The title of the policy statement released yesterday by the American Academy of Pediatrics says it all – Ultraviolet Radiation: A Hazard to Children and Adolescents. Years of expert advice on the dangers of too much sun don’t appear to be sinking in, according to the report. The problem, specifically, is the ultraviolet radiation (UVR) lurking in the sunshine, which causes the three major forms of skin cancer: basal cell carcinoma, squamous cell carcinoma and cutaneous malignant melanoma.
Melanoma rates continue to rise as Americans stay out too long in too little clothing without enough sunscreen. And teens and adults continue to visit indoor tanning parlors, which pose the same UVR exposure risks.
The policy’s advice is fairly standard:
Do not burn; avoid suntanning and tanning beds.
Wear protective clothing and hats. Tightly woven dark-colored fabrics protect better than loose weaves in lighter shades. An ultraviolet protection factor (UPF) rates fabrics’ protection as “good” (15 to 24), “very good” (25 to 39) or “excellent” (40 to 50). Learn more here …
Seek shade. But realize that even shade doesn’t offer total protection. A fair-skinned person sitting under a tree can burn in less than an hour.
Use extra caution near water, snow and sand. These reflect the sun’s rays and increase UV exposure.
Apply sunscreen. This means a full ounce of a formulation with SPF of at least 15, reapplied every two hours and every time you swim, sweat, or towel off.
Wear sunglasses. These don’t have to be pricey. They just have to offer the best UV protection you can find.
The report raises two issues causing some controversy.
First is the potential of oxybenzone, a common sunscreen ingredient, to have what the report calls “estrogenic (mimicking estrogen) and other systemic effects.” Oxybenzone is absorbed through the skin, has been detected in urine and in breast milk, and researchers have called for further study of its impact.
Second is the body’s need for vitamin D, which is essential for normal growth, and the development of strong bones. The report says that 30% of teens and young adults are vitamin D deficient, as are 8-15% of children ages 11 and younger. Sun exposure is one source of vitamin D, and there have been calls for “sensible sun exposure” of the arms and legs for 5-30 minutes to fend off deficiency. Dermatologists, on the other hand, contend this is too risky.
In the absence of studies showing just how much sun exposure kids would need to keep their vitamin D levels high enough that they wouldn’t need supplements, the AAP recommends that kids take 400 IU per day.
There is also some mention of how telling kids to stay out of the sun might impact childhood obesity rates. With as many as a third of children in the U.S. being overweight or obese, the report urges doctors to deliver sun protection advice “in the context of promoting outdoor physical activity.” So go outside and play – in the shade, in protective clothing and a hat and sunglasses, re-applying sunscreen every two hours. And have fun.