By Drs. Sally Robinson and Keith Bly

Sunburn is the skin’s reaction to ultraviolet (UV) radiation exposure. UV rays can cause invisible damage to the skin, which can lead to premature aging of the skin, as well as to skin cancer. Most of the damage that the sun causes to our skin happens when we are children. Even a few serious sunburns can increase your child’s chance of getting skin cancer.

Unprotected skin can burn in as little as 15 minutes outdoors, and even if skin does not turn red, it may still be burned; tanned skin is damaged skin. Most sun damage occurs during daily activities, rather than just during trips to the pool or the beach. Check the UV index in the newspaper before you go outdoors, and apply sunscreen when the UV intensity is ≥ 2.

With so many sunscreen products on the market, it is sometimes confusing to decide what you should buy to protect your child. A sunscreen that has both UVA and UVB protection and an SPF (sun protection factor) of 15 or higher (higher if your child has fair skin) offers the best protection against sun damage. Broad-spectrum sunscreens contain ingredients such as zinc oxide or titanium dioxide and block both UVA and UVB rays. If you use a combination sunscreen/insect repellent, make sure that the sunscreen has a high SPF, because DEET lowers the effectiveness of sunscreens.

Use sunscreen even on cloudy days, because clouds only slightly filter UV rays. The sunscreen should be applied in a thick coat at least 30 minutes before going outside and reapplied at least every two hours to all exposed areas, including rims of ears, lips, the back of the neck and the tops of feet. If your child is swimming or sweating a lot, you should reapply more often, even if using a waterproof sunscreen.

Besides using sunscreen, other steps to protect your child from the sun include:

• Having your child wear protective clothing, including a hat, long-sleeved shirt and long pants. Most clothing only has an SPF of 5-9, so sun damage can still occur.
• Limiting sun exposure between 10 a.m. and 3 p.m. The sun is at its strongest during these hours.
• Putting a brimmed hat on your child.
• Protecting eyes with sunglasses that filter UV rays.
• Keeping babies under one year of age out of direct sunlight. Move your baby to a shaded area under a tree, umbrella or stroller canopy, and dress her in clothes that cover her arms and legs.

Some medications can make your child more sensitive to the sun. If your child is on medication, check with your doctor. Side effects of some medications that increase sun sensitivity include rash, redness and swelling.

If your child does get sunburned:

• Bathe in cold water or use cool compresses
• Give a pain reliever if necessary
• Use aloe vera gel or hydrocortisone cream
• Keep your child out of the sun until the burn heals

Call your doctor if the sunburn is severe or forms blisters, or if your child has symptoms of heat stress, such as fever, chills, nausea, vomiting or feeling faint.

Dr. Sally Robinson is a pediatrician in the division of children’s special services at the University of Texas Medical Branch at Galveston. She teaches medical students about caring for children with chronic medical conditions. Dr. Keith Bly is a hospitalist and assistant professor of pediatrics at UTMB.

The Your Health column is written by health and medical experts at the University of Texas Medical Branch at Galveston. The column focuses on topical health issues that we believe are of interest to your readers. It is e-mailed every Tuesday. If you have any questions about the column, or would like to suggest topics, please contact John Koloen, media relations specialist, at (409) 772-8790 or email jskoloen@utmb.edu.