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More Sun Protection Needed for Children

June 10, 2008 - 7:30am
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More Sun Protection Needed for Children

image for child skin cancer article The sun does most of its damage in childhood. An estimated 80% of total lifetime sun exposure occurs in the first 18 years of life. Yet, the majority of children and teens are not using sunscreens or following sun safety advice. This worrisome conclusion was reached by two recent surveys on parent’s sun protection attitudes and practices for their kids.

It may be because tans are popular and still felt to be healthy and attractive. Alan Geller, RN, MPH, lead researcher from Boston University, observes, “Attitudes associated with tanning, such as the preference for tanned skin, having many friends who were tanned, and belief in the worth of burning to get a tan, were generally associated with sporadic sunscreen use, more frequent sunburns, and increased use of tanning beds.”

Risk for Skin Cancer

But sun-worshipping behaviors are putting our kids at risk. More than one million Americans are diagnosed each year with skin cancer and excess sun exposure is the leading cause. In addition, severe sunburns in childhood are associated with an increased risk of melanoma, the deadliest form of skin cancer that may even strike teens or young adults. Although sunburns are thought to potentially increase the risk of melanoma formation, there is little data suggesting they cause melanomas in young people. Melanomas, like most malignancies in youth, are probably a combination of a genetic misstep and an environmental exposure. That is, young people probably don’t develop cancers unless they have a genetic predisposition to do so. It is likely that sunburns and accumulated sun exposure are more associated with skin cancers, including melanomas, developing later in life (50s and 60s).

With rates of most skin cancers on the rise, the Centers for Disease Control and Prevention (CDC) and the American Cancer Society (ACS) urge sun protection measures starting in childhood. Results from the two surveys shed some light on why many parents and children are ignoring medical advice to wear sunscreen and protect their skin from the sun. Just how big is this problem, and what can we do about it?

Boston University Study

In the largest national survey on the subject to date, researchers analyzed data on 10,000 boys and girls aged 12 to 18. They found that only one-third of the youngsters surveyed had routinely used sunscreen over the past summer. During that time, 83% had gotten sunburned at least once, and 10% had used a tanning bed. Girls were far more likely than boys to report tanning bed use, with a rate of 14.4% in girls compared to 2.4% in boys. Researchers concluded that “many children are at subsequent risk of skin cancer because of suboptimal sunscreen use, high rates of sunburning, and tanning bed use.”

University of South Florida Study

This study also found that regular use of sun protection for children is infrequent. Using a two-page questionnaire, researchers surveyed 100 parents of children ages 1-16 who came to a medical clinic waiting room. Only 43% of the respondents reported regular use of sun protection for their child.

Misconceptions about sun protection were quite commonly seen in the survey. Data indicated that 41% of parents believed sun exposure is healthy for children, and 44% thought their child looked better with a tan. In addition, half of parents believed it is okay for children to stay in the sun longer if they use sunscreen. But, say the researchers, relying solely on sunscreen may lead to an increased overall sun exposure for children if they do not wear protective clothing or follow other sun protective measures.

Parents who reported regularly using all forms of sun protection for their child had higher scores on the knowledge and attitude scale than those who did not. These parents were more likely to be informed about sun protection measures and to use the methods regularly themselves. They also more commonly taught their children about sun protection.

Childhood: a Critical Time

When we’re young, we tend to spend much more time in the sun. Ultraviolet light rays cause invisible damage that accumulates over time. Years later the built-up damage may appear as wrinkles, age spots, or skin cancer.

Research suggests that up to 80% of skin cancers can be avoided with routine use of sunscreens and sun protection in children and adolescents. Here are tips from the American Academy of Pediatrics (AAP) on how to protect your children from the long-term damaging effects of the sun:

  • Stay away from the sun in the middle of the day when its rays are most intense. Schedule outdoor activities before 11:00 am and after 3:00 pm. Avoid long periods of direct sun exposure and play in the shade when possible.
  • Use sunscreen with a SPF of 15 or higher. Reapply it often, especially after swimming or excessive sweating.
  • Wear a hat and T-shirt or light clothing when outdoors.
  • Keep babies out of direct sun and covered by protective clothing. Sunscreens are not approved for infants less than six months of age.
  • Set a good example for your children by following good sun protection measures yourself.

One final note, despite the benefits of avoiding sun exposure, potential harm may result too. Sun exposure is the most potent source of vitamin D. Inadequate vitamin D intake may lead to increased risk of various types of cancer, including some that are much more difficult to treat than cancer of the skin, such as colon and breast cancer. The solution? Make sure children consume plenty of vitamin D enriched foods, like milk. Vitamin D supplements are also an option.


American Academy of Family Physicians

American Cancer Society

National Cancer Institute


BC Cancer Agency

Canadian Cancer Society


Geller AC, Colditz G, Oliveria S, et al. Use of sunscreen, sunburning rates, and tanning bed use among more than 10,000 US children and adolescents. Pediatrics. 2002;109:1009-1014.

Johnson K, Davy L, Boyett T, Weathers L, Roetzheim RG. Sun protection practices for children. Arch of Pediatr and Adolesc Med. 2001;155:891-896.

Strayer SM, Reynolds P. Diagnosing skin malignancy. J of Fam Pract. 2003;52:210-218.

Sun protection for children: A parent’s guide. (pamphlet) American Academy of Pediatrics; 1993.

Last reviewed March 2008 by Ross Zeltser, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.



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