Fun in the sun: Everything you need to know about sunscreen

It’s summer in Wisconsin — and it's a hot one.

Having children who burn easily, I know well the trials and tribulations of trying to put sunscreen on a squirmy child or one who just wants to get outside. Also, being native to Wisconsin I know how hard it is to listen to the recommendation to avoid direct sunlight from 10 a.m. to 4 p.m. when the rays are the strongest — we just want to be outside!

Let’s review some of the basics:

For kids older than 6 months:

• Use sunscreen all areas exposed to the sun
  
  
• Use a sunscreen that is at least SPF 30,  broad spectrum against UV A and B rays and contains zinc oxide or titanium dioxide
  
  
• Try to put sunscreen on 15-30 minutes before going outside
  
  
• Use sunscreen even on cloudy days! 80 percent of ultraviolet (UV) rays can go through the clouds
  
  
• Reapply often, at least every two hours, after swimming and if you are sweating a lot
  
  
• Use more than you initially think you need

For kids younger than 6 months:

• Infants burn so easily, so it’s best to try and avoid direct sunlight as much as possible.
  
  
• If they are going into the sun, dress them in a long sleeve shirt, pants, hat and sunglasses.
  
  
• If it’s too hot or you want to apply sunscreen, it’s best to test a small area first (with a mineral sunscreen — more on that later) to make sure there is no reaction. 

Is sunscreen safe to use on kids?

The short answer is yes. Sunscreen is an important tool for protecting kids from the negative effects of sun exposure. But if you’ve watched the news lately, you might be hesitant to use sunscreen because of stories about it potentially being toxic. While that may sound scary, nobody should be avoiding sunscreen.

Let’s break it down so you can feel confident using sunscreen.

Chemical vs. mineral

Two types of sunscreen are currently available — chemical and mineral — and they both have pros and cons.

Until recently, chemical sunscreens were the most popular option. These work by using ingredients like ensulizole, octisalate, homosalate, octocrylene, octinoxate, oxybenzone or avobenzone. They absorb into the skin, then soak up UV rays, turn the rays into heat and dispense them away from the skin.

Generally, chemical sunscreens are easier to put on and feel lighter on the skin. However, they are more likely to cause skin irritation. Additionally, the two most popular ingredients, oxybenzone and octinoxate, are not "generally recognized as safe and effective" by the Food and Drug Administration (FDA). They may also be a hazard for the environment. Hawaii passed a bill banning oxybenzone and octinoxate as they were found to damage coral. When shopping for sunscreens, look for those labeled "reef safe."

Nowadays, mineral sunscreens are a popular alternative and are widely available. They work by using ingredients like zinc oxide or titanium dioxide — both considered safe and effective by the FDA — to physically block UV rays. They act as more of a shield on top of the skin. That means that they can be difficult to apply (think the old-school lifeguard with a white lotion on their nose) and can wipe off a bit easier.

The star of the show is zinc oxide as it does a great job of protecting the skin and is the gentlest ingredient we’ve mentioned. I recommend using a sunscreen with at least 5 percent zinc oxide and has an SPF between 30 and 50. Going above 50 does not add much in protection. 

Application tips

Your sunscreen choice may depend on the ease of application as each product is different and kids can be squirmy. No matter which product you choose, it’s important not to assume all sunscreens should be applied the same. Read the instructions and follow them closely.

Chemical formulas take up to 30 minutes to soak in after application before working, while mineral formulas are active as soon as you put them on. You can find lotions or creams for both chemical and mineral sunscreens. However, sprays usually only contain chemical sunscreens. I recommend lotions or creams for your first application as they give the most thorough protection when applied. Sprays can be a good option for reapplication.

All sunscreens are water resistant (never waterproof), so you’ll need to reapply if your kid is in the water. No sunscreen lasts longer than about 90 minutes if swimming or perspiring, so frequent reapplication is key for good protection. An average 8-year-old will need about an ounce of a creamy sunscreen for proper protection.

How to care for sunburn

You bought the sunscreen, and you’re careful to apply it. Unfortunately, it can still happen – sunburn. It’s important to take it seriously and keep it from happening again, since the risk of melanoma increases each time a child has a sunburn.

Here are some steps to take if your child does get burned:

• Act fast to cool down. Cover up and get out of the sun immediately. Continue to cool the burn with a cold compresses but don’t apply ice directly to the sunburn. Take a cool shower or bath, but not for too long since it can be drying. Avoid harsh soap, which might irritate the skin even more.
  
  
• Moisturize. While skin is still damp, use a gentle moisturizing lotion. Repeat to keep burned or peeling skin moist over the next few days.
  
  
• Manage pain and inflammation. At the first sign of sunburn, taking a nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen, can help with discomfort and inflammation. You can continue with the NSAIDs as directed until the burn feels better. You can also use a 1 percent over-the-counter hydrocortisone cream as directed for a few days to help calm redness and swelling. Aloe vera may also soothe mild burns and is generally considered safe. It is important to wear loose, soft, breathable clothing to avoid further skin irritation, and stay out of the sun.
  
  
• Replenish fluids. Burns draw fluid to the skin’s surface and away from the rest of the body, so dehydration is a risk. It’s important to rehydrate by drinking extra liquids, including water, immediately and while skin heals.

Get medical help if your child has severe blistering over a large portion of the body, has a fever and chills, or is woozy or confused. Don’t scratch or pop blisters, which can lead to infection. Signs of infection include red streaks or oozing pus.

The bottom line on sunburn is that skin will heal, but real damage has been done. I hope this information will help you confidently make sunscreen choices for your family. No matter which options you choose, sunscreen is an essential part of keeping kids safe. 

Sharyl Paley, MD Pediatrician Bayshore Pediatrics

Children’s Wisconsin has more than 20 primary care offices conveniently located throughout the Milwaukee area and southeast Wisconsin. Find a pediatrician near you.