Skin cancer - children

Protecting a child from the sun’s ultraviolet (UV) radiation reduces their risk of sunburn, of skin and eye damage, and of skin cancer, including melanoma, later in life. UV damage that builds up during childhood and adolescence is strongly associated with an increased risk of skin cancer in later life, and skin cancer is among the most common cancers in many parts of the world.

Too much UV can cause sunburn, skin and eye damage, and skin cancer. The good news is that sun protection can reduce the risk of skin cancer at any age, whether you are 6, 36 or 60.

Why children need extra protection#

Infants and toddlers (up to about 4 years of age) are particularly vulnerable to skin damage from UV radiation, because they have lower levels of melanin and a thinner outermost layer of skin. Around 25% of a person’s lifetime sun exposure happens during their first two decades of life, and research has found that UV exposure during a person’s first 18 years is the most critical for cancer-causing skin damage and skin ageing.

Understanding UV radiation#

We can see sunlight and feel heat (infrared radiation) from the sun, but we cannot see or feel UV radiation. UV can reach us directly from the sun, but it is also scattered in the air and reflected off surfaces such as buildings, concrete, sand, water and snow. It can also pass through light cloud cover.

Do not wait for hot, sunny days to use sun protection. UV can still be damaging on cool or cloudy days. Whenever UV levels reach 3 or higher, use a combination of sun protection measures.

Many weather services forecast the daily “sun protection times” for a location, the times of day when UV is forecast to reach 3 or higher. In many places UV regularly reaches damaging levels for much of the year, so check your local UV forecast each day. At these levels, sun protection is recommended for all skin types.

The 5 sun protection measures#

During the daily sun protection times, use a combination of all five measures:

• Slip on sun-protective clothing
• Slop on SPF50+ broad-spectrum, water-resistant sunscreen
• Slap on a broad-brimmed hat
• Seek shade
• Slide on sunglasses

Clothing#

Use cool, loose-fitting clothing to cover as much of your child’s skin as possible. Where you can, choose fabrics made from natural fibers such as cotton, linen and hemp. Lightweight synthetics such as polyester, nylon, Lycra and polypropylene also work well. The tighter the fabric structure, whether knitted or woven, the better the sun protection.

Sunscreen#

Some tips when using sunscreen with children:

• Apply sunscreen to any skin not covered by hats or clothing about 20 minutes before going outside.
• From around 3 years of age, encourage children to start applying their own sunscreen under supervision, to build independent skills ready for preschool. Try placing a dot on each cheek, the nose and the chin, and squiggles on the parts of the arms and legs not covered by clothing, and teach them to spread it carefully to cover the skin.
• Reapply sunscreen every 2 hours, or more often if swimming or sweating, even if the label says it is 4-hour water-resistant.
• Never use sunscreen as the only form of sun protection, or to extend the time spent outdoors, as it does not offer complete protection.
• Store sunscreen below 30°C, out of direct sunlight, and only use it within its expiry date.

When it comes to babies:

• A baby’s skin is sensitive and can burn easily.
• If babies are kept out of the sun or well protected by clothing, hats and shade, sunscreen need only be used occasionally on very small areas of skin.
• The use of sunscreen on babies under 6 months of age is not recommended.
• If you do use sunscreen, choose one suitable for babies, such as a sensitive or baby formula. These are just as protective but gentler on the skin, usually using reflecting ingredients such as zinc oxide and avoiding ingredients and preservatives that may cause reactions in young skin.

If you are concerned about reactions, it is recommended to do a “usage test” before applying a new sunscreen. Put a small amount on your baby’s skin for a few days to check for a reaction before applying it more widely. A usage test may show whether the skin is sensitive to an ingredient, but it may not always reveal a reaction, as some reactions develop only after repeated use. If you notice any unusual reaction, stop using the sunscreen immediately and seek medical attention for the child. Assessment and testing by a dermatologist may help identify the ingredient causing the reaction.

Hats#

To help protect the neck, ears, temples, face and nose, children should wear a broad-brimmed, legionnaire or bucket-style hat. Remember that:

• Baseball caps and visors are not recommended, as they offer little protection to the cheeks, ears and neck.
• Choose a style that can be adjusted at the crown, or that has a strap with a safety snap to avoid any choking hazard.
• A brim that shades the eyes can also reduce UV reaching the eyes by about 50%.

As a guide to brim width:

• Infants (up to about 1 year): broad-brimmed and bucket styles at least 5 cm
• Toddlers (1 to 2 years): at least 5 cm
• Children 3 to 8 years: at least 5 cm
• Children 8 to 12 years: at least 6 cm
• Adults: broad-brimmed around 5 cm, bucket style around 6 cm

Shade#

Use shade to protect your child whenever you can. Choose shady play spaces, or take some shade with you. For most of the day there is as much scattered and reflected UV as there is direct UV, so even in the shade, UV can still reach your child. It is important that children continue to wear a hat, appropriate clothing and sunscreen while in the shade.

As the sun moves across the sky through the day, the area protected by your shade also moves, so reposition yourself or your shade to stay well protected.

Sunglasses#

During sun protection times, a hat and sunglasses help protect your child’s eyes from UV. Where practical, children should wear close-fitting, wrap-around sunglasses that cover as much of the eye area as possible. Choose sunglasses that meet a recognized sun-protection standard and offer a high level of eye protection. Eye protection is worth using all year round.

Be a role model#

Children often copy those around them. Research has shown that children are more likely to use sun protection if the adults around them do too.

Convincing teenagers about sun protection#

Although adolescents usually know the dangers of too much sun, they often do not plan ahead or forget to use the five measures. When reminding your teenager:

• Focus on the appearance-related effects of sun exposure, such as premature ageing, wrinkles, blotches, freckles or burnt, peeling skin. Teenagers are often conscious of their appearance, so this may convince them to take precautions.
• Give them a choice. Let your teenager pick clothing and sunglasses they are happy to wear and that still protect them. Some clothing brands make bucket hats and wrap-around sunglasses that offer good protection in styles teenagers may like.
• Remind your teenager to take sunscreen with them when they leave the house. Many outdoor venues do not have enough shade, and teenagers may be reluctant to wear protective clothing and hats. Many young people who get sunburnt say they simply forgot to protect themselves, so frequent reminders to pack and apply sunscreen may help.

Work with your child’s school#

Encourage your child’s school to develop and implement a comprehensive sun protection or UV policy that includes relevant curriculum programs. Sun protection organizations can provide schools with resources and support.

Key points#

• Too much UV can cause sunburn, skin and eye damage, and skin cancer.
• Infants and toddlers (up to about 4 years) are especially vulnerable because they have lower melanin and thinner skin.
• UV can damage skin even on cool or cloudy days, and is scattered and reflected, so protection matters whenever UV reaches 3 or higher.
• Use all five measures together: protective clothing, SPF50+ sunscreen, a broad-brimmed hat, shade and sunglasses.
• Children continue to need a hat, clothing and sunscreen even in the shade.

Where to get help#