How to protect children from UV exposure

The understanding of risk from UV exposure is not consistent among all individuals.
There is a belief by some dark-skinned individuals that photoprotection is not essential.
More specific guidance and education about photoprotection are needed especially for children under 18 years old.¹

What about children’s skin?

Solar radiation has more pronounced biologic effects on the skin of children compared to adults. Children’s skin, particularly up to 3 years of age, has a lower concentration of protective melanin and a thinner stratum corneum which allows UV to penetrate deeper, resulting in more photodamage. ^2,3

However, the minimal erythemal dose in children has been shown to be similar to that of adults.⁴

The epidermis of young children is thin; the basal cell layer is relatively rich in stem cells.
UV can easily reach dermal papillae and the dermal capillaries, which may promote photoimmunosuppression and induce mutagenesis⁴

In newborns, the ability to develop pigmentation (tanning) after UV exposure has been demonstrated to occur within the first months (30-45 days) of life.⁵
The increased vulnerability of the skin of children to exposure indicates that children and their parents need to be properly educated on photoprotection, whatever the skin types.

What about UV exposure?

UV exposure during childhood is a critical period for the increase in skin cancer risk later in life.
Having a sunburn during childhood almost doubles the risk for the development of cutaneous melanoma in adulthood.⁶

Children and teenagers spend a mean of 1.5 to 5.1 hours outdoors daily.⁷
Regular use of sunscreen with an SPF of at least 15 during the first 18 years of life can reduce the incidence of basal and squamous cell carcinomas by 78%.¹
By 18 to 20 years of age, everyone will have received 40% to 50% of their cumulative UV exposure up to 60 years of age.⁸

How to protect children from UV exposure?

What about education on photoprotection?

Different ways to educate can be promoted:¹

• Public health campaigns that educate children and their parents/caregivers;
• School programs are key to improve children’s knowledge of photoprotection, modify their perception of the healthiness of a tan and their intentions to seek shade when outdoors. They can also organize activities involving families to encourage sun-safe behaviors at home;
• Age-relevant programs highlighting the deleterious consequences of sun exposure on physical appearance like drama and art that allows active participation, seem to produce better results in terms of changes in attitude and behavior;
• Strategies to educate older children and teenagers may require the use of the Internet and involve specialists trained in youth language with whom children can identify themselves (e.g. My UV Patch app12).

General practitioners and pediatricians are in an excellent position to promote sun protection because they see children and families on a regular basis.
A clear message should be communicated: being attractive and healthy does not mean being tanned, and aesthetic alternatives should be presented.
Education on the side effects of indoor tanning should be done, and restriction of indoor tanning by minors should be enforced (minors aged under 18 years are already banned from tanning salons in several European countries, including France, Germany, and the United Kingdom).¹