Prather Pediatric and Allergy Center - Ask Doctor Brent

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Title: Problems with the Sun - Two Worrisome Skin Conditions

Category: Child Care


Is sun exposure an important factor to keep in mind when it concerns our children? The American Academy of Pediatrics feels it most definitely is. Even though only fifteen malignant melanomas occur per year in children under ten years old in the United States, the ongoing sun exposure that our children receive over time makes them more likely to have melanoma in later life. A few years ago my 8 year old daughter contracted melanoma and, fortunately, it was caught early enough to be cured by a large biopsy. This proved to me how any child can develop melanoma at any time. Congenital nevi, which are simple moles, can change to melanoma because of prolonged exposure to sun, usually over 30, 40 or even 50 years. We would all do our children a great service by teaching them to protect their skin while in their childhood as well as into their adulthood to prevent this dreaded disease later in life.

The incidence of melanoma has increased 340% in the southeastern United States, largely due to the attitude of people "needing to look tanned to feel healthy". In other words, people thinking they always have to look tanned. The American Academy of Pediatrics and the American Academy of Dermatology are actively involved in trying to change people's attitudes in regard to tanning. This includes not only sun tanning in the regular sunlight, which is full of ultraviolet light, but also tanning under special sun lamps in tanning studios. Simple use of an effective sunscreen, (the higher number the better) goes a long way toward decreasing this risk. This is especially important in high risk groups which include the fair-haired, blue-eyed individuals.

Besides the increase in malignant melanoma, dermatologists have also seen a great increase in basal cell and squamous cell carcinomas. These are also thought to be related to increased tanning because of the western idea of always looking tanned.

There is a debate among both pediatricians and dermatologists as to whether or not to remove large congenital nevi (large brown moles) in children. Most feel the large ones should be removed and any moles greater than 6 millimeters (the size of a pencil eraser) should be either removed by biopsy or at least observed regularly by a dermatologist. If your children have any such moles, consult with your doctor and consider seeing a dermatologist, particularly if the color, texture, or size of the mole changes. Another skin condition which is totally different from melanoma, but which is also linked indirectly with the sun is vitiligo. Strangely enough, I have another child that has this disease. It is a skin disease of unknown etiology or cause. It involves a complete loss of pigment in the skin. Usually these involve spots which are relatively symmetric on both sides of the body. It can involve a few small spots on the trunk and extremities or it can involve large areas of the body and face. It does not appear to be genetic. Fifty percent of patients develop their areas of vitiligo before they are 20 years of age. There are therapies available for vitiligo, including Soralins and UV light and corticosteroid creams but they are not considered very effective and some are potentially dangerous. New research with small skin transplants seems to be encouraging. Cover makeup is probably the safest treatment and is certainly important in any child who has a disfiguring lesion on the face particularly if they are a dark skinned individual. Because vitiligo can rarely be associated with other organ diseases involving the eyes and blood system, a good checkup by your pediatrician and/or dermatologist is warranted. Children with vitiligo are best treated by covering their exposed white skin with sunscreens at all times and avoiding heavy sunlight exposure. Finally, just aging of the skin occurs at a more rapid rate through prolonged sun exposure. The bottom line I believe is to use common sense and enjoy the beautiful sun God blesses us with but not to overdo it. This is particularly important over a long period of time or you and your children may pay the consequences years later. Remember, start using sunscreen on your children as young as infancy and be aware of how much sun exposure they get throughout their childhood.