Skin cancer - children

Skin cancer and children

Protecting a child from the sun’s ultraviolet (UV) radiation reduces their risk of sunburn and skin cancer.

UV damage accumulated during childhood and adolescence is strongly associated with an increased risk of skin cancer in later life. Australia has one of the highest rates of skin cancer in the world.

More than two in 3 Australians will be diagnosed with skin cancer in their lifetime.

Encourage your child or teenager to be SunSmart and use a combination of sun protection measures – slip on sun protective clothing, slop on SPF50+ sunscreen, slap on a broad-brimmed hat, seek shade and slide on sunglasses.

Too much UV can cause sunburn, skin and eye damage, and skin cancer. Infants and toddlers (up to 4 years of age) are particularly vulnerable to skin damage caused by UV radiation. This is because they have lower levels of melanin and a thinner outermost layer of skin.

Around 25% of lifetime sun exposure occurs during a person’s first 2 decades of life. A Queensland study found UV exposure during a person's first 18 years of life was the most critical for cancer-causing skin damage and skin aging. The good news is sun protection can help reduce risk of skin cancer and melanoma at any age, no matter if you are 6, 36 or 60 years young.

UV radiation

We can see sunlight and feel heat (infrared radiation) from the sun, but we cannot see or feel UV radiation from the sun.

UV radiation can reach us directly from the sun. It can also be scattered in the air and reflected off surfaces such as buildings, concrete, sand, water and snow. UV radiation can also pass through light cloud cover.

Don't just wait for hot and sunny days to use sun protection – UV can still be damaging even on cool, or cloudy days. Whenever UV levels reach 3 or higher, use a combination of sun protection measures (hats, clothing, sunscreen, shade and, if practical, sunglasses).

Every day, the Bureau of Meteorology forecasts the sun protection times – the times of day UV levels are forecast to reach 3 or higher. At these levels, sun protection is recommended for all skin types.

In Victoria, UV levels regularly reach 3 or higher from mid-August to the end of April.

Find the daily sun protection times for your location on the free SunSmart Global UV app, online at SunSmart or at the Bureau of Meteorology. There is also a free SunSmart widget available on the SunSmart website.

Check the local daily sun protection times each day and use a combination of the 5 sun protection measures during those times.

5 sun protection measures

During the daily local sun protection times, remember to use a combination of 5 sun protection measures – slip, slop, slap, seek and slide.

1. Slip on covering clothing

Use cool, loose-fitting clothing to cover as much of your child's skin as you can. If possible, choose fabrics with natural fibres. These include cotton, linen and hemp. Lightweight synthetics such as polyester, nylon, Lycra and polypropylene are also recommended. The tighter the fabric structure, whether knitted or woven, the better the sun protection.

2. Slop on SPF50+ broad-spectrum, water-resistant sunscreen

Some tips when using sunscreen with children include:

• Apply sunscreen to any skin not covered by hats or clothing about 20 minutes before going outside.
• From around 3 years of age, encourage children to start applying their own sunscreen (under supervision) to help develop independent skills ready for preschool and school. Try applying a dot of sunscreen to each cheek, nose and chin and squiggles of sunscreen to parts of the arms and legs not covered with clothing and teach children how to apply this carefully to cover the skin.
• Reapply sunscreen every 2 hours or more frequently if swimming and sweating, even if the label states 4-hours water-resistant.
• Never use sunscreen as the only form of sun protection or to prolong the amount of time you or your child spends out in the sun, as it does not offer complete protection.
• Store sunscreen under 30ºC out of direct sunlight and only use sunscreen within the expiry date.

When considering sunscreen for babies, remember:

• A baby's skin is sensitive and can burn easily.
• If babies are kept out of the sun or well protected from UV by clothing, hats and shade, then sunscreen need only be used occasionally on very small areas of a baby’s skin.
• The use of sunscreen on babies under 6 months old is not recommended.
• When using sunscreen, choose one that is suitable for babies such as a sensitive or baby sunscreen. These are just as protective, but much gentler on their skin. Sensitive and baby sunscreens usually use reflecting ingredients such as zinc oxide and avoid ingredients and preservatives that may cause reactions in young skin.
• If you are concerned about reactions to sunscreen, Cancer Council recommends performing a ‘usage test’ before applying a new sunscreen. Put a small amount of the product on your baby’s skin for a few days to check if their skin reacts, before applying it to the rest of their body.
• While the usage test may show whether the skin is sensitive to an ingredient in the sunscreen, it may not always indicate an allergy, as this may also occur after repeated use of the product.
• If you observe any unusual reaction, stop using the sunscreen immediately and seek medical attention for the child.
• Professional assessment and testing by a dermatologist may be useful in identifying the ingredient in the sunscreen that is causing the reaction

3. Slap on a sun protective hat

To help protect the neck, ears, temples, face and nose, children should wear a broad-brimmed, legionnaire or bucket style hat. Remember that:

• Baseball caps and visors are not recommended – they offer little protection to the cheeks, ears and neck.
• Choose a style that can be adjusted at the crown or has a strap with a safety snap to avoid any possible choking hazards.
• Wearing a hat with a brim that shades the eyes can also reduce UV radiation to the eyes by 50%.

Recommended brim width measurements

4. Seek shade

Try to use shade to protect your child whenever possible. Choose shady play spaces or take some shade with you.

For most of the day there is as much scattered and reflected UV as there is direct UV from the sun so even when your child is in the shade, UV can still reach them. It is important that children continue to wear a hat, appropriate clothing and sunscreen in the shade. Remember, as the sun moves around the sky throughout the day, the area protected by your shade will also move – it is important to bear this in mind and move yourself or your shade to ensure you are well protected.

5. Slide on some sunglasses

During sun protection times, you can use a hat and sunglasses to help protect your child’s eyes from UV radiation.

Where practical, children should wear close-fitting, wrap-around sunglasses that cover as much of the eye area as possible. The sunglasses should meet Australian/New Zealand Standard AS/NZS 1067 and preferably be marked EPF (eye protection factor) 10. Optometry Australia recommends using eye protection all year round.

SunSmart role models for children

Children often copy those around them. Research has shown children are more likely to use sun protection measures if the adults around them do too.

Convincing teenagers about sun protection

Although adolescents are usually aware of the dangers of too much sun, they often don't plan ahead or forget to use the 5 sun protection measures.

When reminding your teenager about sun protection:

• Focus on the negative health and beauty effects of sun exposure – such as premature ageing, wrinkles, blotches, freckles or burnt, peeling skin. Teenagers are often very conscious of their appearance, so this may convince them to take precautions.
• Give them a choice – allow your teenager to choose clothing and sunglasses they will be happy to wear and that will provide protection from the sun. Some surf clothing companies produce excellent bucket hats and wrap-around sunglasses that will offer good sun protection and be a style they may be comfortable wearing.
• Remind your teenager to take sunscreen with them when they leave the house. While sunscreen should be used in combination with other measures for best protection, many outdoor venues do not have sufficient shade, and teenagers may be reluctant to wear sun protective clothing and hats. Many young people who get sunburnt report that they forgot to protect themselves – reminding them frequently to pack and apply sunscreen may help.
• Work with your child's school – encourage your school to develop and implement a comprehensive sun protection or UV policy that includes relevant curriculum programs. Cancer Council's SunSmart Schools Program can provide you and your school with the resources and support you need. Contact Cancer Council for information.

Where to get help

• Your GP (doctor)
• Maternal and child health nurse
• Pharmacist
• NURSE-ON-CALL Tel. 1300 606 024 – for expert health information and advice (24 hours, 7 days)
• SunSmart Tel. (03) 9514 6419
• Cancer Council Tel. 13 11 20 – for information and support
• Cancer Council – Support in your own language Tel. 13 14 50