A sunburn in a child is a painful skin reaction that is caused by exposure to UV light. Human skin absorbs ultraviolet (UV) light from both natural and artificial sources such as sun exposure and tanning beds. UV rays can also damage the skin in children even though it is not visible at the time of exposure. Excessive or repeated sunburns can lead to wrinkles and premature aging of our skin, especially on the face.
Also, sun exposure is also one of the leading causes of skin cancer.
Which children have the most risk from sunburns?
During the summer months, children often spend hours outside in the sun. They are more likely to develop skin cancer later in life if they have the following risk factors:
- Fair skin
- Moles
- Freckles
- Multiple blistering sunburns, especially before age 18
- A family history of skin cancer
- Excessive exposure to the sun during daily activities / work/ outdoor sports
What are the symptoms of sunburn and risk factors for severe burns?
Symptoms of a sunburn in a child can range from mild skin redness to systemic symptoms such as nausea and vomiting. There are many factors that can determine how severely affected a child can become from a sunburn.
Length of exposure and time of day are the top two reasons why a child can have a severe burn.
The longer someone is out in the sun, the more damage the UV rays can do to the skin. This is especially true in young children who have more delicate skin. Time of day can also be a factor. The sun’s rays are strongest and closest to the earth between the hours of 10 am and 4 pm. Sunburns can happen anytime of the year, but they’re most likely to occur during the hot summer months.
Another factor in determining severity of the burn is the level of protection that the child has. Is he wearing a hat and a long sleeved rash guard or is he bare chested in the pool? How much sunscreen does your child have on and has it been reapplied often? The more unprotected skin that is exposed, the worse the burn can be.
How do you treat a child with a sunburn?
If your child has a sunburn, these simple tips can help make him feel better:
- Take a cool bath or use cold compresses on the sunburned areas.
- If your child has a fever or pain, give them acetaminophen or ibuprofen.
- Apply a topical moisturizing lotion, aloe gel, cortisone cream, or topical pain relieving ointment to sunburned skin to help soothe the burn. Putting it in the refrigerator before applying it to your child can provide extra relief.
- Don’t break blisters, as that can lead to increased pain and the possibilty for skin infections.
- Protect your child from direct sunlight until the burn heals.
- Keep your child hydrated by encouraging them to drink extra fluids for several days.
- If your child is vomiting and can’t keep fluids down, consult your pediatrician or head to the ER
How do you prevent sunburns in children?
Spending time out in the sun is an important thing for children to do. It is a rite of passage during the summer months to spend time splashing in puddles, blowing bubbles in the front yard, covering the driveway in sidewalk chalk and swimming the day away.
However, it is important to remember to protect your kids from sunburns and the long term effects of sun exposure.
There are many ways to protect your children from sunburns:
- Apply a broad spectrum (UVA/UVB) sunscreen that is at least SPF 30
- Reapply sunscreen at least every 2 hours, more often if in the water
- Put protective clothing on them such as a hat, sunglasses and long sleeves
- Limit time outdoors during the hottest parts of the day / spend time in the shade between 10 am and 4 pm when the sun is the most intense
How to choose the best sunscreen to prevent sunburns in your children
Have you ever walked down the sunscreen aisle at the local store and felt a sudden sense of dread. Picking out a sunscreen to prevent sunburns for your child does not have to be so daunting. Let’s look at some of the words that are on the different bottles and help determine what sunscreen is best for your child.
What is SPF?
SPF is a measure of how much solar energy (UV radiation) is required to produce sunburn on protected skin vs the amount of solar energy required to produce sunburn on unprotected skin. Sunburn protection does increase as SPF increases, but it is not exponential. A sunscreen with an SPF of 15 blocks about 93% of the UVB waves, while SPF 30 blocks 97% and SPF 50 blocks 98%.
Dermatologists recommend choosing a sunscreen between SPF 30 and 50 for children. Most kids’ sunscreens are around SPF 50.
What is UVA & UVB?
UVA and UVB are two different wavelengths of light that are emitted from the sun. UVA is a longer wavelength and exposure contributes to skin aging. UVB is shorter and contributes to sunburns in children and adults. Both contribute to causing skin cancers.
All sunscreens block UVB rays, but not all sunscreens block UVA rays. Chemical sunscreens are much better at blocking UVB than UVA. Physical sunscreens protect against both wavelengths.
What are chemical vs physical sunscreens?
Physical sunscreens are also known as mineral sunscreen. They contain the ingredients zinc oxide or titanium oxide. A benefit for this type of sunscreen is that it protects from both kinds of harmful sun rays. The downside is that it can leave you looking like Casper the friendly ghost, especially if you have dark skin. Another drawback of physical sunscreens is that they are not as water resistant as their chemical counterparts. They need to be reapplied more often if your child is sweating a lot or in the water.
Chemical sunscreens contain one or more of the following chemicals:
- oxybenzone
- avobenzone
- octisalate
- octocrylene
- homosalate
- octinoxate
These chemicals absorb the UVB rays and prevent them from burning the skin. The advantage of a chemical sunscreen is that it goes on smoothly and doesn’t leave behind the ghostly hue that physical sunscreens do. The downside of a chemical sunscreen is that they can often irritate the skin if your child has sensitive skin or any skin conditions. They also have gotten a bad rap in our trying to live “chemical free” society. There are ongoing research studies that are evaluating the safety of these chemicals. As of now, the jury is still out. However wearing sunscreen is the best way to prevent sunburn.
What about sunscreen that you can spray?
As a doctor, I dislike spray sunscreens. They are hard to apply well, they stink and inevitably I end up with a sunburn stripe down one part of my body.
As a mother, spray sunscreen saves the day. My daughter is willing to apply a spray sunscreen to her body more readily than a drippy sunscreen lotion or a pastey white concoction.
Spraying the sunscreen into your hands first and then applying it to the body or allowing your child to do it greatly increases its coverage ability and consistency. Spray sunscreens are also beneficial to send with your child if they are attending summer camp and you are not present to reapply the sunscreen. Often, a grade school aged child can reapply this type of sunscreen easily. Who wants a teenage boy camp counselor reapplying sunscreen to your 9 year old daughter?
I certainly do not.
So, most days the motherly side of me wins out on this issue.
Concluding thoughts
Helping you to know how to protect your children from the sun is one of the most important things that I can do as a pediatrician. From choosing a good sunscreen to understanding the importance of staying out of the sun at certain points in the day, there are many easy to do safety measures to protect kids from sunburn.
There are lots of things that we can do as physicians and as parents to protect our children. Sun protection is of utmost importance on those lists of things. The things that we do today can prevent many issues down the road for our children.
If you need a pediatrician that you can trust to provide evidenced based care for your kids, visit our website to find out more about our practice.
© 127 Pediatrics, June 2022
Dr. Andrea Wadley is the owner, pediatrician, and breastfeeding medicine specialist for 127 Pediatrics. She has an established house calls pediatric practice in Colleyville, TX. She also sees patients all over Tarrant county for concierge breastfeeding medicine consults, lactation consults, fourth-trimester care, tongue tie clipping, and medical ear piercing.
