PAMF Health Blog

Be Well, Be Well Informed

Kids & Sun Safety: Q&A With a Pediatric Dermatologist

Posted on Aug 10, 2012

Swimming, playing hide-and-go-seek at the park, picnics or building sandcastles on the beach – some of the best childhood activities are outdoors. Amy Gilliam, M.D., a pediatric dermatologist at the Palo Alto Medical Foundation, says that good sun protection is a must and should become just as much part of your child’s daily routine as brushing teeth and flossing. In this blog post, Dr. Gilliam answers commonly asked questions about how to ensure that your child can safely enjoy the beautiful outdoors.

What’s the best way to protect my children from the sun?

First of all, don’t save your sunscreen for sunny days only – even on a cloudy day, up to 80 percent of the sun’s ultraviolet rays (the rays that cause sunburns, skin damage, cancer and future wrinkles) can pass through the clouds. Follow these sun safety tips daily:

  • Apply enough sunscreen – with a sun protection factor (SPF) of at least 30 – to cover all the exposed areas of the body. To give you an idea of how much sunscreen you’ll need – it takes about 1 ounce (enough to fill a shot glass) to cover the exposed areas of the body of an adult – a little less for a child depending on his or her size. A 3- to 4-ounce tube of sunscreen should last for about three whole-body applications for an adult. If you have any bottles of sunscreen left over from previous years, you are probably not using enough. Make “More Is Better” your motto!
  • Apply sunscreen 20 to 30 minutes before heading outdoors as it can take 30 minutes for a sunscreen to start working.
  • Reapply sunscreen every two hours and after a dip in the pool, even if you are using a water-resistant product. Sunscreens rub, wash and sweat off easily. If your child is playing sports and sweating a lot, reapply more frequently.
  • Wear protective clothing, a broad-brimmed hat, lip balm with an SPF and sunglasses. Clothing with a tight weave provides the best protection – hold your favorite shirt up to the sun so see how much light comes through. For example, a dry, white T-shirt typically only offers an SPF of about 7.
  • Stay in the shade during the sun’s peak hours of 10 a.m. to 4 p.m.

Remember, too, that the sun reflects from sand, snow, water and the pavement, so make sure your kids apply sunscreen all over to protect themselves from the sun’s rays whether they come from above or below.

When I get to the sunscreen isle at the drugstore I feel overwhelmed – there’s so much choice. How do I pick the right one?

I can understand your confusion – here’s a quick sunscreen 101:

  • Broad-spectrum is best. Choose a sunscreen that provides broad-spectrum (this will be listed on the packaging) coverage against both ultraviolet A (UVA) and ultraviolet B (UVB) light. These are the rays of the sun that can cause sunburn, skin damage, cancer and wrinkles.
  • Go for at least SPF 30. Pick a product that is water-resistant and has a sun protection factor (SPF) of at least 30. Anything above 30 does not give you that much additional protection. The SPF number on the sunscreen bottle is a guide to how long you can stay in the sun without risking sunburn. This is calculated by comparing the amount of time it takes to get sunburn on sunscreen-protected skin, compared to the time it takes to cause sunburn on unprotected skin. For example, it takes about 10 minutes for unprotected skin to burn; whereas with an SPF 15 sunscreen, it takes 150 minutes to burn. Currently, SPF refers only to protection from UVB light – there is currently no measurement for UVA protection on American sunscreens but this is likely to change. Look out for a UVA SPF on sunscreen packaging soon.
  • Zinc oxide or titanium dioxide for young children and those with sensitive skin. Look for these ingredients if you have infants or young children (elementary school age or younger), or you or your kids have sensitive skin or eczema. These ingredients physically block the sun’s rays from penetrating the skin. Chemically-based products absorb the sun’s rays and dissipate them as heat. These are also effective and safe for older children and adults without any skin sensitivities.

We’re taking our 4-month-old baby boy to Hawaii. What’s the best way to protect him from the sun?

Babies under 6 months of age should avoid all sun exposure and direct sunlight. Dress your son in lightweight pants and long-sleeved shirts and a hat with a brim. If you are out and about with him on your trip, apply a minimal amount of sunscreen to exposed areas such as the face and back of the hands. Use a sunscreen that contains zinc oxide or titanium dioxide (a physical block) rather than a chemically-based sunscreen.

I’ve heard that getting enough vitamin D is really important for your health and you can get it through sun exposure. Should my children be out in the sun more?

A lack of this important vitamin can cause serious illnesses such as rickets, a disease that weakens bones. Sun exposure is one way of obtaining vitamin D and wearing sunscreen does decrease the skin’s production of it. However, intentional sun exposure is not the best option for your child’s health. Instead talk to your doctor about adding more vitamin D rich foods to your children’s diet or taking a daily supplement.

My teenage daughter wants to go to an indoor tanning salon. Should I let her?

Teens, especially teenage girls, can be very attracted to indoor tanning because they see it as a quick and easy way to improve their appearance and their friends are doing it, too. Don’t believe your teen, or anyone else, telling you that an indoor tanning salon is a safe way to get a tan. Tanning beds emit similar amounts of ultraviolet rays as the sun and can cause equal skin damage and cancer. The majority of light emitted from tanning beds is UVA radiation, whereas UVB light is required to make Vitamin D – so it’s not a good way to get Vitamin D either. The bottom line is there’s no upside to indoor tanning beds or home-tanning equipment – your teen should definitely avoid both.


Amy Gilliam, M.D., is a  pediatrician, dermatologist and pediatric dermatologist at the Palo Alto Medical Foundation’s Dublin, Fremont and Palo Alto Centers.