Childhood is a critical period for melanoma risk because of sun exposure, as shown by ecological studies, and, less consistently, case-controlled studies.1 Intensive childhood UV exposure increases the risk of developing BCC, while chronic childhood exposure increases the risk of SCC.2
How parents can protect their children from the sun’s ultraviolet radiation when UV levels reach 3 and above.
- Take extra care outdoors during the peak UV times – UV radiation levels are highest in the middle of the day and therefore your child’s unprotected skin will damage more quickly during this period than in the early morning or late afternoon. UVR cannot be seen or felt. It is still possible to get burnt on cool or cloudy days. Parents should aim to minimise outdoor activities and events (when possible) between 11am and 3pm during the daylight saving/summer period in Canberra.
- Use hats and clothing. Children should wear broad-brimmed hats, bucket hats or legionnaire caps. Broad-brimmed hats should have a brim of at least 6 cm and bucket-hats should have a downward sloping brim of at least 5 cm with a deep fitting crown. Headwear that shades the face, neck and ears can reduce UV radiation to these areas by about 50 per cent. Children should also wear loose, comfortable clothing that protects the arms, legs, body and neck from the sun. Generally, the closer the weave of the fabric the better the protection from UV radiation.
- Be a SunSmart role model. Children often copy those around them and learn by imitation. Parents and carers should adopt positive sun protection behaviour so the children in their care will be more likely to do the same.
- Encourage children to play in the shade. Plant trees or erect temporary or permanent shade structures in places where your child/ren plays, or relocate activities, eg. wading pools and sand pits to under adequate shaded areas. Remember that UV rays can be reflected from many surfaces onto your child even when they’re in the shade, so always use a combination of the 5 sun protection measures.
- Use at least an SPF 30+ broad spectrum and water-resistant sunscreen on body parts not able to be covered by clothing. Apply 15-20 minutes before going outdoors and reapply at least every two hours as sunscreen can be is easily wiped or sweated off. Never use sunscreen as the only form of protection or to increase the amount of time you and your child would normally spend outside in the sun.
- Use sunglasses to protect your child’s eyes. There is a wide range of effective and inexpensive children’s sunglasses available. Make sure they are close fitting that wrap-around the eyes.They should comply with Australian Standard 1067:1998 and carry a label stating EPF 10 (EyeProtection Factor rating 10) catagory 2,3 or 4. Suitable sunglass lenses should block out 100% of UV radiation. Sunglasses can be worn all year round when spending time outdoors.
- Ensure that SunSmart practices become a lifestyle habit for your child (and your family). Remember that childhood protection reduces skin damage and decreases the chances of developing skin cancer later in life.
- Use the SunSmart app.
The SunSmart app is a simple way to see what time sun protection is required each day in Canberra.
In the ACT from the beginning of August to the end of May, UV radiation levels will reach 3 and above for part or most of each day.
I grew up playing in the sun. Now I hear it is wrong to let children play in the sun. What’s the truth?
There is nothing wrong with children playing outdoors (in the sun), but they must be protected from over-exposure to the sun’s ultraviolet (UV) radiation, which causes sunburn and, in the long term, skin cancer. Children (and parents) should be SunSmart when UV levels reach 3 and above, and take extra care during the middle hours of the day, particularly in Summer.
Do children get skin cancer?
Melanoma in children is very rare, however it is the most common diagnosed cancer in young Australians aged between 12 and 24, with more than double the numberof cases of any other kind of cancer. Research also reveals that over-exposure to UVR during childhood and adolescence is a major risk factor for the development of skin cancer later in life.
Isn’t it true that UV radiation (Vitamin D) is good for my child’s health and growth?
Everyone needs some daily UV radiation for the production of Vitamin D, however, in Canberra our UV radiation levels are high enough during August to May, that even when using sun protection, most of us get all we need from the ‘incidental’ exposure we receive from the sun each day. If however, you are concerned about your child’s vitamin D levels, you should seek advice from your GP. We all need a few minutes of sun exposure most days of the week for vitamin D, being physically active will also assist with Vitamin D production.
To me, my child looks and seems healthier with a suntan. Is this true?
While we used to think of a tan as being a sign of “good health” or wellbeing, it’s not! In fact it’s a sign of over-exposure to potentially dangerous UV radiation. Continued exposure damages and weakens the skin and increases the risk of skin cancer. There is no longer such a thing as a "healthy tan"!
Are any skin types immune to skin cancer?
Not really. While children with white skin are obviously more prone to skin damage and sunburn and therfore an increased risk of skin cancer later in life, every child in Australia, regardless of skin colour, should still protect their skin and eyes from UV exposure. Children with naturally very dark (ie African) should still apply sunscreen if spending long periods outdoors, they should always aim to protect their face and eyes from too much sun by wearing a brimmed hat and sunglasses whenever UV levels are 3 and above, and using shade when it is avaliable.
Can I use sunscreen on my children?
Yes, but always in combination with clothing, hats, sunglasses and shade to provide the best possible protection. Babies and very young children should not have their whole body covered in sunscreen as this is not the best form of protection. In fact the widespread use of sunscreen on babies under six months is not generally recommended as babies have very sensitive skin which may be more likely to suffer a reaction.
If sunscreen is required- use at least a broad-spectrum SPF30+ (Sun Protection Factor) sunscreen areas on skin that cannot be protected by sensible clothing and a hat, ie. face, hands and feet etc. Zinc cream or lip balms can be used on sensitive areas such as the lips and nose for extra protection. Using a sunscreen will not stop the skin absorbing some UV radiation, even an SPF30+ sunscreen will still let some UV radiation through. While most SPF30+ sunscreens will protect the person wearing them for up to two hours, a stronger sunscreen doesn’t mean that someone can stay out in the sun longer. Sunscreen should always be used in combination with other sun protection measures and never used to extend time in the sun.
When and where should I protect my kids from the sun?
Sunburn is caused by UV radiation and is not related to heat (infra-red light). The UV radiation, which damages our skin, is present every day of the year and children can get burnt on a cloudy, overcast or windy day. UV radiation can also be reflected from sand, water and snow. UV radiation is strongest during the daylight saving/summer period of the year, however children in the ACT need sun protection for part or most of each day from the beginning of August until the end of May, as this is when UV levels will reach 3 and above each day.
During the winter months of June and July sun protection is not generally necessary in the ACT, due to our ‘low’ UV radiation levels. Sun protection may still be necessary, if your child has very sensitive skin or certain skin conditions, or is spending time near reflective surfaces such as snow or water, in Alpine areas or spending extended periods outdoors.
What about children with naturally very dark skin?
While children with white skin are obviously more prone to skin damage and sunburn and therefore an increased risk of skin cancer later in life, darker skin can still be damaged by UV. Every child in Australia, regardless of skin colour, should still protect their skin and eyes from over-exposure to UV. Children with naturally very dark (ie African) should still apply sunscreen if spending longer periods outdoors, and especially in Summer when Australian UV levels peaks. They should always aim to protect their face and eyes from too much sun exposure by wearing a brimmed hat and sunglasses whenever UV levels are 3 and above, and using shade when it is available.
Infants and toddlers (say up to 4 years of age) are particularly vulnerable to UV radiation-induced changes in the skin due to lower levels of melanin and a thinner stratum corneum (the outermost layer of skin). Skin thickness shows a gradual increase from birth to adulthood.3 The epidermis is thicker in adults than it is in children. Therefore, limiting sun exposure and using clothing cover and shade when outdoors is recommended regardless of skin type.4
Cancer Council recommend families with children who have naturally very dark skin who rarely/never burn discuss their sun protection and vitamin D requirements with their GP.
Further information and resources
This information is based on current available evidence at the time of review. For further information or advice contact Cancer Council 13 11 20.
This information can be photocopied for distribution.
1. Whiteman DC, Whiteman CA, Green AC. Childhood sun exposure as a risk factor for melanoma: a systematic review of epidemiologic studies. Cancer Causes Control 2001 Jan;12(1):69-82 [Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/11227927.
2. Leiter U, Garbe C. Epidemiology of melanoma and nonmelanoma skin cancer--the role of sunlight. Adv Exp Med Biol 2008;624:89-103 [Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/18348450
3. Seidenari S, Giusti G, Bertoni L, Magnoni C, Pellacani G. Thickness and echogenicity of the skin in children as assessed by 20-MHz ultrasound. Dermatology 2000; 201(3): 218-22
4. Paller AS, Hawk JL, Honig P, Giam YC, Hoath S, Mack MC, Stamatas GN. New insights about infant and toddler skin: implications for sun protection. Pediatrics 2011; 128(1): 92-102