appropriate items of clothing.  [back to top]

Children 6 Months of age and older

Children over 6 months of age should use sunscreens that have an SPF of at least 15, (30 would be best). Sunscreen should be worn whenever your child plays outside. Regular use of sunscreen (15 - 30) starting at age 6 months and continuing to age 18 years, can decrease the chance for getting skin cancer as an adult by almost 80%..

Keep all sunscreens out of the reach of children. Sunscreens can be dangerous if swallowed and should only be used on the skin. Avoid getting sunscreen in your child's eyes and warn them not to rub their faces if they have sunscreen on their hands. If sunscreen does get into the eyes, wash thoroughly with water. If irritation and redness continues, call your pediatrician. Discontinue using a sunscreen if your child develops a rash or irritation on the skin and call your pediatrician.

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How to Use Sunscreens

Sunscreen should be used every day and applied to dry skin about 30 minutes before going outdoors. It is important to use sunscreen even on days that are not hot and sunny. Even on a cloudy day, up to 80% of the sun's ultraviolet rays can pass through the clouds.

When applying sunscreen, cover all exposed areas of skin, especially the face, hands and arms. Don't forget your child's ears and back of the neck, an overlooked spot could mean a patch of painful sunburn! Sunscreen should be applied in the morning and again after swimming, perspiring heavily or toweling off. Reapply sunscreen according to the instructions on the product's label. Remember that "water-resistant" products only maintain their potency for 40 minutes in the water, and "waterproof" products for only 80 minutes.

When reapplying sunscreen, remember that protection will be restored to the product's SPF value. By applying more, you do NOT increase the SPF number. Because some ingredients can cause staining, be sure the sunscreen is allowed to dry on the skin before touching clothing, vinyl or fiberglass.  [back to top]

A Word about Sensitivity to Sunscreen

The sunscreens most likely to cause a "sensitivity" reaction on the skin (i.e. contact dermatitis) are those that contain PABA or the PABA derivatives. Adults and children who are prone to allergies and/or have allergies to certain drugs, including benzocaine, thiazides, or the sulfonamides, are more likely to be allergic to these sunscreen products.

Children and adolescents who suffer from acne should look for products labeled as "noncomedogenic" (will not clog pores), fragrance-free, and hypoallergenic. Those with dry skin should avoid products containing ethyl or isopropyl alcohols, which have a tendency to further dry skin.  [back to top]

What if My Child Does Get a Sunburn?

Sunburns are painful and can be dangerous. A first-degree sunburn causes redness and will heal in a few days with peeling of the skin. This type of burn is best treated with cool compresses or a cool bath. Some topical creams, sprays or gels are available over-the-counter to alleviate soreness as well. Some are called "local anesthetics". That means they provide pain relief in one area of the body. Examples of local anesthetics include benzocaine, dibucaine, lidocaine and tetracaine. Check with your pharmacist because some of these ingredients are not appropriate for children, especially younger children and infants. Another class of ingredients found in sunburn products are the "counterirritants". These include ingredients such as camphor, menthol, benzyl alcohol, and phenol. The counterirritants are not recommended for use in children and they may further irritate the burned skin. Occasionally, your physician may recommend acetaminophen or ibuprofen to help alleviate pain, redness or swelling.

Second-degree sunburns usually form blisters and can be considered a medical emergency if a large area is affected. If your child has blistering with a headache, chills, or fever, seek medical help immediately.

Infants, children and the elderly do not tolerate the effects of a sunburn very well. Children with chronic illnesses are more likely to develop complications from sunburns. Evaluation by a doctor should be done if there are any sunburns that involve the eyes, ears, face, hands, feet, or anal area, as well as any second-degree sunburns (involving blistering, fever, chills, headache) to prevent complications, such as infection.  [back to top]

Lip Protection

Lips need to be protected from sunlight as well. Usually a product with an SPF of 15 or greater is sufficient and preferably one that covers both the UVB and UVA rays.  [back to top]

Sunglasses for Children?

Many experts now agree that wearing sunglasses to filter out the sun's ultraviolet rays can prevent some harmful effects on the eye such as the development of cataracts later in life. Some now think that starting in childhood can only help to prevent sun damage to the eye and cataract formation.

The FDA along with the Sunglass Association of America developed a voluntary labeling program for sunglasses. Sunglasses are placed into one of the following categories depending on their ability to filter out ultraviolet rays. The categories are:

 

American Academy of Dermatology: Fact Sheet (Sunscreens). American Academy of Dermatology, Evanston, IL.

Drug Facts and Comparisons, JB Lippincott Company, 53rd edition, 1999.

Knodel LC. Nonprescription Products: Formulations & Features "98-99. American Pharmaceutical Association, 1998.

Nonprescription Products: Patient Assessment Handbook, American Pharmaceutical Association, Washington D.C.,1997