Sunscreen Dos and Don’ts

Understanding SPF and the best ways to protect against UV rays

With all the things we as parents have to remember, applying sunscreen to wiggly bodies can seem like too much. We may find ourselves wondering if all that SPF stuff is really that important.

According to Skin Cancer Foundation the answer is yes, it really is that important: “One blistering sunburn in childhood or adolescence more than doubles a person’s chances of developing melanoma [potentially deadly form of skin cancer] later in life and a person’s risk for melanoma doubles if he or she has had five or more sunburns at any age.” As parents it is our responsibility to keep our little ones safe from all hazards, including the damaging effects of too much sun.

To find out more about keeping kids safe in the sun, I spoke with Kelli Lovelace, M.D., board certified dermatologist at the Tulsa Dermatology Clinic.

TK: What is SPF anyway?

KL: SPF means Sun Protection Factor. It gauges the protection from UVB rays, but doesn’t indicate protection from UVA rays. [UVB is the chief cause of sunburn. UVA penetrates more deeply and is the dominant ray in tanning. Both rays cause skin damage and can lead to skin cancer.]

Because both rays are harmful you need to look for sunscreens with a “broad spectrum” component. An SPF of 15 blocks 93 percent of the UVB rays. An SPF of 30 blocks 97 percent. The American Academy of Dermatology recommends that everyone use a minimum of SPF 30. Additionally, most people don’t use enough sunscreen. A full shot glass is recommended to cover the exposed portions of an adult body. If you use an SPF of 15 and don’t use a lot, you may only be getting an SPF of 2. In that case, an SPF of 50 might give more protection.

TK: We know that chemicals can be absorbed through the skin. Are the chemicals in sunscreens safe for kids?

KL: That’s a hot topic right now. There are two kinds of sunscreens: chemical sunscreens and physical blocking sunscreens. The Environmental Working Group [a non–profit agency specializing in environmental research and advocacy] recommends avoiding chemical sunscreens containing oxybenzone—a chemical in all spray-on sunscreens.

As a dermatologist, I don’t have enough evidence to say it is not safe. I believe the benefits outweigh the risks. For patients with sensitive skin we recommend physical blocking sunscreens. Instead of absorbing UV rays, they block them. However, even these are not without controversy, as they often contain micronized zinc oxide. There is some concern that, being so small, the particles can get into the cells of the body. I use spray-on Coppertone on my kids and I feel good about it. However, I don’t recommend spraying directly on the face. To avoid inhaling the chemicals use the spray in a well-ventilated area and spray onto the hand and apply the sunscreen to the face.

TK: Is it safe to put sunscreen on infants?

KL: Sunscreens are not recommended for use on children under 6 months of age. We recommend sun avoidance for babies.

TK: Do children of color need to use sunscreen?

KL: Yes, children of color do need to use sunscreen because it protects against damaging UV rays. Children of color may not be as likely to get sunburns, but they do get skin damage. They can get skin cancers, including melanoma. We see slightly higher ratios of melanoma on people of color, especially on the palms and soles of the feet.

TK: Is it really necessary to reapply sunscreen every two hours? Is that a reasonable request of parents and teachers?

KL: The chemicals in sunscreens aren’t very stable and break down rather quickly. Parents should apply sunscreen in the morning before a child goes to school and sunscreen should be reapplied before recess. Spray-on sunscreens are really convenient for this. Yes, I think reapplying is reasonable. The two to three minutes it takes is well worth it.

TK: How important is it to apply sunscreen 15 minutes before being in the sun?

KL: Sunscreen should be applied before going outside to allow it to dry completely and to absorb into the skin. Spray-on sunscreens dry faster. Ten to 15 minutes is adequate.

TK: Can’t you just pop a T-shirt on a kid who is getting a little pink?

KL: Clothing does provide some protection, but it doesn’t block 100 percent. A typical white T-shirt offers about an SPF of 7. If the T-shirt is wet the protection is even less. The best way to see if a fabric can protect the skin is to hold it up to the light. If you can see through it, then UV radiation can penetrate it.

TK: Is there any benefit from getting a “base tan” at a tanning booth to prevent sunburn?

KL: When you are tanning, you are exposing your body to UV light [whether you are outside or in a tanning bed]. Your body makes the pigment to protect itself. When you get a tan, it indicates that you are getting damage. Tanning is an extremely unsafe way to keep from burning. People who use tanning beds are 74 percent more likely to get melanoma than people who do not.

If you want the look of tanned skin, spray tans are very safe and look natural. I get fooled by them all the time in my practice!

TK: How about the scalp? Do we need to use sun protection on the scalp?

KL: Absolutely! We see skin cancer in scalps. My daughter won’t keep a hat on, so I spray sunscreen on the part in her hair. Children should also protect their eyes with sunglasses. If they see you wearing sunglasses, they are more likely to be compliant about wearing them.

“At the end of the day the basic recommendation is to have sun avoidance,” Dr. Lovelace says. “Wear a hat and protective clothing and seek shelter from the sun.”

To see how your sunscreen measures up according to the Environmental Working Group visit www.ewg.org/2010sunscreen.