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Daily Dose

Moles On A Child's Skin

1:30 to read

Everybody gets moles, even people who use sunscreen routinely. Moles can occur on any area of the body from the scalp, to the face, chest, arms, legs, groin and even between fingers and toes and the bottom of the feet.  So, not all moles are related to sun exposure.

Many people inherit the tendency to have moles and may have a family history of melanoma (cancer), so it is important to know your family history. People with certain skins types, especially fair skin, as well as those people who spend a great deal of time outside whether for work or pleasure may be more likely to develop dangerous moles. Children may be born with a mole (congenital) or often develop a mole in early childhood. It is common for children to continue to get moles throughout their childhood and adolescence and even into adulthood.

The most important issue surrounding moles is to be observant for changes in the shape, color, or size of your mole. Look especially at moles that have irregular shapes, jagged borders, uneven color within the same mole, and redness in a mole. I begin checking children’s moles at their early check ups and look for any moles that I want parents to continue to be watching and to be aware of. I note all moles on my chart so I know each year which ones I want to pay attention to, especially moles in the scalp, on fingers and toes and in areas that are not routinely examined. A parent may even check their child’s moles every several months too and pay particular attention to any of the more unusual moles. Be aware that a malignant mole may often be flat, rather than the raised larger mole. Freckles are also common in children and are usually found on the face and nose, the chest, upper back and arms. Freckles tend to be lighter than moles, and cluster. If you are not sure ask your doctor.

Sun exposure plays a role in the development of melanoma and skin cancer, so it is imperative that your child is sun smart. That includes wearing a hat and sunscreen, as well as the newer protective clothing that is available at many stores. I would also have your child avoid the midday sun and wear a hat. Early awareness of sun protection will hopefully establish good habits and continue throughout your child’s life.

That’s your daily dose, we’ll chat again tomorrow. Send your question to Dr. Sue!

Your Child

Protecting Your Child From Harmful Sun Rays

2:00

With longer daylight hours and summer knocking at the door, it’s only natural that kids will be spending more time outside in the sun.  With skin cancers on the rise in young people, many parents are concerned about their children getting too much sun exposure.

Parents may be worried, but teens and younger kids often think skin cancer is something that only happens to older adults. But the facts tell a different story.

Melanoma (the most dangerous type of skin cancer) is one of the most common cancers in young adults, especially young women, according to the American Cancer Society (ACS). It’s the leading cause of cancer death in women ages 25 to 30, according to the Melanoma Research Foundation and since the 1970s, cases of melanoma have increased by 250% in children and young adults, according to a 2011 study.

Skin cancers take time to develop. Just a few serious sunburns can increase your child’s risk of skin cancer later in life. Kids don’t have to be at the pool, beach, or on vacation to get too much sun.

Knowing the facts about skin cancer doesn’t mean that your child can’t play or spend time outside, but by following a few simple sun-protection rules kids can still have fun enjoying the great outdoors.

Sunscreen: The number one protection from sunburn and skin damage is sunscreen. An SPF, or sun protection factor, indicates a sunscreen's effectiveness at preventing sunburn. "If your child's skin reddens in 10 minutes without sunscreen, SPF 15 multiplies that time (10 minutes) by 15, meaning she'd be protected from sunburn for approximately 150 minutes or 2 1/2 hours," says Sancy Leachman, M.D., Ph.D., director of the Melanoma and Cutaneous Oncology Program at the University of Utah's Huntsman Cancer Institute in Salt Lake City.

This all depends on good application, so make sure your child’s skin is evenly covered. The American Academy of Pediatrics (AAP) recommends using sunscreens with at least an SPF of 15, which blocks 93 percent of UVB rays. Higher SPFs provide even greater protection, but only to a certain point: SPF 30 blocks 97 percent of UVB and SPF 50+ (the maximum SPF you'll find on sunscreen labels due to new Food and Drug Administration (FDA) rules) blocks 98 percent.

Shade: UV rays are strongest and most harmful during midday. If your child is outside during this time, if possible- seek shade under a tree, an umbrella or pop-up tent,

Cover up: When possible wear lightweight long sleeves and pants. Clothes made from tightly woven fabric offer the best protection. A wet T-shirt offers much less UV protection than a dry one, and darker colors may offer more protection than lighter colors. Some clothing certified under international standards comes with information on its ultraviolet protection factor.

Sunglasses: They protect your child’s eyes from UV rays, which can lead to cataracts later in life. Look for sunglasses that wrap around and block as close to 100% of both UVA and UVB rays as possible.

Wear a hat: The trend in wearing baseball or gimme caps is actually working out in favor of protecting kids’ faces and heads from UV rays. While the caps are helpful, they don’t protect necks and ears, so make sure these areas have plenty of sunscreen as well as the face.

Sunny days are not the only time kids need skin protection. UV rays, not the temperature, do the damage. Clouds do not block UV rays, they filter them—and sometimes only slightly.

And, remember to plan ahead, and keep sun protection handy—in your car, bag, or child’s backpack.

Story sources: https://www.cdc.gov/cancer/skin/basic_info/children.htm

Jeannette Moninger, http://www.parents.com/kids/safety/outdoor/sun-care-basics/

Daily Dose

Spring Break Essentials

1.30 to read

Winter is quietly receding and for many spring break is here or in sight!  I only wish that I still had a spring break but with everyone grown up, spring break is no longer on my calendar. But for those of you lucky enough to be traveling, you may want to pack a few key items.

Bug spray:  If the beach or an exotic tropical locale is your destination you will need to pack bug spray. Interestingly, insect repellent products are not regulated by the FDA, but rather by the EPA. The ingredients in bug sprays, that are registered with EPA for use on the skin include: DEET, picaridin, oil of lemon eucalyptus, oil of citronella, and IR3535.

DEET is the most commonly available insect repellent that is used in the U.S. DEET products are available in different concentrations ranging from 6% - 98%. It is generally accepted that the higher the concentration of DEET the longer the duration of protection.  Some studies have suggested that the duration of protection from DEET may plateau at a concentration of 50%. I would start with a lower concentration product depending on how long my exposure was planned to be.

There are definitely differences among mosquito species as well,  some really are more aggressive than others. DEET effectiveness may also be compromised by higher temperatures, amount of perspiration,humidity, wind speed and swimming. The AAP also states that DEET products may be used in children as young as 2 months of age.

Picaridin is also an effective non-DEET insect repellent and my be found in products with varying concentrations from 7% - 20%, and again the duration of protection increases with higher concentrations of picaridin.

Sunscreen:  Whether you are heading to the mountains for skiing and snow activities or the beach you need to pack sunscreen. Ultraviolet light is composed of both UVA and UVB rays.  UVA causes phototoxicity and aging and UVB produces sunburns. They can both produces changes to DNA and cause skin cancer.

Sunscreens containing several ingredients which together are capable of absorbing both UVA and UVB rays are called broad spectrum and are preferred. Think of SPF really as “sunburn protection factor” as it really only refers to UVB protection.

To date the FDA has not regulated a product’s ability to protect from UVA rays, new guidelines may be forthcoming. I would look for a product that is labeled “broad spectrum” with a SPF of at least 15 (and at least 30 SPF for the face). Sunscreen should be applied 30 minutes before sun exposure and that it should be reapplied every 2 -4 hours while in the sun. Remember there are UV rays even on cloudy days!! (hard to convince a teen of that.

If you need both bug and sun protection apply the sunscreen first and let it be absorbed, then apply the insect repellent. Do not use a product that contains both as you do not need to reapply bug spray like you do sunscreen. 

Safe travels!  

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Daily Dose

Break Out The Sunscreen!

1:15 to read

As the temperatures continue to warm up across the country and everyone is spending more time outdoors, it is time to break out the sunscreen.  The majority of a child’s sun exposure (somewhere between 50 – 80%) occurs before the age of 20.

Sun exposure is directly related to the risk of melanoma, and melanoma is on the rise in youth.  To prevent sunburn damage it is imperative that parents begin using sunscreen on their children at very young ages, even younger than 6 months. Sunscreen needs to be applied about 15 minutes before your child heads out to play, swim or any outdoor activity.  Sunscreen should then be re-applied at least every 2 hours, and more often if a child is swimming or perspiring.  An ounce of sunscreen is about the amount necessary to cover a child for a single application.

There are two types of ultraviolet rays.  UVA rays which penetrate more deeply into the skin causing damage to the DNA which subsequently leads to wrinkles, aging and skin cancer.  UVB rays penetrate the first layer of the skin and typically are the rays that cause sunburn.  There are 20 times more UVA rays in the environment than UVB.  Therefore, you need to look for a sunscreen product with both UVA and UVB protection. It is also good to look for a sunscreen that will provide a physical block like zinc oxide (now micronized so it is transparent on the skin) or titanium oxide.  These blocks help scatter the UV light and are typically less irritating and less allergenic than chemical sunscreens. These products may be preferable in young children, and remember you can use sunscreen on children under 6 months of age if they are going to be sun exposed.

Chemical sunscreens contain compounds that abosorb some of the sun’s damaging rays, including PABA, cinnamates, Parsol and helioplex. Many parents with infants are concerned about using sunscreen.  Both the American Academy of Pediatrics and the American Academy of Dermatology state that sunscreen may be used on infants, but preferably an infant will not be exposed to the sun for any extended period of time.  An infant’s skin contains less melanin and therefore is even quicker to burn.. Children should also wear sun-protective clothing that is now readily available at chains like Target and Walmart, and is available in all different sizes. Infants should also wear a hat.  Putting an infant under an umbrella does not provide complete sun protection either as the sun’s rays may penetrate through an umbrella or awning.

The use of a good sunscreen with frequent re-application will make your child sun-smart and prevent those burns that we know are a major cause of later skin cancers. That's your daily dose for today. We'll chat again tomorrow. Send your question to Dr. Sue right now! Check the UV Index in your neighborhood here

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sun smart

Protect Your Skin All Summer!

Your Teen

Tanning Beds & Teens

Many teens want that sun-kissed glow before the prom, but it comes at a price. Tanning beds are far worse than the sun...Many teens want that sun-kissed glow before the prom, but it comes at a price. Tanning beds are far worse than the sun at causing skin cancer. Dermatologists say the major wavelength found in a tanning salon is the most carcinogenic (cancer-causing) wavelength in the ultraviolet spectrum. Indoor tanning will dramatically increase a child’s odds of getting melanoma, the worst type of skin cancer.

A growing number of states are now requiring teens to get their parent’s permission before they can switch on the tanning bed. Advice to parents? Many experts recommend keeping your children away from the tanning salons and don’t give in because “it’s a special occasion like the prom.” The American Cancer Society recommends applying sunscreen at least 20 minutes before going outdoors and re-apply every 2 hours. The American Cancer Society also recommends performing a skin check on your children to make sure birthmarks, moles or blemishes have not changed in appearance. Check with your pediatrician if you have any questions.

Daily Dose

White Patches On The Skin

During the summer months I get frequent phone calls or an occasional office visit, with the chief complaint being, my child has white patches on their faceDuring the summer months I get frequent phone calls or an occasional office visit, with the chief complaint being, “my child has white patches” on their face. I even remember someone calling my attention to my own son’s white patches when he was a little boy playing baseball and another mother was concerned that he had ringworm all over his face and might be contagious to all of the other players!!

The most common reason for these white patches is a condition called pityriasis alba, which really just means scaly, white patch. Pityriaisis alba is in many ways similar to mild eczema. It usually affects children, typically between the ages of three to 13. These light patches are usually pronounced during the summer months as the skin becomes tan and these areas do not tan. They appear as light colored patches that then blend in to the normal tanned skin, and are more ill defined than ringworm and do not have the typical border of a fungal skin infection. When looked at closely they may even have very fine skin flakes as the condition is related to dry skin. Although it typically occurs on the face you can see it on the upper arms or neck. The child is totally asymptomatic, and may often have several patches on their cute faces. The treatment is simply to moisturize the skin with something like Eucerin or Aquaphor or any other moisturizer. But even with moisturizer, the white patches will remain through the summer and early fall until a child’s tan has faded. If the moisturizing routine is continued during the winter and spring months the areas will miraculously re-pigment with a summer tan the following summer. Speaking of tans, this is a good time to remember to use sunscreen and re-apply frequently. Sunscreen will also help to moisturize the skin. We still have lots of sunny days ahead of us and don’t want to neglect sunscreen, even when sending your children back to school. That’s your daily dose, we’ll chat again tomorrow. Send your question to Dr. Sue!

Daily Dose

Summer Series: How to Treat a Sunburn

Seeing that we have discussed sunburn and its prevention, this unfortunately brings us to the topic of "what to do if you forgot the sunscreen and are now dealing with a sunburn?"Seeing that we have discussed sunburn and its prevention, this unfortunately brings us to the topic of  "what to do if you forgot the sunscreen and are now dealing with a sunburn?"  Sunburn is no fun for anyone and can cause significant problems. A sunburn by definition is an "acute inflammatory reaction that follows excessive exposure to ultraviolet radiation."  In other words it is not a thermal burn, but an ultraviolet burn.

Sunburns may cause first-degree burns, when a child's skin turns pink and red and is uncomfortable, and itchy. Sunburn may also cause second-degree burns where the burn penetrates the dermis and causes blistering and a deeper burn and more cell damage. With blistering may come scarring and also an increased risk of skin cancer and skin damage later in their lifetime. Repetitive sunburns are cumulative and put a child at even more risk for melanoma. Recurrent sunburns are often seen on the nose, ears, chest, and shoulders. Symptoms of sunburn often don't begin until 2-4 hours after the damage has begun. Redness will be the first symptom and may progress over the next 12 -24 hours with further pain, swelling and blistering. Some children will even develop nausea, fever, vomiting or dizziness after a significant sunburn and are at risk for dehydration. Treatment of sunburn includes moisturization to cool the skin and reduce inflammation. This may also include taking cool baths or applying cool, wet cloths to the sunburned area. A product called Domeboro is also soothing when added to the bath or to cloths that you soak in the solution. Push fluids orally to replace fluid losses. Giving your child a pain reliever like Tylenol or Motrin/Advil to help with discomfort may be beneficial. Some children also respond to an oral antihistamine to help with itching. Do NOT let your child back in the sun until their symptoms are improved and even then they should wear sun protective clothing as well as sunscreen. Remember, you can even get a burn in the shade, or under an umbrella or on a cloudy day. Most of us heard that from our own mother's but unfortunately did not believe it until we ourselves had experienced a sunburn. That's your daily dose, we'll chat again tomorrow. Send your question or comment to Dr. Sue! Check the UV Index in your neighborhood here

Daily Dose

Why All Kids Need Sunscreen

Unfortunately, I have already seen several rather severe sunburns on children who had forgotten to use sunscreen and came in with blistered shoulders or noses and ears.It certainly felt like summer in Texas today. Most of our schools are out and children are already heading to the pool. Unfortunately, I have already seen several rather severe sunburns on children who had forgotten to use sunscreen and came in with blistered shoulders or noses and ears. The majority of our sun exposure occurs before the age of 20, somewhere between 50 - 80 % is the number often quoted. Sun exposure is directly related to the risk of melanoma, and melanoma is on the rise in youth.

To prevent sunburn damage it is imperative that parents begin using sunscreen on their children at very young ages, even younger than 6 months. Sunscreen needs to be applied about 15 minutes before your child heads out to the park to play or to swim or for any outdoor activity, and re-applied at least every 2 hours, and more often if swimming or perspiring. An ounce of sunscreen is about the amount necessary to coat a child each time it is applied. There are two types of ultraviolet rays, UVA rays which penetrate more deeply into the skin damaging DNA, which leads to wrinkles, aging and skin cancer. UVB rays which penetrate the first layer of the skin and typically causes sunburn. There are 20 times more UVA rays in the environment than UVB. So, look for a sunscreen product with both UVA and UVB protection. It is good to also look for a sunscreen that will provide a physical block like a zinc oxide (now micronized so it is transparent on the skin) or titanium oxide. These blocks help scatter the UV light and are typically less irritating and less allergenic than chemical sunscreens. These products may be preferable in young children, and remember you can use sunscreen on children under six months if they will be sun-exposed. Chemical sunscreens contain compounds that absorb some the sun's damaging rays, including PABA, cinnamates, Parsol, and helioplex. I have had lots of questions about sunscreen in infants and the AAP and AAD all state that sunscreen may be used on infants, but that preferably an infant is not in the sun for lengthy exposure. Their skin contains less melanin and therefore is even quicker to burn. If you are taking your infant out, have them wear a hat, sun-protective clothing and put sunscreen on sun-exposed areas. Do not rely on an umbrella for complete sun protection either, as the rays can penetrate through an umbrella or awning. Better to keep the your-baby inside than on the beach for an extended period of time. That's your daily dose, we'll chat again tomorrow.

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DR SUE'S DAILY DOSE

No tech summer: enjoy the outdoors!

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