Most people have heard of a skin disease called melanoma, a deadly cancer that can affect children and adults alike. Do you know anything about what triggers this tumor and, more importantly, do you know how to lower your children’s lifetime risk of ever developing this horrible disease? Stay tuned as we discuss all of this in this installment of Portable Practical Pediatrics
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Summer Means Fun in the Sun
As I post this podcast, we just celebrated Memorial Day 2020, the beginning of summer when we start enjoying meals with family and friends, long summer days, beach trips, and most significantly, the warmth of the summer sunshine. All that sounds great but there is a darker side to the long days of sun, however. All that lovely sunshine may cause enough skin damage to initiate an extremely dangerous skin cancer called melanoma in your children- years after the sunburn-especially if the sun damage comes in the form of a blistering sunburn. In fact, just one blistering sunburn in a young child doubles their chance of melanoma in their lifetime. The more burns, the more risk. But while melanoma makes up just 10% of all types of skin cancer, it causes the overwhelming majority of skin cancer-related deaths. It is the gorilla in the room when it comes to skin cancer deaths, even in children. So, let’s explore this cancer a little closer, shall we?
What is Melanoma:
Skin cancers come in a variety of types, but the most deadly form is a cancer of the pigment producing cells in the skin called melanoma, the cells that give your children’s skin color by producing a pigment called melanin. These pigment producing cells are located very close to the surface of your children’s skin and are therefore quite susceptible to damage from the UV rays of the sun. You would think that children with darker skin, and therefore more melanin, would be more likely to develop melanoma, but the opposite is true. The children most likely to eventually develop melanoma are those that have very pale skin, who burn in the sun rather than tan. Other risk factors for melanoma are a child having a high numbers of moles, freckles, red hair, blue eyes, as well as a family history of melanoma. Fair skinned children have dearth of pigment which allows the high energy UV sun rays to penetrate more deeply into the child’s skin and cause DNA damage that can trigger melanoma. In fact, melanoma, is thought to have a wider variety of genetic mutations than any other type of human cancer and these gene mutations are mostly caused by exposure to sunlight-especially when your child is young. In other words, melanoma is a disease triggered by damage from sunlight in genetically susceptible-fair skinned children and adults. And most importantly, it is preventable!
Melanoma Good News
But there is some good news when it comes to melanoma in children. From 2006 to 2015, the number of melanoma cases in teens, in the US has actually decreased by about 5% after decades of rising. This is great news! This means that the preventative steps that public health advocates, pediatricians, and dermatologists have been stressing are being taken seriously and have been implemented by parents. We want this trend to continue, and hopefully we’ll also see this trend in adult cases. Unfortunately, the most recent research shows that adult cases of melanoma continue to increase but maybe that will change soon as well.
How Do Parents Prevent Melanoma in their Children?
So, we now know that melanoma and other skin cancers are mostly preventable, especially if that prevention starts early a child’s life. But how does a parent make sure their children are protected? Here is my list of action points for you to commit to memory and start implementing if you have not already done so:
- Use Sunscreen: This likely comes as no surprise. Sunscreen of 15 SPF or greater has been proven to be an effective way of protecting yourself from the powerful UV rays of the sun. Consistent use of sunscreen is probably the reason there are fewer cases of teen melanoma being reported. In fact, according to scientific projections, we could potentially decrease melanoma cases by 10% if children just increased sunscreen use by 5% over a 10-year period.
- Use the right kind of sunscreen: It’s important to know that there are typically two types of sunscreen and they are not created equally. Mineral-based sunscreens use zinc or titanium oxide to physically block UV rays and are effective immediately after application. They literally reflect the UV light and prevent it from affecting your child’s skin. They are sometimes a bit harder to spread and may leave white streaks, but they are more reliable and typically more effective than the chemical sunscreens. The sun protection is worth the extra time to apply! The second type of sunscreens are chemical filters that absorb the UV rays. These require 20 minutes post application before they work. Many sunscreens are made of a combination of both, but make sure to look for “zinc” or “titanium oxide” on the label. To help you choose the right sunscreen for your children, check the Environmental Working Group’s ratings of sunscreens that I have linked in the show notes.
- Avoid sunburns at all cost: Sunburns are dangerous. I wish I’d known just how dangerous when I was a kid. It turns out that the number of sunburns a child has throughout their life is directly correlates with their risk of suffering from melanoma. I know it can be tough to wrangle slippery children at the beach or by the lake or even while they’re outside on their bikes. But, making sure they leave the house with a coat of sunscreen, protective clothing, a hat, and even sunglasses to help avoid sunburns is worth the effort.
- Reapply sunscreen after a swim: One of the best summer feelings is cooling off in the lake or ocean. But doing so takes some of the sunscreen off your child’s skin, even the water-resistant sunscreens! So, remember to reapply after you swim to keep damaging sun exposure at bay. Reapplication should be done at least every two hours for children in water. An excellent alternative to sunscreen in these situations however is clothing specifically designed to protect your children from the sun. There are many brands to choose from and they are generally known as swim shirts. No reapplying needed here with consistent SPF/UPF all day. And finally, there are laundry additives that can convert your children’s existing clothes into super sun blocking clothes with a simple wash once. Whether manufactured to be sun protective or done at home by you in your washer, it is easy to get clothes that have a UPF (ultraviolet protective factor) of 50 or greater.
- Seek out shade and cover up: Sun can feel great but avoiding too much sun can be the difference between your child developing or not developing melanoma in the future so make sure your children don’t spend too much time in the sun. Limit their sun exposure between 10am-2pm, the time of day when the UV light is at its peak. And, bring an umbrella to the beach or plan on having your picnics under the shade of a big ole tree.
- Teach your kids how to put on sunscreen: Teach your kids from an early age how to effectively apply sunscreen, particularly the parts of their bodies most prone to future melanoma, the tops of things- the top of their ears, the top of their nose, the top of their shoulders, and the top of their feet. Most children use too little sunscreen too infrequently. Teach your children otherwise.
- Do not encourage tanning: Other things you can do to prevent future melanoma in your children are to never encourage them to get a “healthy tan” and by all means, do everything you can to prevent your children from ever going to a tanning bed. These tanning beds expose your child to 10-15 times more UV radiation than direct sunlight! Yikes.
So, you can see, the word of the day with skin cancers is prevention, especially when your children are young. By limiting the number and intensity of sunburns, you can greatly reduce or even eliminate your children’s chances of suffering skin cancers. By the time your children are old enough to take care of their own skin, most of the damage is already done. That leaves you mom and dad, to take the bull by the horns and make sun protection a priority for your children by following the steps we just discussed. Someday, your children will thank you for it.
Well, thanks for taking a few minutes to listen to my pedcast, now starting my 11th year in production. With over 500 posts, I feel certain that there are other pedcasts that you will informative and maybe even entertaining. If you value the information you get on Portable Practical Pediatrics, consider taking a moment to like and share a few of your favorite posts with friends and family. This is pediatrician, Doc Smo, broadcasting from studio 1E, that’s my first child’s bedroom on the east side of my house, figuring it is now a good bet, that you now know how to protect your children from damaging ultra-violet. Until next time.