Michael Ramsey, a dermatologist at the Geisinger Medical Center in Danville, Pennsylvania, coaches his son's Little League team these summery days when he's not removing patients' skin cancers.
"The last thing I want is to someday see one of my baseball players as a patient," he remarked recently in The Skin Cancer Foundation Journal.
And so, while encouraging the players to do their best on the field, he also pays close attention to their need to protect themselves from the sun's skin-damaging ultraviolet rays. For he knows all too well that more than 90 percent of all skin cancers are caused by sun exposure; that the risk for a future skin cancer doubles with five or more sunburns; and that while the jury is still out, the risk of future melanoma, the deadliest form of skin cancer, may well be increased by even one blistering sunburn in childhood.
Moreover, while children may find it hard to imagine ever being old (over 50), repeated sun exposure also ages the skin, causing premature wrinkling and a mottled, leathery hide that resembles an elephant's. It may also be hard to impress children with the possibility of cumulative sun damage to their eyes, like cataracts.
Children - as well as their parents and school authorities - have a lot to learn about protection against sun damage. Arrangements should be made in school, for example, for children to apply sunscreen and wear hats at recess. A child's skin is especially vulnerable to the damaging effects of ultraviolet radiation. Most children will have had nearly a quarter of their lifetime exposure to this radiation by age 18, and the resulting damage is compounded repeatedly by subsequent exposure.
I'd be the last person to suggest that children spend the glorious months of summer indoors. I want them out playing actively year-round, and the warm months are ideal for such activities as running through sprinklers, swimming, boating, playing ball, riding bicycles and scooters, playing in sandboxes and on playground equipment, and otherwise having a grand old time being children.
But just as children must be protected against the hazards of traffic and predators, so must they also be protected against the downside of that life-giving force, the sun. Yet a study in Florida in 2001 found that only 33 percent of parents used any form of sun protection for their children, and those who did relied solely on sunscreen, which other studies have found is used incorrectly most of the time.
Some parents worry about a possible deficiency of vitamin D in babies kept out of the sun, since this essential nutrient is produced in skin in the presence of sunlight. But it takes only a few minutes of exposure to ultraviolet light two or three times a week during the summer months to make enough vitamin D to last all year. And child health experts, including the American Academy of Pediatrics, suggest that a safer alternative is to take 200 International Units of vitamin D a day, starting at the age of 2 months, through infant formula, fortified cows' milk or soy milk, or a vitamin. Short of remaining indoors, there are three main approaches to sun protection, regardless of age:
- Wearing clothes that block much of the sun's radiation.
- Applying a complete sunscreen throughout the day every day.
- Staying out of the midday sun and in the shade as much as possible.
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