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.

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