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Recently social media has been filled with trending “Sunburn Art” photos – people strategically applying sunscreen in extravagant patterns then getting intensely sunburned to display the masterpiece. Although it may be tempting to show off artistic talents for the Instagram likes and retweets, sunburns can have long term consequences on your skin health, including risk for skin cancer and premature aging. As you enjoy the outdoors this summer here are a few tips for sunscreen use:

What kind of sunscreen should I buy? Do I really need the SPF 100+? The best option is to find one that you are willing to wear regularly! The American Academy of Dermatology recommends that sunscreen should be broad spectrum with protection against both UVA and UVB. This should be at least SPF 30 and water resistant. Many dermatologists recommend a higher SPF, even SPF 100. This is due to recent research showing that many people do not apply sunscreen as thick as how the SPF number was established. Often, people use as little as 25-50%! Using a higher SPF may partially compensate for putting on too little. Using a moisturizer containing sunscreen on exposed skin can be nice for daily use when you know you won’t have extended time outside. Usually the SPF in makeup is an added bonus but is not applied thick enough to rely on.

What is the safest way to apply sunscreen? It is best to apply sunscreen 15-20 minutes before going outdoors. It takes this long to fully absorb. Make sure to apply it to all exposed skin, getting help for hard to reach places like the middle of the back. To get the true SPF value on the bottle, sunscreen amount should be based on the “teaspoon rule” – 1 teaspoon to the face/neck/scalp, 1 teaspoon for each arm, 1 teaspoon to the chest and abdomen, 1 teaspoon to the back, and 2 teaspoons for each leg. Please be sure to re-apply every two hours while outside because the sunscreen will lose effectiveness over time. The re-application rule is also important after swimming or heavy sweating. Many people who wore sunscreen at the beginning of long day outside get burned because of not reapplying. Keep up the good work!

But I hate the feel and smell of sunscreen. What are my alternatives? Physical blockage from the sun by clothing is an alternative to sunscreen. There are many marketplace options for UPF (ultraviolet protection factor) clothing with UVA and UVB protection based on weave and thickness of the fabric. This should be taken with caution because bleaching or stretching the fabric can decrease the effectiveness. A broad brim hat can be helpful but this has been documented to only show SPF protection less than 10 (and a baseball hat has a SPF 1.5 for the nose at best!). These are best used in combination with other forms of sun protection.

Do the sunscreen recommendations change for my kids? Sun protection for kids and teenagers is super important! It is well documented that sun exposure in childhood is a risk factor for developing skin cancer as an adult. Per the American Academy of Pediatrics, it is best to use other sun protective methods first (shade, sun protective clothing, hats) with broad spectrum sunscreen applied on skin that is still exposed. Sunscreens with UV blocking active ingredients titanium dioxide and zinc oxide are recommended for children under two years old.

If you are interested in having a skin cancer screening or would like to have a concerning lesion evaluated, our board-certified and experienced dermatologists at IHA Dermatology are always happy to help in any way that we can. Just call us at 734-667-DERM (3376) to schedule an appointment.

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Sleep has a number of key health benefits for children and is important for their growth and overall development. Sleep is important for muscle growth, tissue repair and growth hormone release. Sleep is also critical for learning and memory consolidation, making sleep important for children to perform their best in school. Sleep is necessary for maintaining the overall health of our immune system and our metabolism.

The amount of sleep a child needs really depends on the age of the child. Newborns typically require the most sleep, which can be up to 14-17 hours per day. As children get older, their sleep requirements decrease so that by adolescence their sleep needs are similar to adults.

The National Sleep Foundation recommends that toddlers get 12-15 hours of sleep and preschoolers 10-13 hours of sleep per day, including their daytime nap. The National Sleep Foundation recommends 9-11 hours of sleep per night for school-aged children, 8-10 hours of sleep for teenagers and 7-9 hours of sleep per night for adults between 18 and 64. Adults aged 65+ need 7-8 hours of sleep.

Unfortunately, we know that many children and adults do not get the recommended amount of sleep each night. A 2004 National Sleep Foundation poll found that children of all ages got less than the recommended amount of sleep. Our sleep deprivation gets worse as children get older, with teenagers usually being the most sleep deprived age group.

A 2006 National Sleep Foundation poll found that 45% of adolescents got less than 8 hours of sleep per night, with high school seniors averaging only 6.9 hours of sleep on school nights. Adults do not usually fare much better, with about 40% of adults getting less than 7 hours of sleep each night.

Insufficient sleep is associated with daytime consequences, in which children can be very different than in adults. Most adults will present with symptoms of sleepiness such as falling asleep at work, while reading or watching TV. Children, on the other hand, can present with increased energy (hyperactivity) or problems with focus/concentration. They can sometimes look very similar to children with ADHD. In fact, children are sometimes misdiagnosed with ADHD when in the symptoms are really due to poor sleep.

Children can also present with more behavior problems or poorer school performance. Daytime sleepiness is also seen in children. For example, children may have a harder time getting up in the morning and may even be late for school as a result. They can also be more likely to fall asleep in the car or on the bus ride to school. Or, they can even fall asleep in the classroom, which can affect their ability to learn.

The National Sleep Foundation estimates that about 25% of teens fall asleep in the classroom at least once per week. Some children who are chronically sleep deprived will try to catch up on their sleep at home either through an after school nap or “sleeping in” on the weekends. If your child takes regular naps, especially if they are 45 minutes or longer, or if they “sleep in” more than 2 hours on the weekends, then your child may not be getting enough sleep.

If you have any concerns about your child’s sleep patterns, particularly if your child snores, pauses in their breathing during sleep, gasps for air, has mouth breathing, has frequent night awakenings or restless/sweaty sleep it is important that you talk to your child’s doctor as these could all be signs of obstructive sleep apnea. Difficulty falling asleep or staying asleep could also be signs of other sleep problems that you should discuss with your child’s doctor.

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Question: I’m getting married this summer and want to be tan in my wedding photos and on my honeymoon. Will visiting the tanning salon a few times decrease my chances of getting a sunburn if I get a base tan? Also, aren’t tanning salons safer than laying out in the sun?

Answer: You’d be surprised how often these questions are asked! The short answer is NO and NO! Any type of tan is a sign of skin damage. A tan is the skin’s response to UV damage to the skin’s DNA. The skin darkens to prevent more damage, but your risk of skin cancer is already increased. There is no such thing as a “safe” or “healthy” tan.

Tanning beds deliver concentrated levels of UVA and UVB radiation, both of which cause cell damage that can lead to skin cancer. UVA radiation also penetrates deeper into the skin and causes irreversible skin aging like loss of elasticity, wrinkles and brown spots.

If you want to look tan in your wedding photos, try a sunless tanning cream or lotion. You can still get the glow you want without any of the skin damage.

As far as your honeymoon, take plenty of sunscreen with you. Look for a sunscreen that is SPF 30 or higher, broad spectrum (blocking both UVA and UVB), and water-resistant. Be sure to apply sunscreen at least 15 minutes before going outdoors, and to reapply sunscreen at least every 2 hours or immediately after getting wet (for example, after getting out of a pool). Forgetting to reapply sunscreen throughout the day is the one step that most people forget during vacation and that leads to sunburns. Sunscreen only maintains its listed SPF for approximately 90 minutes, after which point the SPF starts to decrease and the sunscreen starts to lose its ability to block ultraviolet light. Shade and clothing can also help protect you from UV rays. Wear protective UV-blocking sunglasses, broad-brimmed hats and tightly-woven clothes and seek shade when possible. Getting into the habit of protecting yourself from UV rays is as simple as the steps above and will allow you to enjoy the outdoors without damaging your skin.

This article was originally published on May 18, 2015, and was updated on April 12, 2017.