ABC of Sun Safety...

... and other tips for living it up outdoors

Monika Pis, PhD, CPNP *First published in Spring/Summer 2012 in Ready, Set, Grow magazine Playing outdoors is a healthy way to get exercise, and spending time playing in the shade is just plain smart!  Sun damage is cumulative over a lifetime, and every sunburn increases a person’s risk of skin cancer. Since we get the most sun exposure before the age of 18, it’s important to teach kids sun safety early on.  Sun Protection From Day 1  Here are tips on shielding your children from the start.  For Babies Six Months of Age and Younger  • Keep your baby in the shade as much as possible.  • Cover your child with a long-sleeved cotton shirt and pants.  • Place a broad-brimmed hat on your baby’s head.  • Sunglasses are also needed.  • Use sunscreen lotion.  For Children Older Than Six Months  • Stay in the shade, especially between the hours of 10 a.m. and 3 p.m., when the sun is the strongest.  • Wear sunscreen even on cloudy days, as 80 percent of the rays penetrate the clouds.  • Slather sunscreen with UVA/UVB protection and an SPF of at least 30 on all exposed areas of the body, and reapply it every two to three hours when outdoors and after swimming.  • Wear protective clothing: a hat, sunglasses, long-sleeved shirts and pants.  Sun exposure may lead to first- or second-degree sunburn. Therefore, preventing sunburn is important to protect against skin cancer and the discomfort of the sunburn itself.  First-degree sunburn causes redness or discoloration of the skin, mild swelling and pain. These symptoms usually last one to five days. Second-degree sunburn causes redness, blistering of the skin, swelling and considerable pain. When blisters pop, the compromised skin barrier allows bacteria to enter, increasing the risk for serious skin infections. Healing of second-degree burns may take 10 to 14 days.  If you or any of your family members get sunburned, take the following steps.  • Increase fluid intake.  • Apply cool compresses to the affected skin.  • Give acetaminophen as needed for pain.  If there is no improvement or if symptoms get worse, contact your health care provider immediately.  There’s No Safe Tan  Teens and young adults should also be aware that tanning salons are not any safer than tanning outdoors. Tanning booths contain light bulbs emitting UV light, which causes sunburn, skin cancer and early skin aging. Authorities report increasing cases of melanoma and other types of skin cancer related to sun exposure (and tanning salons!) among adolescents and adults.  Though this is an alarming trend, it’s not too late for you and your family to take care of your skin.  Overexposure to UV light from the sun or tanning salons is the most preventable risk factor for skin cancer. Therefore, practicing sun safety and avoiding tanning beds are crucial in preventing skin cancer, as well as skin damage and wrinkles. If you want the look of a tan, use self-tanning products and continue using sunscreen. Avoid sunscreen containing DEET.  Taking Charge of Skincare  Early detection of skin cancer leads to a cure. Everyone should check moles monthly, and your health care provider should inspect any changes in your moles. The American Academy of Dermatology advises watching for the following warning signs of skin cancer.  1 Changes in the surface of a mole.  2 Scaliness, oozing, bleeding or the appearance of a new bump.  3 Spread of pigment from the border of a mole into surrounding skin.  4 A change in sensation, including itchiness, tenderness or pain.  If any of your moles appears suspicious, contact your health care provider right away.  Leaves of Three, Let Them Be!  There are other potential skincare risks when spending time outdoors, particularly if your kids play in wooded areas. Poison ivy is a poisonous plant associated with an allergic response to poison ivy oil, or urushiol. Teach your kids to avoid the plant, which appears as leaves in clusters of three growing from one stem.  An allergic response occurs within 24 to 48 hours after exposure. The rash is very itchy, red, and may turn into blisters. New blisters may appear during the first two weeks after exposure, and they usually resolve in three to four weeks.  More than 90 percent of people in the United States are sensitive to urushiol. If you are among the lucky ones not allergic, note that sensitivity may develop in time.  Poison ivy oil can remain on gardening, sporting or camping equipment for weeks, causing repeated allergic reactions unless the objects are washed with soap and water. Also, pets can carry poison ivy oils on their fur, so bathe your pet after a walk in a wooded area.  Do not burn poison ivy in a campfire. Some people are sensitive to urushiol and can have an allergic reaction by inhaling the burning oil. The inhaled oil reacts with the lining of the lungs, causing extreme pain and possibly fatal respiratory distress. Ingesting poison ivy also can be fatal.  Treating Poison Ivy  Here are ways to help ease the discomfort of poison ivy.  Oatmeal Baths  Oatmeal baths can soothe itching. You can find several types at your local supermarket, or you can make one yourself. Put 1/2 cup of oatmeal into a cotton sock with 1/2 cup of baking soda, then tie the sock and toss it into the bathtub while the water is running. Note that oatmeal can make the tub slippery.  Burrow’s Solution  Burrow’s solution was invented in the mid- 1800s by Karl Burrow, an ophthalmologist. A preparation made of aluminum acetate dissolved in water, it serves as an astringent and has antibacterial properties. You can use it to treat poison ivy dermatitis by applying cold compresses of Burrow’s solution over the affected area three times a day.  Poison Ivy Wash  You can find a topical solution for treating poison ivy at your local pharmacy that actually removes urushiol from your skin. This poison ivy wash binds itself to the urushiol so it can be effectively washed away. Although a rash may still be visible for a few days, the pain and itching are relieved immediately.  Insect Safety  We can’t escape insects when spending time outside, but we can prevent being stung or bitten. Insects are attracted to bright colors, fragrance and standing water. Therefore, if you wear your favorite perfume or lotion on a camping trip, insects may mistake you for a delicious flower!  To protect against uncomfortable stings, always wear an insect repellent when outdoors. Products with ten-percent DEET will give you protection for up to three hours and may be applied up to three times a day. However, it is always a good idea to wash the repellent off after coming indoors.  Insect repellents should not be used on infants younger than two months of age, and should be used with caution on infants two to six months of age. Do not apply the repellent to the face and hands, as babies tend to rub their faces and may get the chemical into their eyes.  Insect bites may get infected: The surrounding soft tissue (cellulitis) is swollen and hot to touch after 24 to 48 hours, despite cold compresses and antihistamines. You may need an antibiotic.  Apply cold compresses to the bite as needed. Give your child an antihistamine for itching. If swelling, tenderness, or redness persists or worsens, seek help from your health care provider as soon as possible.  West Nile Virus  West Nile virus is a potentially serious illness. Experts believe that West Nile virus is seasonal, flares up in the summer and continues into the fall. According to the Centers for Disease Control and Prevention (CDC), the best way to avoid West Nile virus is to prevent mosquito bites in the first place. Insect repellents containing DEET are the only ones recommended for prevention.  West Nile Virus is spread by the bite of an infected mosquito. Mosquitoes become infected when they feed on infected birds. Infected mosquitoes can then spread West Nile virus to humans and other animals when they bite. If you find a dead bird, avoid handling it. Contact your local health department for instructions.  People typically develop symptoms between 3 and 14 days after being bitten by an infected mosquito. If you are experiencing symptoms such as unusually severe headaches or confusion, seek medical attention immediately.  For more information, contact the CDC public response hotline at (888) 246-2675, or visit www.cdc.gov.  DR. MONIKA PIS Monika Pis, PhD, CPNP is the Editor in Chief of our health, safety, and nutrition sections. She is a pediatric nurse practitioner with a doctoral degree earned at the University of Michigan in Ann Arbor.  She has provided health care to infants, children, and adolescents for over a decade.