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Pediatricians group updates policy statement to stress sun safety

Dr. Cohen
Elk Grove Village, Ill. — Dermatologists welcome a recently updated policy statement from the American Academy of Pediatrics (AAP) that adds new information about sunscreen ingredients, vitamin D and the dangers of tanning for teens.

Pediatricians are well-positioned to deliver the message of sun safety long before most patients require a dermatologist, the policy's lead author says.

Published in February, the statement updates the AAP's UV guidelines in effect since 1999, says Sophie J. Balk, M.D., attending pediatrician, The Children's Hospital at Montefiore Medical Center, Bronx, N.Y., and professor of clinical pediatrics, Albert Einstein College of Medicine.

The message is one that dermatologists endorse.

In many cases, schools don't have an official policy on sun protection, says Denver dermatologist Joel Cohen, M.D.

"One key point of the AAP guidelines — and what I have been working on with schools and the Colorado Board of Health — is encouraging early recesses, thereby avoiding peak midday sun hours (Council on Environmental Health, Section on Dermatology, Balk SJ. Pediatrics. 2011;127(3):588-597. Epub 2011 Feb 28. Review)," he says.

Dr. Fusco
School officials also should ask parents to select appropriate sunscreens and send them with their children, Dr. Cohen says. With younger kids for whom teachers must apply sunscreen, he adds, instructions should be specific; for instance, "Please apply before recess, and reapply if there's another recess."

Educators may worry about allergies to sunscreens or sunscreen ingredients, Dr. Cohen says.

"That's why it's important for parents to use permission slips specifying what sunscreen their kid is supposed to use, and actually send the sunscreen with the child," with the child's name written on the product in permanent marker, he says.

Although schools bar children from wearing hats indoors, Dr. Cohen adds, "It's critical that preschools and elementary schools encourage kids to wear hats for recess and outdoor activities. For older kids, schools should encourage wearing hats and sunglasses on athletic fields."

He and the AAP also encourage use of shade structures over areas such as jungle gyms or other places where children congregate. Similarly, in 2010 the American Academy of Dermatology's Shade Structure Program awarded nearly $300,000 for construction of permanent shade structures for outdoor areas.

At the very least, Dr. Cohen says, playground designs should spare existing trees wherever possible.

Manhattan, N.Y., dermatologist Francesca Fusco, M.D., says the AAP's policy mirrors guidelines from the Skin Cancer Foundation. She says pediatricians play an important role in teaching and reinforcing the appropriate recommendations regarding sun protection.

"Skin cancer prevention is indeed a lifelong effort," she says.

However, Dr. Balk notes that as pediatricians, "We have many things that we need to talk to parents about," such as children's development and diets.

"We generally don't have much time to do that," she says. "But we're trying to get pediatricians to discuss sun protection regularly, hopefully once a year." By the time a child is referred to a dermatologist for a suspected melanoma, she says, "It may be too late."

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