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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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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

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!

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.

Daily Dose

Stay Sun Safe

Memorial Day weekend is the unofficial start to summer. Be sun smart all summer long.

With the long Memorial Day weekend here, it is another good time to discuss the importance of using sunscreen. Sunscreen labeling is about to undergo some changes which will probably make it easier for all of us to read labels and understand how to use sunscreen appropriately. The FDA has been working for over a decade on standardizing labels as to the amount of UVA sun protection each sunscreen product provides. UVA rays, are not the ultraviolet rays that lead to sunburn, but they are the rays that contribute to skin cancer and sun related skin aging. Many products have claimed to be waterproof, sweat proof, or even provide all day protection and these labels will no longer be allowed. At the same time labels promising over 50+ protection will also be pass
Daily Dose

Wear Sunscreen During Spring Break!

1.30 to read

Spring break season has begun and many families will be heading to the mountains for skiing or to the beach for some warmer weather.  Either destination requires sun protection, especially for the face. 

I have just returned from skiing with my best friend from medical school days, who is a dermatologist. Whenever we travel together I know that one of her big focuses will be if I am wearing sunscreen and enough of it!!  She was teaching (reprimanding) the teens and young adults on the trip as well, as they needed some sunscreen “re-education”. 

The sun was shining for our entire trip and we had lots of snow, so perfect conditions for great skiing but also for a sunburn. On top of the direct sun, the reflection of the sun off the snow (or the sand at the beach) just adds to the risk for sun damage to the face.   

The best way to protect your face (and this goes for other areas too) is to apply a GENEROUS amount of sunscreen to the face and neck at least 30 minutes before heading outside.  She advocates layering sunscreen as well. By that I mean put on a base of sunscreen and really rub it into the skin. 

If you are using a spray on sunscreen you need to rub it in as well.  I used an SPF of 60 for my face.  Then wait for 10-15 minutes and get those ski clothes on (that takes awhile).  After letting the sunscreen absorb I reapplied another GENEROUS (maybe an ounce) of sunscreen to my face and neck.  What my derm friend told me is that layering a 60 SPF plus a 60 SPF does not make the protection 120 SPF, but it does make it more likely that you are getting better sun protection than one layer alone. Make sure that you are also applying sunscreen to the lips followed by Chapstick or lip balm that also contains sunscreen. 

Now, throw a small tube of sunscreen and lip balm in your pocket so that you can re-apply later on, as you know that you should continue to re-apply if you are spending the day outside. There are also some good sunscreen sticks that are convenient with an SPF of 50 or more. These are great for a parent to use on children off and on during the day. I am a fan of the Neutrogena and Cerave products, as they are hypoallergenic as well. 

Enjoy the break....but be sun smart too. 





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

Winter Skincare & Sun Protection

Your family needs sunscreen and moisturizers during the winter months. Even though winter is upon us in full force, you want to make sure you don’t forget skin care and sun protection. Due to the drier air and the need to turn up the heat, it is important to protect your skin and keep it from drying.  In general, you need to use a gentle bath soap such as Vanicream or Cetaphil during this time of year.

It is not necessary to bath or shower every day in the winter months.  Try bathing your children every other day and see if this might help with some of the dry skin symptoms. Shorter baths and warm rather than hot water will also help prevent dry skin symptoms.  Right after the bath, while the skin is still damp get out a good moisturizer such as Cetaphil, Cerave, Vanicream or Aveeno (some of my favorites) and apply it generously. This method will help increase the absorption of the moisturizer. The dry air and heat also dries other parts of our body including the nose and lips. To protect the lips make sure you use a lip balm that has sunscreen in it with at least SPF 15. Children often lick their lips and have excessive chapping and redness. This is called lip lickers dermatitis.  Mother’s laugh when I tell them this term, as it totally describes the problem.  It is best treated by bringing their “licking habit” to the child’s attention (if they are old enough to understand the problem). Use Chapstick, or Aquaphor, and apply it frequently so that the child is actually licking off the moisturizer rather than the skin. Cover the skin around the lips too if they are licking that area. If it is really inflamed you can use an over the counter steroid to help calm down the redness. Unfortunately, this is a habit that takes a while to break but be consistent with the moisturizer.  I often go reapply the chapstick once a child has gone to bed and the licking has stopped. For outdoor activities you will also need a chapstick or lip balm that contains a sunscreen with an SPF of at least 15 or greater.  For an older child get them their own stick so that they learn to reapply the lip protection throughout the day. Nasal mucosa can also get dry and the skin inside the anterior nares (the part just inside the nostril) may become irritated.  As children often pick and rub at their noses the skin inside the nostril can crack and allow bacteria inside.  To help prevent infection you can buy Polysporin (an over the counter antibiotic cream). Take a little bit of the Polysporin on a q-tip and put it inside each nostril, just inside the tip.  After applying squeeze the nose together to help disperse the antibiotic inside the nose.  It is best to try and do this both morning and night. Bloody noses are also more common in the winter and may be prevented by using a saline nose drop and some aquaphor or Vaseline inside the nose. I also like the brand Ayr Gel. Sunscreen is not only for use in the summer.  Children who are outside in the snow require sun protection too. When travelling to areas with higher altitude and snow it is especially important to protect your children’s skin (and yours too). The reflection of the sun off the snow only makes it more intense, and liberal use of sunscreen to sun exposed areas is necessary. Throw a stick of sunscreen in the parka and reapply sunscreen throughout the day. Use a broad spectrum sunscreen which has both UVA and UVB protection.  Neutrogena makes some excellent ones. Lastly, when you tuck a child in at night a cool mist humidifier in their room may help prevent dry skin and lips. A little moisture added to the dry heat can make a big difference. Try it and let me know if this works for your family!



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