Doctor Q&A Youtube EczemaBlues Channel

AAD A:Z Videos with Dr Thomas Rohrer – How to Treat Sunburn

In 2013, I’ve featured American Academy of Dermatology (AAD)’s Dermatology A: Z Videos (here). Since then, AAD has added several other videos which are informative and practical. AAD’s public relations team has once again been most helpful in introducing me to the dermatologists who assisted with my questions, making it possible to bring this special AAD Dermatology A:Z video series to you!

The video covered today is “How to Treat Sunburn”. For this video, I interviewed Dr. Thomas E. Rohrer, M.D., who is a dermatologic surgeon at SkinCare Physicians, and previously served as the Chief of Dermatologic Surgery at Boston University Medical Center and Boston Veterans Administration Hospital for eight years and as the Director of the Boston University Center for Cosmetic and Laser Surgery. Dr Rohrer is passionate about education and is the editor of six cosmetic and laser surgery textbooks and guest editor of numerous journals.

MarcieMom: Thank you Dr Rohrer for helping us with how to shave last week. This week, we are learning about how to treat sunburn and at the same time, learn about how sunburn affects eczema skin.

In the video, the key points on the treatment of sunburn were covered: (note: AAD has amended the video on Treatment of Sunburn but the contents in this blog post was still based on the previous video which is no longer available on Youtube. The video above features AAD’s updated video)

  1. Get out of the sun
  2. Take cool baths
  3. Pat dry, moisturize while there’s still a layer of water on the skin
  4. Choose creams with aloe vera
  5. Apply hydrocortisone cream to reduce inflammation but do not treat with benzocaine
  6. Take aspirin and ibuprofen
  7. Drink extra water as the sunburn draws water from the skin and rest of the body
  8. If there’re blisters from the sunburn, do not pop them but let them heal
  9. Watch for signs of infection

The way to shower and moisturize looks the same for both sunburned skin and eczema skin – not hot bath, not rubbing dry (but pat dry), trapping more moisture on the skin after shower and moisturizing right after.

In a previous interview with Dr Robin Schaffran, we learnt that ultraviolet light rays penetrate through the epidermis and dermis layers of the skin and damage the DNA in skin cells, collagen and elastin in the dermis.

How to treat sunburn AAD Video with Dr Thomas Rohrer
How to treat sunburn AAD Video with Dr Thomas Rohrer

MarcieMom: Dr Rohrer, what is it about the sunburned skin that makes it important to maximize the retention of skin moisture? What are the factors that affect the recovery of sunburned skin? (for instance, do certain conditions like eczema and psoriasis take longer to recover? Or whether skincare measures are taken after the sunburn?)

Dr Thomas: It is a good idea to try to maximize retention of skin moisture in everyone’s skin.  When the skin is burnt it becomes even more important as there is increased loss of water through the damaged skin. Similarly, with eczema or other conditions that result in dry scaling skin, the increased permeability of the skin makes it more important to keep the skin well moisturized. Keeping the skin moisturized will allow it to function more normally and recover more quickly.

In the video, it seemed that hydrocortisone is applied liberally on the sunburned skin to reduce inflammation. A few questions to provide some guidelines to patients who have access to mild hydrocortisone cream and want to self-treat at home.

Potency – What % of hydrocortisone should the lotion/cream be?

Frequency – How frequent (in a day) can it be applied onto sunburned skin?

Duration – What would be the duration and is there a decreasing frequency of application during this period?

Amount – How much of hydrocortisone can be applied? What is the sunburned skin covers a large skin area?

Dr Rohrer: Hydrocortisone can help reduce inflammation. On the face, no more than the over the counter 1% hydrocortisone should be used.  On other parts of the body a slightly stronger 2.5% formulation may be used.  It is best not to use either more than twice a day and only for a short period of time.  Most of the time only a couple of days are necessary before the burn feels much better.    

MarcieMom: Benzocaine is mentioned not to be used. However, I read on Mayoclinic that benzocaine is used for sunburn and on Pubmed that benzocaine is effective for treating the pain (but not the itch) on sunburned skin. What are the reasons why benzocaine should not be used for sunburn treatment?

Dr Rohrer: While benzocaine preparations do help reduce pain, many people are or become sensitive to it.  We frequently see allergic skin reactions to benzocaine and therefore do not recommend it for use with the majority of patients. 

MarcieMom: Lastly for those with eczema, sun exposure is not recommended during eczema flare-ups.

How does sun exposure affect eczema skin?

Dr Rohrer: Sun exposure and sunburn are not recommended for anyone.  While some people do find that mild sun exposure improves their eczema, it is not recommended as it adds to the cumulative radiation effect of the sun and can lead to skin cancers. 

Thank you Dr Thomas for helping us with treatment of sunburn and clarifying questions we have on self-treating at home. Sun protection is important (see AAD Video on How to Apply Sunscreen with Dr Sonia Badreshia-Bansal MD on this blog).

Youtube EczemaBlues Channel

(Video) Sun Protection for Kids – Sun Good or Bad?

This is the second of baby skincare series, which kickstart last week with Common Baby Rash.  I NEED YOUR SUPPORT, do subscribe to my EczemaBlues channel here. As I’m just starting out, and camera-shy, the video is my voice over slides that I prepared. Do share your comments pleeease on how I can improve them.

Now on sun protection, it is sadly not uncommon to see young babies being strolled into the hot sun and this is definitely NOT recommended as it is bad on so many levels, for the skin and also for the baby’s eyes which let in more harmful UV rays than adult’s.

To start with, the baby’s skin has less pigment cells and thus more vulnerable to the UV rays which penetrate and damage skin cells – resulting in sunburn and possibly, skin cancer over prolonged exposure. It is therefore important to take sun protection measures, and this ‘sunscreen’ tag link provides many expert tips on how to do so, including the choice of physical blockers for sunscreen and ingredients to avoid.

There is also much controversy on the benefit of sun for Vitamin D, BUT only 10-15 minutes is sufficient (the fairer the skin, the less time) and any longer sun exposure beyond that contributes to skin damage. Moreover, those with eczema flare-ups should avoid the sun as it can worsen the skin inflammation. Photo-therapy has to be prescribed (mainly for adults) and not the same as sun-tanning.

Do watch the video for more details and as always, appreciate you sharing your experience, thank you!

Video’s photo credit: photon bomb via Compfight cc

News & Research

Eczema Research News – More Sun and Vitamin D?

Does the Sun help? And is more sun good for eczema child? or bad?
Does the Sun help? And is more sun good for eczema child? or bad?

Today’s topic is on Vitamin D, should we need more Sunshine? Sunshine has been covered in this blog, but mostly to understand whether we need sunscreen (answer is yes!) and what types of sunscreen and how to apply. Tips on sun protection from renowned dermatologists have been shared, such as

Protecting Skin – by Dr Ava Shamban

Common Skin Rash in Children – Sunburn – by Dr Robin Shaffran

AAD Skincare Video for Eczema – by Dr Joshua Zeichner

AAD Skinccare Video – Sunscreen – by Dr Sonia Badreshia-Bansal 

Children Skin Conditions – by Dr Lynn Chiam

There is much talk about whether sun is good for our children with eczema, and there are some companies that recommend Vitamin D products (be it skincare or oral supplement). What we know about the sun and our skin is

  1. A child’s skin is thinner and thus more susceptible to harmful effects of ultraviolet light, such as sunburn and skin cancer.
  2. UV light is required for the skin to synthesize Vitamin D; vitamin D that comes from sunlight has been shown to increase the production of skin proteins (cathelicidin) and antimicrobial peptide (AMP) which protects against skin infection.
  3. For eczema patients, sun exposure is drying for skin and can aggravate eczema, esp. flare-up.

No wonder there is so much controversy on sunshine and vitamin D; in line with this Eczema Research News series, below are the studies from 2013 onward of the efficacy of Vitamin D:

Vitamin D deficiency is associated with atopic dermatitis (eczema) in children, more severe eczema (here, here)

Increased sun exposure during summer holidays associated with reduced eczema, but not related to Vitamin D level (here)

Children living in hot and humid climate have more eczema flare-ups (here), but contradicted with this study

Vitamin D has some protective function for food allergy in infants (here)

What age Vitamin D supplement is given, and in what form (soluble or tablet) may alleviate or worsen allergic diseases – as to which is best is still unknown (here), no conclusive evidence (here)

Updating with study in Nov 2014 – where 186 children were regularly followed up at clinics for a four-year follow-up period. Low cord blood Vit D levels were associated with higher risk of food sensitization throughout childhood. Cord blood Vit D levels were inversely associated with the risk of milk sensitization at age 2, at which age a higher prevalence of milk sensitization was significantly associated with the risk of allergic rhinitis and asthma development at age 4.

Have anyone tried any Vitamin D related treatment? Do share in the comments, thank you!

Doctor Q&A

Rise and Shine Feature – Seminar with Dr Lynn Chiam on Children Skin Conditions

Dr Lynn Chiam Dermatologist Children Skin Conditions Eczema

Dr Lynn Chiam shared during the Rise and Shine Expo on ‘All about Children’s Skin’. She consults at Children & Adult Skin Hair Laser Clinic and subspecializes in pediatric skin conditions. She was formerly the head of pediatric dermatology at National Skin Centre, Singapore. She has also shared her expertise on Teen Eczema, Hand Eczema and Facial Eczema.

Baby Sweaty Hands and Feet

Palmar Hyperhidrosis is the excessive and unpredictable sweating from hands, even when it is not hot or exercising.  This is due to overactive sweat glands. Primary hyperhidrosis refers to the excessive sweating from hands, feet and armpits and affect 2-3 percent of population with genes being a factor. Minimally invasive procedure can be carried out but for children, use of antiperspirant or prescriptions containing aluminium chloride.

Children Body Odour

Children may also experience body odour and it is the bacteria and not the sweat that creates the smell. Avoid tight clothing/foot wear and wash clothes thoroughly.

Children Hair Loss

Alopecia Atreata (Hair Loss) is a type of hair loss due to the immune system attacking the hair follicles (auto-immune condition). For most, the hair will grow back and if so, some opt not to treat the condition. Treatments can be topical corticosteroids, injections containing steroids or immunotherapy.

Sun and Baby Skin

The UV rays can cause sun burn, sun spots, wrinkles, enlargement of blood capillaries and even skin cancer. Particularly for children whose skin is thinner and less protected against UV rays, sun protection measures should always be taken. Avoid direct sunlight from 10am to 4pm, wear shades, hats and appropriate clothing. Also bear in mind that the sand and the sea can also reflect the rays, and thus sitting in a shaded area also requires sun protection.

Sunscreens are divided into chemical absorbers and physical reflectors; chemical absorbers absorbs the light and converts them into harmless rays but these are known to trigger more skin irritation than physical reflectors. Physical reflectors reflect the light off the skin. Be sure to put sufficient amount, one teaspoon on the face and to use one at least SPF30.

Stress and Baby Skin

Stress is also known to trigger skin conditions such as eczema and pimples/acne and therefore parents are encouraged to share stress relaxation techniques such as massage and breathing with their children.

Q&A with Dr Lynn Chiam

Dealing with Drool – Dr Lynn answered a question on dealing with the child’s drool and her tip is to use a wet cloth to dap away the saliva, followed by a dry cloth to dap dry and then moisturize immediately.

Air-conditioning – Children with eczema can sleep in air-conditioned room, bearing in mind that there is no ideal environment as too hot can also trigger eczema. A temperature of 24 to 25 deg C is comfortably cool.

Oil as Moisturizer – Dr Lynn pointed out that oil is not as easily absorbed onto the skin as moisturizer, and thus does less to improve the skin barrier function.

Water as Irritant – Dr Lynn explained that eczema skin is like a crumbling brick wall and prolonged washing can weaken the skin barrier function. Therefore good skincare includes a bathing routine that is not in hot water and not longer than ten minutes.

Steroid cream – Dr Lynn explained that steroid potencies range from 1 to 7, 1 being the strongest and 7 the weakest. There is also new generation topical corticosteroids that have less side effects.

Next week, I’m asking questions for eczema children in relation to what Dr Lynn had shared during the Rise and Shine seminar, and as always, grateful to her for reviewing the above.

Doctor Q&A Youtube EczemaBlues Channel

AAD Skincare Video Series: Sunscreen

Today’s video is “How to Apply Sunscreen – Protect your Skin against Skin Cancer and Premature Aging‘. For this video, I interviewed Dr. Sonia Badreshia-Bansal MD, who is the CEO and medical director of Elite MD. Dr Badreshia-Bansal is a board certified dermatologist trained at the prestigious Penn State, College of Medicine and the Milton S. Hershey Medical Center, where she served as Chief Resident.

Sunscreen Sun Protection Dr Sonia Bansal AAD video
  1. Face Washing 101
  2. How to Get the Most from Your Skincare Products
  3. Eczema Tips: How to Help your Child Feel Better
  4. How to Apply Sunscreen

MarcieMom: Thank you Dr Sonia for helping with this AAD Skincare series. No matter what the season is, sunscreen should be applied, even during winter.

For children with active eczema on the neck, forehead and face, is sunscreen recommended?

Dr Sonia: Sunscreen is recommended on all skin types daily in those  over the age of 6 months.

Application of Sunscreen on Eczema Skin

MarcieMom: What is the procedure for applying moisturizing and sunscreen for a child with eczema, going for a swim? What is the recommendation for after a swim? (considering preventing chlorine irritation, trapping moisture, yet wanting the benefits of chlorine to kill staph bacteria that frequently colonizes eczema skin)

Dr Sonia: A thick moisturizing cream should be used first, followed by sunscreen 30 min prior to going outside and swimming. After a swim, take a shower to get the chlorine which can further dry out the skin to produce eczema. Reapply thick moisturizer to lock in moisture.

Sunscreen for Child vs Adult

MarcieMom: What is the difference between a sunscreen for a child and that for an adult? Is it possible for a child to use an adult’s and for the adult to use the child’s?

Dr Sonia: Both can be used interchangeably. Look for a broad spectrum, SPF 30 sunscreen. I also recommend looking for zinc oxide or titanium dioxide, which will be less irritating than the chemical based sunscreens.

Sun Protection on Child’s Lips

MarcieMom: In the video it is also mentioned about protecting lips. Is that necessary for a child?

Dr Sonia: Lips may also sunburn. Preventing sunburns will prevent skin cancers, including the lip. All sun exposed areas should be protected, including lips.

MarcieMom: Thank you Dr Sonia for helping with my questions, and it has been an enriching month learning the AAD dermatology videos!

Doctor Q&A Eczema Tips Youtube EczemaBlues Channel

AAD Skincare Video Series: Skincare for Eczema

How to Get the Most from Skincare Products with Dr Joshua Zeichner AAD Video

Today’s video is “How to get the most from your Skincare Products“. For this video, I’ve interviewed Dr Joshua Zeichner, M.D., who is the Director of Cosmetic and Clinical Research in Dermatology, Mount Sinai Medical Center in New York and board-certified in Dermatology. He is Board Certified in Dermatology and considered one of the country’s key opinion leaders in treating acne and rosacea.

  1. Face Washing 101
  2. How to Get the Most from Your Skincare Products
  3. Eczema Tips: How to Help your Child Feel Better
  4. How to Apply Sunscreen

MarcieMom: Dr Zeichner, thank you for taking time to help with this AAD video series. 

Cross-Reactivity in Beauty & Skincare Products

For individuals with sensitive skin using multiple products, say facial cleanser, moisturizer and make-up, is there any guideline to ensure that there is no cross-reactive ingredient? e.g. choosing the same brand or ensuring that each does not have certain ingredient?

Dr Joshua: If you are sensitive to skin care products, your dermatologist can perform patch testing, an exam to determine what ingredients you may be allergic to.  You should avoid products with those particular ingredients.  Unfortunately, you cannot necessarily just stick to one brand because individual products do vary in their composition.  However, some brands in general do stick to being fragrance free, etc.

Medication or Moisturizer – Which to Apply First?

MarcieMom: It is recommended to wash the face first, followed by medication, then moisturizer or sunscreen, followed by make-up. What is the interval between applying moisturizer and sunscreen? Does the moisturizer have to dry before applying sunscreen? 

Dr Joshua: We do not have great data on this.  We do not really know if it is best to moisturize or medicate first.  In general, I recommend applying one product in a thin layer, allowing it to dry for about 60 seconds, then applying the next layer.  If you apply too much cream it may take longer to dry.

Does sunscreen have moisturizing effect and therefore, can skip applying moisturizer? 

Dr Joshua: Only if you are specifically using a facial moisturizer with sunscreen. Straight sunscreens for the beach are not designed to be moisturizers.

Common Irritants for Children Eczema Skin

MarcieMom: What are the ingredients that frequently irritate a child’s sensitive/eczema skin?

Dr Joshua: Usually fragrances and preservatives

MarcieMom: Thank you Dr Joshua for your reply, I’d be sure to remember applying moisturizer even when I’d be applying sunscreen for my child with eczema, and thankfully, we found skincare products that don’t irritate her eczema skin.

Doctor Q&A

Common Summer Skin Rashes in Kids Series: Sunburn

This is a 3-week series with Dr. Robin Schaffran, M.D., a caring mom and Pediatric Dermatologist. She is a board-certified Dermatologist and attending staff physician at Cedars Sinai Medical Center. She attended the University of Toronto Medical School where she graduated as a member of the Alpha-Omega-Alpha Honors Medical Society.

Common Summer Children Skin Rashes with Dr Robin Schaffran Pediatric Dermatologist

Sun and Child’s Skin

MarcieMom: Finally, there’s sun everyday and it is a great season to have family activities outdoors. We know that the ultraviolet rays damage the skin, and have seen images whereby a middle-aged twin who likes to suntan looks visibly years older than one who doesn’t. I also understand that skin damaged by the sun, is not only more prone to skin cancer but loses some ability to heal itself.

Can you explain to us how the sun interacts with the child’s skin?

For instance, which layer of skin does it penetrate? Does the sun have some function, for instance, synthesis of Vitamin D? Does sun exposure also carry risk?

Dr Robin: Ultraviolet light are rays from the sun that penetrate through the epidermis and dermis layers of the skin and do damage at all levels. Ultraviolet light damages DNA in skin cells  in the epidermis and damages collagen and elastin in the dermis. Ultraviolet light is necessary for the skin to synthesize Vitamin D. And yes we know that too much sun exposure carries risk of skin cancer and premature aging later in life.

Should Child Eczema Skin have Sun Exposure?

For a child with eczema, should he/she have fewer hours under the sun? How does the sun interact differently on eczema skin?

Dr Robin: A child with eczema does not need fewer hours under the sun than other children. If anything, ultraviolet light has some benefit for eczema skin and is often used to treat recalcitrant eczema. However, the side effects of ultraviolet light (i.e. premature aging of the skin and skin cancer) make this a less desirable treatment.

What to do if your Child get Sunburn?

A child may get sunburn, and the appearance of the skin may differ at various times after being outdoors, generally from pinkish to turning burned the next day. There are also instances that warrant calling the doctor, for instance, an infant’s skin (below a year old) turning pink may require a check with the doctor or when there are signs of blisters, swelling, infection, fever or extreme pain in an older child.

MarcieMom: Dr Robin, how would a parent recognize that the child’s skin is burned, and what is happening to the skin?

Under what circumstances would you recommend them to see a doctor?

Dr Robin: The first signs of a burn are usually redness of the skin. A sunburn is like a burn from any other cause. The skin is injured/ burned by the ultraviolet light (specifically UVB rays). The severity of the burn is based on how deep the burn is. If it’s a deeper injury it usually results in blistering and will likely need medical attention to help with wound care.

Will the appearance of sunburn look different for a child with eczema?

Dr Robin: A sunburn looks the same regardless of eczema skin or not.

MarcieMom: How should sunburn be treated at home? I’ve also read that thick ointment will prevent heat from escaping, and best to use lotion instead to prevent peeling. Why is this so and does it mean that a child with eczema should use only lotion to moisturize before sunburn recovers?

Dr Robin: A sunburn is best treated with soothing lotions such as aloe vera, cool compresses or cool baths. Anti-inflammatory medication such as ibuprofen can also be helpful. Thick ointments such as Aquaphor are best for skin healing and do not prevent heat from escaping.

What Sun Protection Tips For Your Kid?

Apart from not going to the sun during the hottest time of the day, there are sun protection measures such as applying sunscreen, wearing hat, sunglass and light long sleeve shirt and pants.

For a child, what sunscreen lotion would you recommend?

Eg. Sunscreen ingredients – physical reflectors, SPF. Also what would be the common wrong way to wear sunscreen and the right way to do it?

Dr Robin: For children, I recommend mineral based, chemical-free sunscreens that include either zinc oxide and/or titanium dioxide as the active ingredients. These are considered to be physical blockers of the ultraviolet rays. The right way to wear sunscreen is to apply a lot of it and rub it all over so all exposed body surfaces are covered and to remember to reapply after 2 hours of being outside or after swimming or sweating.

MarcieMom: For protection when in contact with water, say at the pool or sea, what would be the additional or different sun protection measures? Does water reflect more light onto the skin (despite feeling cool in it)?

Dr Robin: When in contact with water, protection is the same, ie. Liberally use sunscreen and remember to reapply after emerging from the water. It’s best to use a water resistant sunscreen when in the water. Water does reflect more rays onto the skin so there is more exposure when in the water.

MarcieMom: Thank you Dr Robin for taking time to help protect our child from sun eg sunscreen, something I know you are deeply passionate about. Next week, we will be discussing heat rash.

Guest Interview

What I’ve learnt from Dr Ava Shamban’s Channel – Protecting Skin

Dr AVA MD’s Channel

Been watching Dr Ava Shamban’s Channel – a series of youtube videos relating to skincare. Dr. Ava Shamban–a renowned board-certified dermatologist licensed to practice medicine in California, New York and Hawaii–graduated magna cum laude from Harvard University before receiving her medical degree from Case Western Reserve Medical School. In addition to serving as Assistant Clinical Professor of Dermatology at the UCLA-Geffen School of Medicine, she is recognized as the “Extreme Makeover” dermatologist and the resident expert on the Emmy winning daytime talk show, “The Doctors.” Dr. Shamban is also author of the new book, Heal Your Skin: The Breakthrough Plan for Renewal (Wiley)

Dr. Ava on How Exercise Benefits Skin
Exercise can increase circulation, thereby increasing nutrients to the skin and reducing toxins. Cortisol, produced by adrenal gland, will also be reduced (cortisol lowers immune system). Any exercise that can be carried out on daily/ every other day basis is good!
Dr Ava on How to Avoid Stress that Causes Acne
Stress can manifest both internally and externally, on the skin. Stress, increases cortisol, which is viewed as a male-like hormone (androgen) and increases acne. To de-stress, relax and nap. A combination of rest and exercise is always beneficial.
See also my post here on stress on children with eczema.
Dr Ava on How to Buy Quality Skincare at the Drugstore
The skincare products suited for you may not necessarily be the most expensive; label-reading is important (which is why I’ve started the Sensitive Skin Products series with VMVHypoallergenics). Make sure that the active ingredient is in the first five ingredients and the product is fragrance-free. In Dr Ava’s words ‘If you want to use perfume, use perfume; but not on your face’.
Dr Ava on How to Choose the Right Sunscreen and SPF?
Choose a high SPF especially at least SPF50 on higher altitude. Choose one that is not too oily or greasy and comfortable to use (with make-up). If doing sports, need a water-proof or resistant one. Sunscreen on the face is formulated differently with that on the body.
Sun-protection is discussed and Dr Ava’s recommendation is to have a high SPF sunscreen, wide-brimmed hat and wear sun-protective clothing (there’s even for babies with SPF 50 rating). Choose physical sunscreen that’s safer for children (you can see this post for more info). For face, a non-comedogenic lotion with SPF can also be used. There’re also certain foods that can help increase SPF, mainly red/purple fruits such as pomegranate, carrots, watermelons, blueberry and raspberry!
Eczema Tips

Block Sun, Irritate Skin of Eczema Child?

Wearing a Hat also blocks the Sun (and also my hubby)

That’s something that parents seem to be very worried about and have reason to be as sunscreen lotion does contain several ingredients that are potential irritants. My baby Marcie uses Cetaphil and so far, it has worked well. But I have to confess that apart from applying before swimming, I don’t use the sunblock lotion since her eczema is triggered by heat so we’re seldom in the sun. Still, I did some research online and summarized for those of you who are looking into sunscreen lotion.

What’s UVA, UVB and SPF?

UVA rays can penetrate the skin and causes skin damage and aging; UVB, on the other hand, can cause sunburn. The lower the SPF number, the less protection against the UVB rays. Children should use at least SPF30 (SPF 30-59 is considered high) due to their delicate skin. SPF 30 means about 97% of the UVB rays are blocked. For babies, SPF 40 and above is recommended, though babies below six months should not even be in direct sun.

How to Protect from the Sun?

Apart from applying sunblock, your child can also wear a hat, thin but tightly woven white cotton, sunglass and use his/her favourite umbrella! Avoid going out from 11am to 4pm, where the rays are strongest.

What Sunscreen Lotion to get?

Sunscreen lotion are generally divided into two types – those that are chemical absorbers and those that are physical reflectors. Chemical absorbers penetrate the skin more and are more likely to irritate than physical reflectors, which reflect the UV rays from the skin. Physical reflectors are usually titanium dioxide/zinc dioxide based and the drawback is that they leave a white sheen on the skin (nano particles technology can reduce this white sheen but reported to increase risk of cancer; in particular, avoid spray-on and stick to cream/lotion).

Also, stick to what you’d normally look out for in moisturizers fragrance-free, preservative-free, lanolin-free, propylene glycol-free, PABA-free (para-aminobenzoic acid not only stains clothing but requires an alcohol vehicle to work), suitable for sensitive skin, hypo-allergenic, avoid ingredients like methyldibromoglutaronitrile, quaternium 15, benzophenones, oxybenzone, octinoxate, dibenzoylmethanes, mexoryl, retinylpalmitate, salicylates, octocrylene and cinnamates (I’m not sure if you can find one sunscreen lotion without any of these ingredients; the ones I listed first are what seem to be the more allergic ones).

How to apply Sunscreen Lotion?

First, test on a small part of the body, preferably inside of the arm. Wait for 24 hours to watch for any allergic reaction.

2013 update: Read my interview with Sonia Badreshia-Bansal MD (in collaboration with American Academy of Dermatology) on sunscreen.

2013 update: Read my interview with Dr Robin Schaffran on sunburn in this common summer skin rashes for kids series.

2014 update: Watch (or listen) to my Youtube slideshow on sun protection for kids.

2015 update: Read my interview with Dr Thomas Rohrer (in collaboration with American Academy of Dermatology) on how to treat sunburn.

2015 update: Skin (fun) facts! What’s the difference between normal, eczema and baby skin with regard to sun protection, find out here.

If no issue with the lotion, apply moisturizer as per normal for your eczema child. 30 minutes later, apply sunscreen lotion. 20 minutes later, can go into the sun. Subsequently, apply every 2 hours particularly if contact with water or the child perspires a lot (even if the lotion says it’s water-proof). Apply even if in water as the cooling effect of water does not mean no sunburn. Lastly, make sure the sunscreen lotion hasn’t expired!