Sun Sun Exposure:

The sun is the main cause of skin cancer, the most common form of cancer in the United States. All skin cancers are harmful and some, including malignant melanoma, can be deadly.

Virtually everyone is at some risk for sun exposure damage. Infants, children, and adolescents are at a higher risk because of the time they spend outdoors; between 60% to 80% of a person's lifetime exposure happens before he or she turns 18 years old. Research has shown that one or more blistering sunburns in childhood increase the risk of developing skin cancer later in life. A parent's knowledge of sun exposure helps decrease or avoid the chances of run, re skin cancer in their children.

                                                                   

How can I protect my child?

There are several ways to protect children from the sun. Babies under 6 months of age should be kept out of direct sunlight. Children should be clothed in comfortable, lightweight, tight-woven long pants and shirts. Hats should have a brim of at least 3 inches (7.5 cm) all around to cover the face, neck, and ears. Sunglasses are important for all ages. Protective glass on car windows will decrease the damaging ultraviolet ray exposure. Avoid the sun between 10 a.m. and 3 p.m. (11 a.m. to 4 p.m. during daylight saving time) and use sunscreens and sunblocks whenever outdoors.

Sun products that protect against both ultraviolet A (UWA) and ultraviolet B (UV~) rays are best. Look for the words broad spectrum on the label. Sunblocks such as zinc oxide or titanium dioxide, or combination sunscreens such as benzophenones (oxybenzone, dioxybenzone, sulisobenzone), provide protection against both UVA and UVB rays. Always choose a sunblock or sunscreen with an SPF of 15 to 30. Anything over 30 is unnecessary and may actually harm your child due to strong chemicals. Apply 1 ounce (28.35 grams) 15 to 30 minutes before going outdoors to all areas of the body including the lips, ears, nose, neck, shoulders, hands, back, waist, and feet. Reapply sun lotion every 2 to 3 hours and after swimming and sweating. All children, especially adolescents, should avoid artificial light sources such as tanning beds and sunless tanning products.

Signs of sunburn usually appear 6 to 12 hours after exposure, with the greatest discomfort during the first 24 hours. For red skin, tepid baths and cool soaks arc best. Washcloths dipped in water, milk, or cold teas can be applied directly to the skin. Plain yogurt applied several times a day for 10 minutes may offer relief. Have your child drink plenty of fluids including water and juices. Apply moisturizers and aloe to dry skin and use oatmeal baths for itchy skin. Always avoid butter, grease, or powder on any type of burn; these home remedies can actually make the burn worse. For pain, acetaminophen or ibupro-fen may be given as directed. Ask your primary care provider about applying a low-dose over-the-counter cortisone cream to sore and swollen skin. If your child has severe blisters, fever, chills, headache, or a general feeling of illness, call your primary care provider immediately.

parks, public signs can be posted at playgrounds and swimming pools, lifeguards can set good examples, and policies can be created. Parents can make a big difference in the prevention of sun exposure and future skin cancer in today's children. For more information, contact these national resources:

Setting a good example is the best preventive measure that a parent can initiate. It is a good idea to periodically perform skin assessments on children by looking for the ABCDE's of skin cancer (see chart). Parents can also help by getting involved in the community and schools and encouraging sun-safe activities for children. School teachers and coaches could participate. Trees can be planted along streets and

Although most children's moles are perfectly harmless, it is important to look for changes in size, texture, shape, and color. An easy way to remember what to look for is the "ABCDE" signs of skin cancer:                                               

A= Asymmetric

B= Border irregularity

C= Color variance

                    D= Diameter greater than 1/4 inc                                       

(6 mm)(or the size of a pencil eraser)

E= Elevation and Enlargement                                                   

When the weather turns warm, you may want to use an insect repellent to protect your child from bites by mosquitoes, biting flies, gnats, chiggers, ticks, or other "bugs." In choosing a repellent, you need to keep in mind what insects you want to protect against and which substances are safe and effective.

The best all-purpose insect repellent is a substance called N,N-diethyl-m-toluamide, commonly known as deet. It is the active ingredient in most commercially available repellents. Deet is available in products packaged as sprays, aerosols, gels, liquids, sticks, and impregnated towelettes. Although deet has been used safely for 40 years, it is best not to apply products with a deet concentration of more than 10% to children’s skin. Check the label of the product you are considering for the concentration.

Be sure to apply the deet product to all exposed areas except the hands (particularly of small children) and the skin near the eyes and mouth. Also keep repellent away from cuts or any patches of irritated skin. Deet will remain effective for several hours, but will wash off with water and sweat, so it’s best to reapply it from time to time. The substance also may damage plastics and spandex.

If you prefer a plant-derived product, consider a repellent in which the active ingredient is citronella. Although citronella is effective, it does not protect as long as products containing deet. Soybean oil is another "natural" repellent that works well.

When clothing or other objects rub the skin,some repellent may come off. Evaporation, wind, heat, sweating, and water have the same effect and shorten protection time.

Using an insect repellent with sunscreen. The sun protection factor (SPF) of sunscreens may decrease when an insect repellent containing deet also is applied. Therefore, if you use sunscreen and deet-containing insect repellent on your child at the same time, choose a sunscreen with a higher SPF than you usually use. If you apply one of the new combination sunscreen and insect repellent products, keep in mind that it may not protect as well against sun as the SPF on the label would suggest.

Many parents worry that their child will be bitten by a tick and get Lyme disease. The best protection against ticks is permethrin, which is available in a spray repellent. Permethrin should not be applied directly to the child’s skin, however, because its safety when used that way has not been firmly established. Spray permethrin repellent on clothing, shoes, tents, netting, sleeping bags, and the like.

It will last for several washings. On the child’s skin, use a deer-containing repellent.

• Whatever repellent you choose, observe the following guidelines, developed by the Environmental Protection Agency (EPA), for the safe use of insect repellents:
• Verify that the repellent has an EPA-approved label
• Read the entire repellent label before each use · Use the repellent only as directed by the manufacturer and only for the insects it claims to be effective against · Keep repellents out of the reach of children
• Apply only to areas specified by the label
• Use enough repellent to cover exposed skin or clothing, but avoid frequent applications
• On returning indoors, wash repellent off skin with soap and water
• If you suspect a repellent-induced toxic reaction, wash off the repellent and call the poison control center. If you go to a doctor’s office or other facility, take the repellent with you.
• For information on the active ingredients in repellents, contact the National Pesticide Telecommunications Network at 800-858-7378.
• It is open 24 hours a day, seven days a week.

92 CONTEMPORARY PEDIATRICS Vol. 15, No. 6