The Skin Cancer Foundation Journal

MAY 2012

The 2012 edition of The Skin Cancer Foundation Journal features medically reviewed, reader-friendly articles such as tanning, the increasing incidence of skin cancer diagnoses among young women, & the prevalence of melanoma among white males over 50.

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LIFESTYLE Repelling the Rays When Kids Play A Guide for Parents MARIBETH BAMBINO CHITKARA, MD V ideo games, television, and computer use have made our children more sedentary. Responding to the rise in obesity and type 2 diabetes spawned by this inactivity, pediatricians are urging children to go outside and play. However, exposure to the sun's ultraviolet radiation (UVR) is strongly linked to all forms of skin cancer.1,2,3,4 In fact, suffering just one blistering sunburn in childhood or adolescence more than doubles a person's chances of developing potentially deadly melanomas later in life.5 This means that providing outdoor exercise and protecting children from dangerous UVR go hand in hand as vital public health concerns; accomplishing both should be a goal for every parent. INFANTS AND TODDLERS The UV exposure we receive through- out our lifetime adds up, leading to permanent skin damage and continu- ally increasing the risk of skin cancer. That's why sun protection is important at every age. Children under three years old are especially vulnerable to UVR because they have a thinner protective top layer of dead skin, less protective melanin (the pigment that gives skin and eyes their color), and a higher surface area/body mass ratio.6 These all increase their susceptibility to UVR penetration. Though skin cancer is rare among young children, it does occur. It can be 46 Providing outdoor exercise and protecting children from dangerous UVR go hand in hand as vital public health concerns; accomplishing both should be a goal for every parent. difficult to diagnose, since cancerous lesions in children may not resemble those in adults. For instance, mela- nomas in adults often have ragged or uneven borders, but one study found that children's melanomas were usu- ally raised and had regular borders.7 So parents need to be vigilant for any new or changing lesion. ADOLESCENTS AT HIGH RISK Older children are also at higher risk, for different reasons. While their skin is similar to that of adults', adolescents' increased risk-taking poses a unique challenge. In a 2012 study, just 25 percent of 14-year-olds used sunscreen regularly; more than half were sun- burned by age 11. Unfortunately, the proportion of 14-year-olds who admit- ted to liking a tan and spending time outside to get a tan significantly in- creased as they grew older.8 This study reinforces years of research showing that US adolescents consistently tend to sunburn and suntan, fail to use sunscreen or other sun-protective behaviors routinely, and increasingly use tanning beds.9,10,11,12 AAP RECOMMENDATIONS FOR CHILDREN AND ADOLESCENTS3,4 To address all these challenges, in March 2011, the American Academy of Pediatrics (AAP) Council on Environmental Health published a policy statement and technical report regarding UVR hazards for children. Along with physicians, parents need to heed these guidelines and take an active role in promoting children's sun protection. Here's how: t Discuss sun safety with your child's pediatrician at least once a year to make sure you have the most up-to-date information. 15+ t Encourage your chil- dren to use sunscreen with a sun protection factor (SPF) of 15+ (30+ for extended stays outdoors). Apply or teach your child to apply an ounce (2 tablespoons) of sunscreen liberally to the entire body 30 minutes before heading outside, and to reapply every two hours, or immediately after swimming or sweating heavily: studies show that most people apply too little sunscreen to achieve the level of protection listed on the container. 15+ t Have them dress right. Kids playing outdoors should wear hats with a brim of at least 3" all the way around (or at the least baseball caps), UV-blocking sunglasses, and clothing SK IN CANCER FOUNDAT ION JOURNA L

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