Some Sun-Sational Facts about Safe Sun and More from Direct Doctors

I have always struggled in the sun.  Call it genetics – fair skin, light eyes, blonde hair.  Not just with sunburns, but also heat related illnesses like dehydration.  My joke is that I would get sunburned just thinking about the sun.  Over the years, I become a lot more conscious of applying sunscreen and paying attention to the heat.  With school age children, I want the summer months to be as enjoyable as possible so I have become a huge advocate of safe sun activities and practices.  And this year, I asked the experts at Direct Doctors for their take on “safe sun” and how to deal with other heat related illnesses.
I met Dr. Mark Turshen at a recent North Kingstown Chamber of Commerce networking meeting.  I have recently signed up for his and Dr. Lauren Hedde’s blog, which I highly recommend to all families living in North Kingstown and surrounding areas.  Dr. Turshen was kind enough to answer a few questions I had as a parent and individual who struggles with the sun every year.  Here is an excerpt from our conversation:
Dr. Turshen, we always hear the term “safe sun.”  Is that a misleading term?  Is there such as thing as an acceptable exposure time to the sun without protection?
The short answer is no, especially for kids. If you are going to be outside for any extended period of time (>15 minutes), everyone needs some form of sun protection (whether that be clothing, avoiding the warmest time of day or sunscreen). Even clouds only block out between 20-40% of UV rays while sunscreens are >90% depending on the product. Besides protection from dehydration, sun burns, etc, skin cancer prevention begins in childhood. Although sun exposure is not the biggest risk factor for developing skin cancer, it is the only avoidable one!
What are the medically recommended forms of sunscreen for kids?  What should parents look for on the packaging in terms of SPF and UV protections?
Here are a couple of tips:
  • Use sunscreen that says “broad spectrum” on the label as these block out both UVA and UVB rays
  • Any SPF between 15 and 50 is acceptable. Studies have not shown much benefit of using >50 SPF and most kids do fine with 15-30 if applied correctly
  • Sunscreen should be re-applied every 2 hours if outside for an extended period of time
  • There are some concerns about mild hormonal properties of oxybenzone which is an ingredient in some sunscreens. It is not banned in any countries but limited to a certain percentage. Avoiding this if possible is a good idea, though any sunscreen is better than none, especially in a pinch. 
  • Natural is always better, especially products containing zinc oxide or titanium dioxide
  • The newest recommendation is to avoid spray-on sunscreen in kids, especially those prone to asthma or allergies. In younger children who cannot reliably hold their breath during application, spray on sunscreens pose a risk of inhalation of dangerous ingredients. Though easier to use a lot of the time, this isn’t the best option
sunscreen-2
Ok, this one is personal.  If someone has a “better than average” sunburn, what steps should parents take to remedy the situation?  When is there cause to seek medical attention for a sunburn?
For the common mild sunburn, the usual treatments of aloe or other soothing lotions, cold water, pain control and sun avoidance usually do the trick. However, for blistering lesions, fever, extreme pain or even worse, loss of sensation in the area, see your doctor immediately. Any sunburn in a child under 1 should warrant medical attention and most recommend keeping infants <6 months old out of the sun completely.
Thanks.  Ok, last question Dr. Turshen.  Dehydration can happen in hot, humid conditions if someone is exercising or doing yard work.  What are the tell tale signs that you maybe experiencing signs of dehydration.  What are the most critical steps once you have someone in your presence with dehydration symptoms.
Dehydration is characterized by increased thirst, dry mouth, swollen tongue weakness and dizziness initially but can eventually become much more severe. Heat stroke involves mental status changes, confusion and lack of sweating. The best initial steps to take for someone showing signs of dehydration is to get them somewhere cool, (air conditioning is always helpful), help to cool with wash cloths or ice packs, and have them drink fluids. If there is any concern for more serious effects like confusion, getting them medical attention quickly is very important. Rehydration therapy can get complicated in those instances and should be done in a supervised setting. 
If you would like more information on safe sun practices or heat related illnesses and have questions for Dr. Mark or Dr. Lauren, visit their website at www.directdoctors.org.  Thanks again to Dr. Mark Turshen for answering my questions.
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2 Comments

    1. Hi Joanne, thanks for the comment! We recommend that all patients have yearly skin exams, starting in childhood, done by their primary care physician. For family physicians like us, that means we do skin exams on basically all of our patients. Many primary care docs are also trained in diagnosing skin conditions and performing minor skin procedures like biopsies. Because of that, I do not necessarily recommend yearly skin exams by a dermatologist for all patients. If we need help clarifying a diagnosis, consultation on treatment or referral for a more in depth procedure, that is when I recommend seeing a dermatologic specialist.

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