This week is National Sun Awareness Week

Unprotected exposure to the sun when children are outside playing during the summer months may cause sunburn, permanent damage to the skin, and an increased risk of developing skin cancer. Sunburn may not be immediately apparent, even though it is the most obvious short-term effect of excessive exposure to the sun’s ultraviolet radiation (UVR). Freckles, wrinkles, and changes in skin texture occur as the result of excessive exposure to UVR over many years. Continued overexposure to UVR for many years, especially in children, can increase the risk of developing skin cancer in later life. Sun exposure and ultraviolet damage have also been implicated in the development of cataracts of the eye.

The typical symptoms of sunburn are redness, extreme tenderness, pain and swelling. The redness develops two to six hours after exposure and usually peaks between 20 and 24 hours. Mild or first-degree sunburn resolves within two to five days, usually with skin scaling and peeling. The more UVR received, the worse the sunburn can become. The redness and pain of second-degree sunburn are more intense and last longer. There is considerable swelling over a period of days and blistering of the skin occurs. This type of sunburn may take three to 14 days to heal. Pain, nausea, vomiting, chills, fever, and delirium may occur with any sunburn. These symptoms may last for 24 to 72 hours.

The ultraviolet radiation produced by the sun also causes skin damage and increases the risk for skin cancer. UVB rays have a short wavelength and affect mainly the skin’s outer layers. These rays are thought to be the primary cause of sunburn, skin aging, and skin cancer. This type of ultraviolet radiation is more intense during the summer months, in locations closer to the equator, and at higher altitude. UVA rays have a longer wavelength and are not as powerful as UVB rays, but they penetrate more deeply into the skin. These rays are responsible for contributing to the wrinkling and premature aging of the skin and skin cancer. UVC rays are the strongest form of ultraviolet radiation produced by the sun. They are usually filtered by the ozone layer and do not reach the Earth.

Protecting children against the sun’s radiation

Protection against the sun’s ultraviolet radiation can prevent sunburn, reduce skin damage, and decrease the risk of developing skin cancer. It has been estimated that about 80% of our total lifetime exposure to the sun occurs during the first 18 years of our life. Therefore, sun protection should occur from very early in life to decrease the risk of developing skin cancer. Children should be protected from infancy and should be encouraged to protect themselves from the sun for their entire life.

Several simple precautions have the potential to protect children’s skin against sunburn, skin damage and the development of skin cancer.

• Check the current UV index forecast for your region.
• Reduce your child’s exposure to the sun.
  Plan outdoor activities early or late in the day to avoid peak sunlight hours between 10 a.m. and 4 p.m., when the UVR levels are highest. Stay in the shade as much as possible when outside.
• Dress your child for sun protection.
  Dress your child in protective clothing to cover the upper back, arms, and legs, a hat with a wide brim, and sunglasses. Be sure to cover your child’s upper back when she is swimming.
• Use sunscreen to protect your child’s skin.
  Use a broad-spectrum sunscreen (UVA and UVB) with a sun protection factor (SPF) equal to 15 or higher. Reapply the sunscreen frequently, every one and a half hours, or more frequently if it is sunny or your child is perspiring heavily. Use a water-resistant sunscreen whenever your child is swimming.
• Sun protection is also important in the winter.
  Snow reflects up to 80% of the sun's rays, causing sunburn and damage to uncovered skin. Winter sports in the mountains increase the risk of sun damage due to the increased intensity of the sun’s ultraviolet radiation.

The American Academy of Dermatology recommends teaching children the “ABCs for FUN in the SUN.”

The Canadian Dermatology Association and the Canadian Cancer Society recommend protecting children by putting a barrier between the skin and the sun using the "Slip! Slap! Slop!" approach.

Sun protection is important at any age to protect the skin against the short-term and long-term damaging effects of sunlight. Parents should not only protect their children from infancy but also act as role models so children can acquire attitudes and behaviours that protect their skin against the sun’s ultraviolet radiation.

For more information, please see the page on “Sunburn”  in the AboutKidsHealth A-Z Health Library.

Andrew James MBChB FRACP FRCPC
Chief Medical Editor, AboutKidsHealth

	CATARACTS Thickening of the lens of your eye which eventually causes cloudy vision.

	SYMPTOMS A person’s experience of a sensation or physical effect that could indicate a disease or physical problem.

	NAUSEA The urge to vomit, or bring up the stomach contents through the mouth.

	FEVER A rise in body temperature above normal. "Normal" depends on how you measure your child's body temperature. If you measure by rectum (bum) or by ear, fever means a temperature over 38°C (100.4°F). If you measure by mouth, fever means a temperature over 37.5°C (99.5°F). If you measure in the armpit, fever means a temperature over 37.3°C (99.1°F).

	INFANCY The period from one to 12 months of age.