Hi guys! Happy New Year! I wanted to take the time today to talk about Skin Cancer, Kids and Sunblock.

This should be a relatively short post (I hope)… and also late… again.

Wait second… is this really a Medicine Mondays post?

Yes. Skin cancer is important, and as physicians it is our duty to spread awareness and educate.

Stock Photo From: Pexels

First things first:

Happy New Year! 

I hope everyone approaches the new year with optimism and ambition.

I don’t usually make New Year’s Resolutions, as I usually just set my own goals whenever I have them. However, my goal for this year is to continue to grow this site and to learn more about the problems young doctors face and try to solve them. I would also like to be able continue giving lectures to medical students and/or residents, if possible.

I have a few other things I am working on outside of my normal day-to-day work and this blog as well. However, they are so early on in their processes that they aren’t worth mentioning yet.

Now I want to talk about something which I think is extremely important.

Skin Cancer, Kids and Sunblock

I’m Vietnamese and my wife is Italian, so our kids are Hapa. Vietalian if you will.

However, they both have very fair complexions, more so than both my wife and I. This, in combination with living in Hawaii has made my wife and I hypervigilant about putting sunblock on them everyday – rain or shine.

Wait… every day?

Yes, every day. Where I live it can rain for a few minutes and then the sun will just come out the next minute. So even if it seems like a dreary, stay-at-home Sunday and watch TV in the morning, that can (and usually does) change by mid-morning. The problem is that if we don’t put sunblock on my 3 yo daughter every morning like clockwork, she will fight it more later in the day.

“I don’t need sunblock, the suns not out.” she’ll tell us.

Rather than argue with a 3 yo everyday, we just put the sunblock on every morning. Then if/when she needs more later before going out later in the day, she usually won’t fight (as much).

Wait… isn’t it a weird time to talk about skin cancer and sunblock? It’s WINTER.

That’s actually the reason. People only think about using sunblock when it’s hot and the sun is out. The sun is always out whether it’s cold or hot.

While you may be all bundled up on the slopes this winter… you may forget that your face is still out there taking all those rays from the sun for hours. That makes this the perfect time to reiterate how important it is.

What’s the big deal?

Skin cancer is the big deal. Of course, everyone knows that. However, I want to reiterate just how important it is.

Here is an article I would like everyone to read:

10 Skin Cancer Myths Debunked from the American Society of Dermatologic Surgery.

The take home points are:

Skin color, season, and temperature don’t matter to the sun.

SPF 30 is only enough if you do a 100% coat. SPF 30 with a half coat is functionally SPF 15.

Sunblock needs to be reapplied every 2 hours.

UV Damage is cumulative over your lifetime.

Ok, got it, but how bad is the risk?

In this prospective study:

Long-term Ultraviolet Flux, Other Potential Risk Factors, and Skin Cancer Risk: A Cohort Study (May 29, 2014)

“In sum, we found that risks of BCC and SCC were associated with sun exposures in both adulthood and early life, whereas melanoma risk was predominantly associated sun exposure in early life in a cohort of U.S. women.”

While Basal Cell Carcinoma (BCC) and Squamous Cell Carcinoma (SCC) are important. However, the real one to worry about is Melanoma. From the same study:

“Host factors, including red hair, sun reaction as a child/adolescent, and number of blistering sunburns between ages 15 and 20 years were strong predictors of all 3 types of skin cancer.”

The overall lifetime risk of developing melanoma increases 80 percent (RR 1.8) with 5 blistering burns in childhood.

There is a reason that your doctor will ask about “blistering sunburns” when you fill out your information sheets. It significantly increases your risk.

Ok, so with all that said, we need to protect our kids.

Personally, putting sunblock on them everyday does two things.

It protects them in the morning when they go out to play at pre-school. However, sunblock only lasts 2 hours, so that doesn’t help later in the day when they go out around 3pm or so.

Nonetheless, it also teaches them that sunblock is important at a very young age. My hope is that this will continue on as they get older and will always remember to wear sunblock.

Ok, ok ok… so what should I do then?

Well, this needs to be separated into: Babies versus Kids, because for babies, there are slightly different guidelines.

According to the American Academy of Pediatrics, for babies under 6 months of age:

“The two main recommendations from the AAP to prevent sunburn are to avoid sun exposure, and to dress infants in lightweight long pants, long-sleeved shirts, and brimmed hats that shade the neck to prevent sunburn. However, when adequate clothing and shade are not available, parents can apply a minimal amount of sunscreen with at least 15 SPF (sun protection factor) to small areas, such as the infant’s face and the back of the hands. If an infant gets sunburn, apply cool compresses to the affected area.” (emphasis mine)

In other words, covering up and staying out the of sun are paramount for babies under 6. If for some reason, they are out in the sun without the ability to cover up, then using a small amount of sunblock is ok.

For kids (anyone > 6 months old):

Staying in the shade when possible is better, but sunblock is fine now. Apply every 2 hours.

So what do you use?

To be honest, I haven’t done all that much research on the “best” sunblock. I just know what works for us.

For my 1yo son I use:

Coppertone Water Babies Pure & Simple SPF 50

The major reasons I use this brand are because it is water resistant and tear-free.

***Note: There is a Coppertone Water Babies which is not Pure & Simple, and that one is not tear-free. But it IS cheaper and does come in SPF 70 for those who like that.

I use this on my daughter’s face too because it’s tear-free, and when she got the other one in her eyes before she cried for awhile.

For my 3 yo daughter I use:

Banana Boat Sunscreen Sport Family Size Broad Spectrum Sun Care Sunscreen Lotion – SPF 50

Why do I use this one? Well, it comes in Family Size, it’s SPF 50, and I like the pump rather than squeeze bottles. It also goes on easily and quickly, which is important since my daughter tends to be a squiggly worm.

Wait a second… that one is sunscreen not sunblock… what’s the deal?

Here is a good article on the differences:

Sunscreen versus Sunblock – What’s the difference?

The easy way to think of it is that sunblock is on top of the skin and “blocks” the UVB rays, whereas sunscreen is absorbed by the skin and blocks the UVA rays.

In reality, just about all sunblocks/sunscreens use a combination of both. Just make sure your sunblock or sunscreen states that it offers both UVA/UVB protection.

Did you sunblock?

With all that said… I was bad about using sunblock when I was a kid. I used to go to the beach a lot, especially the summer before senior year in high school. Despite the efforts of my good friend Jim, I never used it and I got a few sunburns which I wish I could take back. Sorry Jim, I should have listened to you. For this reason, I realize my risk is probably higher than the general population.

Nonetheless, it’s never too late to practice safe suncare. For this reason, my wife and I try to lead by example and put on sunblock whenever we go out. This lets the kids know that this isn’t just a “kids thing” but that everyone needs to do it. My hope is that this habit will stick with them into adolescence and adulthood.

It’s kind of like the seatbelt thing. You get in the car, you fasten the seatbelt, that’s just how it is.

If you go out, you put on sunblock beforehand. It’s just how it is.

TL;DR

More than 5 blistered sunburns in childhood almost doubles your chances of getting melanoma.

Stay out of the sun if possible, but if you can’t, make sure you use the appropriate sunblock.

For Babies < 6 months old, keep them covered up… but using a small amount of sunblock is still ok if you can’t keep them covered for whatever reason.

Teaching our kids to use sunblock is just as important as making them put it on.

Lead by example… put on sunblock. Your kids will follow your lead and make it a habit.

-Sensei

What do you do? How often? Which sunblock or sunscreen?

Agree? Disagree? Questions, Comments and Suggestions are welcome.

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