Sunscreens in Children: Make children sun safe!  

Summer is the time when the sun kisses the skin. This leads to the darkness of the skin(suntan), sunburn, and redness. This can be related to long term changes in the skin like pigmentation, cancerous changes in the moles, and an increase in pre-existing skin sensitivity. The summer heat also increases the chances of acne in adolescents.

The education of children and their parents regarding photoprotection is a must. It should be noted that photodamage can occur in children of all skin types. A strong body of evidence indicates that in adults, the use of sunscreens reduces the incidence of premalignant lesions (actinic keratoses), malignant lesions (squamous cell carcinomas), photoaging (solar elastosis), and even viral infections (herpes labialis)

For children aged 6 months and older, current guidelines recommend a broad-spectrum, water-resistant sunscreen with an SPF 15 or higher, ideally with a predominance of inorganic (ie, physical) filters (zinc oxide or titanium dioxide, which cause less irritation to sensitive skin)

Ideal sunscreen products for children should have broad-spectrum UVR coverage and good photostability, dispersibility, and aesthetics. They should be water-resistant and have a low potential for irritation to the skin and eyes. Sunscreen should be applied in adequate amounts (2 mg/cm²) covering all exposed skin surfaces, paying special attention to areas such as the ears, nose tips, neck, and the backs of the hands and feet. It should be applied 20 minutes before sun exposure and reapplied approximately every 2 hours when outdoors(during heavy sun exposure like a park or beach). Sunscreens in cream and lotion form are better for an even application. When the spray is used, it should be sprayed onto the palm of the parent/guardian, and then applied to the skin of the child. When using a spray, care should be taken to avoid inhalation. Sunscreen sticks should be used for the lips. Sunscreen should be incorporated into the daily routine of children in the same way as adults.

For children who are active in sports like swimming, football, cricket, tennis, and other outdoor sport formats, the use of a physical sunscreen with filters containing zinc oxide or titanium dioxide is better. These filters are non-chemical sunscreens and do not react with sweat, chlorine in water, or pre-existing skin sensitivity ( eczema )

International guidelines regarding sun protection:

• Wear sun-protective clothing.
• Wear a wide-brimmed hat to shade the face and neck, and shoes that cover the entire foot.
• Wear sunglasses with UVR-absorbing lenses.
• Apply a broad-spectrum sunscreen with SPF ≥30. Sunscreens without inorganic filters (titanium dioxide and zinc oxide) are generally better accepted by people of dark colour because of their better cosmesis on dark skin.
• Apply sunscreen to dry skin 15-30 min before going outdoors. When outdoors, reapply every 2 h to all exposed skin, and after perspiring or swimming.
• Take vitamin-D supplement: 400 IU daily for infants-age ≤1 y, 600 IU daily age 1-70 y and 800 IU daily age >70 y.

Dr. Pravin Banodkar, Consultant – Dermatology and Cosmetology | SRCC Children’s Hospital, Mumbai