What Parents And Children Need To Know About Sun Protection
With Dr. William A. Biermann, Medical Oncology, Einstein Healthcare Network
How much sun is too much?
“There is a balance in terms of sun exposure,” explains Dr. William A. Biermann, a medical oncologist with Einstein Healthcare Network. “There are some experts who believe strongly that one of the ways to prevent osteoporosis is to have an adequate amount of Vitamin D. Although you can take it in pill form, a small amount of sun exposure — approximately 10 minutes per day — can be helpful. Beyond that, you are asking for trouble in terms of skin cancer.”
What are guidelines for children and sun exposure? How much SPF is right for kids?
“Studies now show that sun damage to our skin begins when we are children,” Biermann says. “The World Health Organization has recognized sun exposure as a class one carcinogen and the American Academy of Pediatrics says that sun exposure before the age of 15 is a big problem.”
An AAP study showed that approximately 25 percent of harmful sun exposure occurs before 18 years of age. The AAP’s recommendations include wearing proper clothing and hats, timing outdoor activities to minimize peak midday sun (10 a.m.-4 p.m.), applying sunscreen and wearing sunglasses. Infants younger than 6 months should be kept out of direct sunlight and protected with clothing and hats.
The Environmental Protection Agency’s guidelines are to generously apply about 1 oz. of sunscreen to cover all exposed skin 15 minutes before going outside. Sunscreen should have an SPF of at least 30 and provide broad-spectrum protection from both ultraviolet UVA and UVB rays. Reapply every two hours, even on cloudy days, and after swimming or sweating.
There has been controversy about tanning salons. Are they really that dangerous?
“Absolutely,” states Biermann. “The harm they do to skin is incredible. The American Academy of Pediatrics is vehemently against the tanning beds.” In 2012, the AAP issued a statement recommending that children younger than 18 be prohibited from using tanning beds. California became the first state to prohibit tanning bed use by people under age 18. In 2013, 17 states — including N.J. and Pa. — introduced similar legislation.
What are the symptoms of skin cancer? How do we know when a mole or freckle should be checked out by a doctor?
“If a mole changes in size or color or if it has irregular borders, or if it is raised or bleeding, get a doctor to look at it,” Biermann says.
What are the different kinds of skin cancer?
Basal cell carcinoma and squamous cell carcinoma are two of the most common kinds of cancers, but melanoma is the most deadly, Biermann says. “Melanoma grows faster than any other kind of skin cancer,” he explains. “It begins by growing radially, along the surface of the skin. But at some point, melanomas grow downward and get into blood vessels and other tissue. That’s when they do a lot of damage.
How are skin cancers treated?
“If a biopsy confirms the skin cancer, an oncologist or surgeon will remove the mole and all of the surrounding skin tissue that is compromised,” Biermann explains. “How deep and wide we go depends on how aggressive the cancer is. Sometimes, on the arm, leg or back, we remove skin all the way down to the surface of the muscle and an inch all around it. The ear and scalp are difficult because there is not a lot of space between the tissue and bone. Whatever we do, there is a scar. Sometimes, it is a quite large and a skin graft is needed.”
Patients with deep melanomas usually need a sentinel node biopsy done to determine if the cancer has spread through the body. “The best thing you can do is prevent skin cancer from ever happening,” Biermann says. “Protecting your skin is protecting your health.”