Sun safety
Children rely on parents for help avoiding sunburn

Fun in the sun today can mean trouble tomorrow for children who aren’t adequately protected. Sunlight can be invigorating and temporarily beautifying to some, but the risks of over-exposure are rarely worth any perceived benefit, according to experts.

Damage from the sun’s rays can be long lasting and deadly for people of all ages and races. One in five Americans will develop skin cancer, according to the National Safety Council.

“Statistics have shown that just one blistering sunburn in childhood is estimated to double the risk of getting malignant melanoma later in life,” said Dr. Harriet Van Hale of Carolina Dermatology in Greenville. “Besides pre-exposing to skin cancer, sun causes aging of the skin, wrinkling, discoloration, brown spots, freckling, sagging skin — those kinds of things.”

Wearing sunscreen is a must for people who spend time with skin exposed to the sun’s rays, dermatologists say. Van Hale recommends a sun protection factor, labeled on sunscreens as SPF, of at least 15. SPF is an indicator of ultraviolet B-ray protection that measures the ratio of the amount of time it takes for the sun’s rays to cause erythema, or redness of the skin, compared to skin that is not protected by sunscreen.

Dr. Karen DeVore of DeVore Dermatology in Spartanburg describes ultraviolet A rays, UVA, as “aging” rays and ultraviolet B rays, UVB, as “burning” rays.

“UVB protection protects against sunburn, but UVA is probably just as important in the damage that it does because it penetrates deeper into the skin,” DeVore said. “UVA is more associated with aging. That’s what’s in tanning beds — supposedly your ‘safe’ tan because you don’t burn because they’re giving you UVA rays, but it’s really not safer. You may not burn, but you’re actually getting damage at a deeper level. It, too, contributes to cancer, and it definitely contributes to the aging side effects that we see.”

Lonn Dugan, an Ohio businessman who’s been in the tanning industry for 20 years and owns www.SunTanning.com, is not a doctor, but he doubts that science has proven a correlation between tanning and skin cancer.

“It’s safe enough for me,” Dugan said. “It’s safe enough that I recommend it to my family and children. The sun is the source of all life on Earth. If you get rid of the sun there would be no life on Earth. Think about it. It is the fuel of life. Plants harness sunlight in what’s called photosynthesis. They produce carbohydrates and proteins. These plants are then eaten by animals, and we eat the animals and the plants. What is the very thing that gives our body energy is really the energy from the sun.”

Dugan believes tanning in moderation, outdoors or in a tanning bed, is beneficial to health, but Van Hale disagrees.

“Tanning salons are a lot more dangerous than previously thought,” Van Hale said. “There’s a lot of new information out that points to UVA rays playing a role in the development of malignant melanomas. There’s been one study I know of that has noted an increase in incidents of malignant melanoma in young women in their late 20s and 30s. These women, when studied, have shown to have spent time in tanning beds when they were teenagers. I think anybody below the age of 18 should never go in a tanning bed, and, of course, I don’t recommend them for anyone.”

Dugan recommends tanning beds for all adults.

“What I call the cancer-connection campaign is simply a myth by what we call the sun-scare industry to make money,” said Dugan. “People should know there are health benefits that come from tanning. In our modern industrialized society where most of us work indoors during the sunlight hours, it can actually be to our health detriment that we don’t get enough sun. I would tell you that some is better than none, and most of us don’t get enough.

“Too much is too much; I’m the first one to agree with that. We should not be burning, and we certainly should not be going to a tanning salon every day, seven days a week, 12 months a year. On the other hand we should be getting more than we get. The world’s best sunscreen is a sun tan. A gently-acquired, moderate sun tan is a natural sunscreen. It’s the way God intended, and it requires no chemicals.”

Powdersville resident Karen Iskandar is mindful of the risks of sunburn, but she said she does not do all she could to protect her two daughters.

“ I see a lot of parents out there with their children covered head to toe,” Iskandar said. “I’m not that aggressive about it. I'm not a teetotaler, so to speak, but I do use 50 SPF and reapply often.”

That helps, though nothing helps as much as avoiding exposure.

“ Sunlight is radiation,” DeVore said. “The amount of radiation and the amount of sunlight you get over a lifetime accumulates. Your sunburn may fade. Your suntan may fade. Some people think that means that your body doesn’t remember that, or that damage wasn’t done because the tan and the burn go away, but every year every exposure adds up.”

She said science hasn’t yet determined definitive causes of all skin cancer, but she said it is clear that exposure is correlated with skin cancer risk.

“It’s not as clear-cut for melanoma, but some people think childhood sun exposure is even more of an issue with melanoma and that it’s more chronic, long-term exposure for increased basal cell and squamous cell carcinomas,” DeVore said.

Experts say infants under the age of 6 months should rely on hats and clothing to offer protection from sun exposure rather than sunscreen. Van Hale recommends young children over the age of 6 months use zinc oxide-based sunscreens.

“The great majority of sunscreens that are on the market and are very good are appropriate for children as well as adults,” Van Hale said. “A lot of companies will market one particular sunscreen toward children, but basically the ingredients are pretty much the same. They may do little different things, such as putting color in the sunscreen or something to make it more appealing to children or interesting to children, but they’re all basically the same ingredients.”

Higher SPF ratings provide more protection from UVB rays, but most sunscreens do not provide protection from UVA rays.

“Physical sunscreens like titanium dioxide and zinc oxide, those will block UVA and UVB,” DeVore said. “Of the chemical sunscreens avobenzone is probably the most effective UVA blocker.”

Some people’s worst sunburns occur on cloudy days because they think the cloud cover is protection enough. It isn’t. And the fickle are running out of excuses. New, improved products offer protection without unwanted side effects, dermatologists say.

“There’s a form of sunscreen that’s much more palatable to different people,” Van Hale said. “For example sunscreens now come in gels, which seem to be very popular with men and work well on scalps because they’re not greasy. They have an alcohol base to them. There are some very good sprays that go on and other sunscreens that go on now and feel dry very quickly so that you’re not left with a greasy or oily feel to the skin.”

Van Hale recommends wearing sunglasses and sun-protective clothing whenever possible. She said sunglasses help guard against damage to vision that can come from exposure to sunlight as well as skin cancer that can strike eyelids.

People of color can suffer damage, too.

“The more olive-toned, the darker the skin, the greater protection you have from sunlight, but it’s never a total thing because some sun-induced skin cancers are seen in people of color, mostly on sun-exposed areas — head, neck, arms and so on,” Van Hale said. “Although they do have more innate protection, it’s not complete. It’s not a sure thing. It’s probably that they may not need as much or as high an SPF sunscreen.”

Young people can be at particular risk because they are often active outside during warm summer months. Infants’ risk is compounded by the fact that they are completely dependent on caregivers’ mindfulness since they can’t apply sunscreen themselves and usually can’t articulate the tight feeling exposure to the sun can leave, a bright red flag for sunburn, dermatologists say.

“ You know how painful it is when you’ve had a sunburn, and a poor baby can’t tell you, ‘Hey, I’m in a lot of pain!’,” Iskandar said. “And what are you going to do for her, anyway?”

Dermatologists say the best thing to do is minimize exposure and use sunscreen. They recommend avoiding peak hours of the sun, from 10 a.m. to 4 p.m. Reapply sunscreen often — every two to three hours, experts say — and use enough in the first place.