The seeds of skin cancer are planted early. Roughly 20 percent of all Americans will develop the disease in their lifetime. And having blistering sunburns as a child can double one's risk of melanoma, the most deadly form of skin cancer. As a mom, these facts freak me out because my husband, Gary, has had skin cancer repeatedly -- starting when he was 20. So far his cancers have been basal- and squamous-cell carcinomas, which are usually less dangerous than melanoma. However, our 17-month-old son, Noah, has inherited Gary's light complexion and blue eyes, and possibly his predisposition toward skin cancer. Fortunately, we now know a lot more about the sun's dangers than parents did when Gary was growing up.
When we take Noah out, we try to follow the latest sun-protection advice -- which is important for all kids, not just those with fair skin. We avoid spending time outside between 10 a.m. and 2 p.m., when UV rays are at their strongest. (A good rule of thumb: If your shadow is shorter than you are, you should seek shade, says Parents advisor Lawrence F. Eichenfield, M.D., chief of pediatric and adolescent dermatology at the University of California, San Diego School of Medicine and Rady Children's Hospital San Diego.) We keep Noah in a shaded stroller, and dress him in a hat, baby sunglasses, and loose clothing with a tight weave to block the sun. We also buy special sun-protective clothing that he wears on beach days. (Another option: Use a wash-in treatment that ups regular clothing's sun-protection ability.) And, of course, we slather on the sunscreen.
Taking these measures should make a difference, Parents advisor Jody Alpert Levine, M.D., a pediatric dermatologist in New York City, assures me. "The risk of basal-cell and squamous-cell carcinomas is directly related to sun exposure, whereas melanoma also has a strong genetic component. So if parents practice careful sun protection, their child should be fine."
Still, as straightforward as sun-safety advice seems, most of us have questions -- especially when it comes to sunscreen. We turned to leading dermatologists for answers.
At least 30. "If your child is fair and burns easily, I recommend using an SPF of 50," says Dr. Eichenfield. SPF (which stands for sun protection factor) measures how many times a product increases your skin's natural sun barrier. So if you burn in ten minutes, an SPF of 15 should give you 150 minutes without turning red. There's probably no need to go any higher than 50. In fact, the FDA has proposed a rule that would prohibit manufacturers from claiming anything above "50+," because there's not enough evidence to prove that higher numbers would offer greater protection. Plus, "Sunscreen rubs off way before you get to the end of the 'safe' period," says Elaine Siegfried, M.D., professor of pediatrics and dermatology at Saint Louis University School of Medicine. But you also need to look for "broad spectrum" on the label. That means that the product not only guards against burning UVB rays, but also UVA rays, which penetrate deeper into the skin and cause skin cancer as well as wrinkling and premature aging.
Is it safe to use sunscreen on my infant?
It is, though doctors suggest that infants younger than 6 months get no sun at all. If you're outside with your baby, seek shade as much as possible, dress your child in a hat and UV- protective clothing, and use sunscreen on any exposed body parts. Babies have less melanin in their skin than older children and adults -- plus their skin is thinner, making them more apt to burn.
Do sprays work as well as lotions do?
Yes, if you use them properly. But most people tend to put on far too little spray sunscreen, especially on windy days when it tends to blow away. Apply liberally and rub well so that the droplets disperse and cover the skin.
Do I need to use as much sunscreen if my child tans easily?
You do. "A tan is a sign that the skin is being damaged by UV light," says
Dr. Davis. Even though we tend to think that a tan makes you look healthy, there's nothing healthy about it. People who have a dark complexion are less likely to get skin cancer than those with fair skin, but they're still susceptible to sun damage like wrinkles, so they need sunscreen anyway.
Does my child need to swear sunscreen during a long car ride?
Actually, yes. "UVA is a long wavelength of light, which means it's able to pass through car windows," Dr. Davis explains.
Is it okay if I use my unfinished bottle from last summer?
As long as it has not expired, it should be okay to use it. But if you left your sunscreen in direct heat for a couple of days -- for example, in a hot car or on a sunny windowsill -- it may have lost some of its efficacy. In that case, especially if there is no expiration date listed on the container, it might be best to play it safe and just start fresh with a new bottle.
"Getting sunscreen onto my daughter's scalp is impossible."Genevieve Ritchie; Buena, NJ
This can be especially tricky with thick or curly hair. To protect your child's part, swipe it with a stick sunscreen. Then shield the rest of her head using a spray sunscreen that's made specifically for the scalp and hair. This will penetrate her hair and make it to the scalp without leaving hair stiff or greasy.
"I worry that my 2-year-old's day-care providers don't put enough sunscreen on him."
Rene Butters; Germantown, MD
Portion it out into small containers with snap lids, suggests Dr. Elaine Siegfried.
Each should hold nearly a shot glass?worth of sunscreen (or a bit less if your child is wearing playclothes instead of a swimsuit). Tell caregivers to use a container's worth before each outing. And then don't forget to refill them each night.
"I need to find a sunscreen that won't sting my children's eyes when they sweat."
Roxy Murphy; Colorado Springs, CO
You can actually skip applying sunscreen to your child's forehead, where it's likely to run into the eyes, as long as she wears a hat and sunglasses, recommends Dr. Dawn Davis. For little kids who tend to pull off their shades, try a pair with a band that wraps around the head, and a hat with a chin strap.
Think of a hat as your child's personal patch of shade. "The earlier you insist your child wear one, the easier it will be to get her to buy into it," says Dr. Elaine Siegfried. Look for one with these features:
A flap that covers the ears and neck. Otherwise, make sure there's a brim that's 2 to 3 inches wide and goes all the way around. (Traditional baseball caps, for example, leave too much skin exposed.)
Lightweight, tight-knit fabrics. They prevent the sun from penetrating -- a loose weave like straw doesn't keep the sun out.
Originally published in the June 2012 issue of Parents magazine.