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Advice for Kids: Stay on the Shady Side of the Street

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Growing up along the Pacific coast of California, Meg Grubb thought nothing of slathering herself with baby oil and frying in the sun, like a fast-food hamburger under a heat lamp.

As she got older, however, she also got wiser and, realizing the harm she was doing to her skin, discontinued the practice. Still, the damage was done, and in 1999 her doctor had to remove a type of skin cancer called a basal cell carcinoma from her face.

Fortunately for the photographer's assistant and mother of three who now lives in San Antonio, there hasn't been a recurrence of the cancer. Yet she continues to see her dermatologist once a year for what she calls a ``full-body scan.'' She's also become adamant that her children won't make the same mistake she did.

They wear sunscreen all the time, year-round,'' Grubb explains.To them, putting on sunscreen is second nature, like washing their hands or brushing their teeth.''

Grubb has reason to be concerned. More than 1 million skin cancers are diagnosed each year, making it the most common form of cancer in the United States. Children are at particular risk.

The sun can be dangerous for everybody, but 80 percent of lifetime sun exposure occurs before age 18,'' says Dr. Patricia A. Burden, a dermatologist in San Antonio.Too much sun at a young age can lead to cancer later on in life.''

Cancer develops when damaging ultraviolet A and B (UVA and UVB) rays from the sun trigger genetic changes in the skin. While these cellular mutations happen all the time, the body's immune system is usually able to clean up the genetic mess. But a young child's underdeveloped immune system may be unable to make the necessary repairs. Children's skin is also very thin and has yet to develop its full complement of melanin, the pigment that gives skin its color and helps protect against the sun's damaging rays.

Although it can take years for a single genetic mutation to develop into cancer, Burden says she's seeing younger and younger patients with the disease.

I recently had one 15-year-old with a melanoma precursor on her back and another with full melanoma,'' she says.That scares me to death.''

Protecting kids from the sun doesn't mean keeping them locked in a darkened room all day, however. Despite the dangers posed by the sun, for example, without it the human body wouldn't be able to produce the vital nutrient vitamin D, once called the ``sunshine vitamin.''

Vitamin D is needed for the absorption of calcium and to build bones. But keeping children out of the sun, and covering them with sunscreen when they are outdoors, can lead to vitamin D deficiency. So the American Academy of Pediatrics recently revised its nutrition guidelines and now recommends that, beginning at 2 months of age and continuing through adolescence, all children should receive 200 IU of vitamin D supplements a day.

Since even a single serious sunburn can double the risk of skin cancer later in life, experts recommend several strategies parents can take to reduce their risk.

Burden, for example, tells parents that children younger than 6 months should never be out in direct sunlight. Even when they're under an umbrella or in the shade, they're still exposed to the sun's rays, which reflect off surfaces such as concrete and water.

One problem area is a young baby's head. ``If they don't have any hair, that'll make it harder to detect a melanoma later, when they do,'' she explains.

Protecting older children can be particularly difficult. During the school year, for example, students are often let outdoors during the part of the day - between 10 a.m. and 4 p.m. - when the sun's rays are strongest. Yet only one state, California, requires schools to allow children to apply sunscreen without a doctor's note. To discourage gang activity, many schools also prohibit students from wearing hats while on school grounds.

The Sun Safety Alliance, a recently formed coalition working to reduce the incidence of skin cancer, would like to see laws passed like those in Australia, which suffers the world's highest skin-cancer rate. As part of a national SunSmart'' educational program, schoolchildren Down Under are not allowed to play outdoors unless they are wearing a wide-brimmed hat. From a young age they're also taught toSlip! Slop! Slap!'' (slip on a shirt, slop on sunscreen and slap on a hat).

``They're starting to see a drop in melanoma cases,'' says Dr. David J. Leffell, professor of dermatology and surgery at the Yale University School of Medicine and medical spokesperson for the alliance.

Experts agree the best way to teach children sun safety is to serve as a good role model. That means slathering on the sunscreen yourself, wearing a hat with at least a 3-inch brim and donning wraparound sunglasses (which block rays that can get around conventional lenses) whenever you go outside. Start early and you'll see the benefits as kids get older.

By the time they're teenagers, kids will only do things that are a habit,'' says Burden.They'll only take sun safety seriously if it's something they've done their whole lives.''

Meg Grubb agrees. ``Even though my kids sometimes grumble about putting on sunscreen, it's to the point where it's almost a no-brainer. They'll usually do it even when they might not feel like it.''


(The San Antonio Express-News web site is at

c.2003 San Antonio Express-News

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