Reality Health

By Dr. Sara Levine

Dear Dr. Levine,

We moved to Boca Raton this past fall.  My neighbor is constantly chasing her kids around with sunscreen.  She makes them wear it every day to school.  Her children grew up here and are used to these products.  My children resent every second that they have to wear it.  They only want to wear it if they in the pool or at the beach. Is there a happy medium?  Is sunscreen really necessary every minute one is outside?

This is a case where being overprotective is preferable to moderation.  The sun emits both Ultraviolet-A (UV-A) and Ultraviolet-B(UV-B) radiation. Such radiation is a carcinogen.  This means that exposure causes genetic changes in the skin that can lead to the development of skin cancer.  Skin cancer is the most common form of cancer in the United States today.  Melanoma, the most lethal form of skin cancer has been increasing in prevalence more rapidly than any other form of cancer, with more than 1 million new cases every year.  Skin cancer has become more common in children as well, causing 4% of pediatric malignancies. The real kicker is that 90% of all skin cancers are preventable.  In fact, this increase in skin cancer is attributed to a variety of high risk behaviors including intentional sunbathing, using tanning lamps or salons, or simply using inadequate sun protection especially in childhood. Some sun exposure is expected as a part of living in the real world.  Fortunately there are sunscreens, hats, and special clothing to decrease the amount of UV exposure during your time outdoors.

Your children hate sunscreen. Sunscreen is only one way to provide your family some protection from the sun’s UV radiation. Moreover, sunscreen alone is inadequate for protecting skin from the sun’s damaging UV radiation.  High SPF broad spectrum sunscreens that protect against UVA and UVB when applied adequately to all exposed skin surfaces (usually one ounce of sunscreen is needed for an adult) are appropriate for use when sun exposure is unavoidable.  The best strategies for skin cancer prevention, however, are behavioral.  These include wearing sun protective clothes and a hat as well as minimizing sun exposure entirely, especially at times of peak UV intensity.

Living in Florida means that your family must consider the importance of skin protection not only when they are at the pool or beach, but also when playing sports outdoors or walking to a friend’s house.  In South Florida, we are exposed to the sun’s damaging rays all year round.  Parents must educate their children about the importance of all sun protective measures. Only 58% of teens use sunscreen at the beach, and 30% of teens experience at least 3 sunburns per summer.  Just one sunburn may double a child’s risk for melanoma.

Teaching your children that there is no such thing as a healthy tan is just a start. 
Discussing the above statistics will certainly provide food for thought. Remind any teenagers in your home that the same UV radiation that causes skin cancer also causes early aging of the skin, i.e. more wrinkles.  Ultimately, you need to understand that you are responsible for protecting your family’s health.  With a good parent-child relationship and positive means of communication, you can address any conflict that arises as your children adjust to their move down South.  Sun protective clothing is easily obtained today in a variety of styles.  Consider using this as an excuse for an extra shopping trip for a stylish cover-up or rash guard shirt to wear outdoors. Most children love new clothes and prefer UV protective clothing because it lets them wear sunscreen on fewer areas of their body.   Encourage outdoor time during the early or late hours of the day when the UV intensity is lower.  

Being your family’s health coach is one of a parent’s most difficult jobs.  Remember that a sunburn or sun damage is not just a cosmetic problem.  Rather, UV radiation from the sun causes permanent genetic damage that can lead to skin cancer.  Speak to your physician about additional details on protecting your family from the sun’s damaging rays without decreasing their enjoyment of outdoor recreational activities.  

Sincerely,

Dr. Sara Levine is board certified by both the American Board of Internal Medicine and the American Board of Pediatrics and has been practicing medicine for more than nine years. She graduated summa cum laude from Case Western Reserve University and was elected to Phi Beta Kappa. She received her M.D. from Case Western Reserve University School of Medicine. She has completed Advanced Clinical Education in Child and Adolescent Obesity from the University of California, San Francisco. Dr. Levine is in private practice in Boca Raton

Please email all questions to drsaralevine@bellsouth.net