Everyone is at risk of the harmful effects of the sun. Effects can include sunburns, unsightly dark spots, accelerated skin aging, and skin cancer. Children are especially at risk because the younger they are, their skin is more sensitive.
Did you know that most sun damage to the skin occurs in childhood? That is why sun protection with sunscreen and other sun-protective measures must be done all year-round starting in infancy!
There is no doubt that sun protection is important. But if you ever spent 5 minutes in the sunscreen section of a store, you know that it is easy to be overwhelmed by the variety of sunscreens to choose from. In this article, I will explain everything from when to use sunscreen to which one to get for the kids.
Can babies use sunscreen?
Depending on their age, some babies can start using sunscreen. You may have seen baby sunscreen and wondered when is it safe to start using them.
Shade is the best sunscreen for babies under 6 months
Babies under 6 months of age should not use sunscreen on their skin. That includes sunscreen that is marketed for babies. The only sun protection that we know is safe for babies under 6 months is keeping them away from the rays of the sun. There are many ways to do that.
When outdoors, move your baby to a shaded area like under an umbrella, a tree canopy or even a stroller canopy cover. Protective clothing also helps cover as much skin as plausible from the rays of the sun.
What if there is no shade? Can sunscreen harm a baby?
If you find it impossible to get any shade for the baby, and you are afraid they are going to get a sunburn, you may have to use some sunscreen. The American Academy of Pediatrics tells us it is acceptable to use a minimal amount of sunscreen on a baby under 6 months to prevent a burn if there is no other way to avoid the sun. Make sure the sunscreen you apply is at least SPF 15.
Things you have to know about sunscreens
Bottles of sunscreen have many technical words to describe the product. Here are the terms you need to know.
Difference between UVA and UVB
Apart from visible light, the sun also produces ultraviolet radiation, which is a type of energy that cannot be seen with the naked eye. These ultraviolet rays can have negative effects on human skin.
Aside from sunburns, dark skin spots, and wrinkles, ultraviolet radiation can contribute to skin cancer. In fact, since 2009 the World Health Organization has classified ultraviolet radiation as a human carcinogen (cancer-causing).
- Ultraviolet radiation A (UVA) is mostly responsible for sunburn
- Ultraviolet radiation B (UVB) is associated with aging of the skin (wrinkles, fine lines, dark spots, darkening of acne hyperpigmentation, and other skin discoloration issues)
- Both UVA and UVB contribute to forming skin cancer.
Physical sunscreens are also known as mineral sunscreens. These products reflect the sun rays away from the skin. They include ingredients such as Zinc Oxide and Titanium Dioxide. These start working soon after you put them on. Physical (mineral) sunscreens protect against both UVA and UVB.
Chemical sunscreens are organic or chemical barriers that will form a film over human skin to absorb ultraviolet radiation, then disperse it as heat to the surroundings. Many chemical sunscreens only protect against UVB. Few chemical sunscreen ingredients like Oxybenzone protect against both UVA and UVB.
These sunscreens have the advantage of not causing a white cast on the skin. Chemical filter sunscreens need to be applied at least 20 to 30 minutes before sun exposure because they don’t start working as soon as you put them on.
Some people with sensitive skin may react with skin irritation when they apply some of the filters in these chemical sunscreens. It’s almost impossible to predict who is going to react with skin irritation to which ingredient. The chance of getting irritated is higher when the product is applied to naturally sensitive areas, like the lips or around the eyes.
Broad Spectrum Sunscreen
The American Academy of Pediatrics recommends choosing a sunscreen that protects both against the UVA and UVB rays. This is often labeled and “broad spectrum” sunscreens. Broad spectrum coverage can be achieved by physical (mineral) sunscreens, some mineral, and combined-type sunscreens.
How much SPF do children need?
SPF stands for sun protection factor, or the ability to protect from sunburn. In the United States, SPF is used as a measure of UVB protection alone. The way to know if your sunscreen protects against UVA is if it explicitly says that it is a broad spectrum sunscreen with both UVA and UVB action. American sunscreens do not label how much UVA protection the products offer.
The American Academy of Pediatrics recommends SPF 15 or above. SPF 30 blocks 97% of UVB, and SPF 50 blocks 98% of UVB. As you can see, the UVB blocking ability does not increase a lot as the SPF number goes up above a certain point.
Is SPF 50+ worth it?
I personally would recommend opting for the higher SPF numbers, of at least 30 to 50. Anything above that it’s hard to justify but does come with at a more expensive price.
Later I will go over the amount of sunscreen that is necessary to get skin protection. But I can tell you now that most people don’t put on enough sunscreen. Most people will spread it very thin so it isn’t visible or too sticky. By spreading it very thin, it is possible that you are not achieving the SPF printed on the bottle. Some dermatologists propose that the higher SPF sunscreens (above SPF 50) may help counter the thinner application that people apply in real life.
When to use sunscreen
All children above 6 months of age should routinely wear sunscreen when they are going to be exposed to the rays of the sun. This includes playing outside, walking outside intermittently, going to the pool or beach, walking to school, etc.
You do not need to put sunscreen on children at night. Sunscreen must be reapplied every 2 hours of sun exposure, even if you did not sweat or got wet. These general rules also apply to teens and adults.
Do people with darker skin color need to use sunscreen?
I often hear people comment that since they have darker skin tones, they do not need to wear sunscreen. Sometimes, they might say, that they don’t need sunscreen because they don’t burn. All of that is not true.
Even if people of darker skin tones might not get sunburnt as easily as very pale people do, they still need to wear sunscreen. If you recall from above, the idea of sunscreen is not only to protect you from sunburns (which can happen in all color skin tones!), but also, to protect the skin from dark spots, wrinkles, and most importantly, from skin cancer.
Most people do not apply enough sunscreen
Now that we have reviewed when to apply sunscreen, it’s important to review how to do it. Several studies have shown that most people only apply 50% or less of the recommended amount of sunscreen. The recommended amount to apply at a time is the necessary amount to reach the SPF number printer on the bottle.
An adult of average size requires about 1 ounce of sunscreen to cover all the sun-exposed areas of the body. This amount is about the size of a golf ball. In the case of children, there is no set amount of sunscreen that will be applicable to all kids of all sizes. In general, kids should aim to use as much sunscreen as they can fit in the child’s cupped hand.
How much sunscreen does a baby need?
For babies younger than six months, as said before shade is the best sun protection. If a shaded area is not available, sunscreen should be only used in a small amount on sun-exposed areas. Be careful with applying sunscreen around the eye area. If sunscreen gets into your baby’s eyes, wipe their eyes with a clean damp cloth.
What to look for in a sunscreen
The sunscreen aisle can be a world on their own. These days, there are so many sunscreen options to choose from. Here’s a guide to navigating the sunscreen labels and manufacturer claims.
- Choose a fragrance-free sunscreen: like any product that is applied to the skin, choosing the fragrance-free version will reduce the chance of developing irritation to the product. This includes natural fragrances, which can irritate some children’s skin as well. You will want to look for the words “fragrance-free” specifically, or you can read the ingredients list and discard anything that includes “fragrance (parfum)”.
- Go for colorless sunscreen: like fragrance, dyes are another ingredient that makes the product look cute (e.g. light pink), but does not really play a role in sun protection. If you can avoid dyes, you are decreasing the chance of exposing to potentially irritating ingredients that may make your child not be able to tolerate that particular sunscreen.
- Choose a product with at least SPF 15, but SPF 30 to 50 will be your best bet. SPF 30 to 50 may be able to compensate with sun protection for areas where you may have applied the product too thin. SPF above 50 is still not proven to be better at protecting from the sun but is more expensive. Generally, going over SPF 50 is not warranted.
- Broad spectrum: choose a sunscreen that protects against both UVA and UVB rays. Some products will label this fact as being “broad spectrum”, but some may say only that they protect against UVA and UVB.
Are sunscreen ingredients safe?
Sunscreen ingredients have received a lot of media attention recently. Concerns have been raised about the ingredients causing hormonal effects or even skin cancer. The research we have so far does not show such a link.
According to the American Academy of Dermatology, there are no studies that show that suggests that any of the FDA-approved ingredients in sunscreens cause any significant health problems in humans. Also, the high risk of skin cancer from sun exposure is way bigger than the proposed theoretical risks from sunscreen ingredients.
Do sunscreen sprays work?
There are many formulations of sunscreen including the traditional creams, but also sprays, sticks, etc. The spray formulation tends to spark curiosity because of the apparent ease of application. Spray sunscreens, however, pose the risk of inhalation of product in the child and those around them when you use the spray. Most if not all spray sunscreens will also require you to rub them to spread the coverage to all the sun-exposed areas. The perceived benefit of ease of use is really not there, and it is not worth the inhalation risk.
Aside from the inhalation risk, spray sunscreen also lends itself for a lot of waste, where you are spraying product onto the surroundings that never make it to the skin. Not only will you waste valuable product by spraying, but also the coverage that you get can be very uneven and variable at best.
As for the stick formulation, there is nothing wrong with them perse. They do entail some more effort in the application process, where you would be expected to rub that stick onto every inch of sun-exposed skin of the child. It is far easier and more cost-effective to use the cream/lotion formula.
When to use “sports” sunscreen?
You will notice some sunscreens with the label “sports”. This means that they have been formulated to provide some water resistance in the case of sports in water, but also when used for recreational swimming. You may also see the label “water resistant”. This kind of sunscreen formulation can also help keep the product on the skin when you are expecting activities that will cause a lot of sweating.
Water resistance can vary among different sunscreen products that are labeled “sport” or “water resistant”. Check the label to see how many minutes they resist water. Typically, these sunscreens will vary from 40 to 80 minutes of water resistance.
These sunscreens will need to be reapplied before the 2-hour mark if they are of continued use onto wet skin (as per the minutes indicated by the label). They also need to be reapplied sooner if the skin is towel-dried before the time is up, but sun exposure is expected to continue.
Can you use Zinc Oxide diaper cream as sunscreen?
Some people have noticed that the active ingredient in some diaper creams, zinc oxide, is the same as the active ingredient in some physical sunscreen products. You cannot substitute one for the other. The other ingredients in the formulations help the zinc oxide have the sun protection effect. I’m all for using a product for multi purposes when possible, but this is one is a no-go!
Do babies need to use baby sunscreen specifically?
Sunscreen that is marketed for babies or for people with sensitive skin tends to be free of fragrance and dyes like I recommended above. They do not have special ingredients that make them exclusive for the marketed population. Anyone can use sensitive skin/baby sunscreen as long as it meets the broad spectrum coverage and has enough SPF.
That said, babies don’t have to use exclusively sunscreen that is marketed for babies. Babies older than 6 months can any sunscreen that is fragrance and dye free, and that has enough SPF and broad spectrum UV protection.
Baby sunscreen can be used at any age
I, however, tend to prefer “baby sunscreen” because the ingredients tend to be cleaner, simpler, and gentler. These sunscreens are generally very well tolerated by most skins including people with sensitive skins. For that reason, I think baby sunscreen and sunscreen labeled for sensitive skin is a great place to start with for anyone. You will eliminate many bad candidates when you look only at baby sunscreen.
You still have to look at the label and the ingredients to make sure it is free of perfumes and dyes, that it has UVA and UVB protection, and enough SPF.
Baby sunscreen for kids with
Many times sunscreen will be marketed towards people with sensitive skin or for babies as mentioned above, but not many companies will outright label their sunscreen eczema-safe. Eczema is a skin condition that can be easily irritated by many ingredients that we often apply to skin.
Patients with eczema (and their families!) have been trained to avoid hygiene products with fragrances since these tend to be one very common trigger of eczema flare-ups. Eczema patients will probably already be savvy in keeping their skin hydrated. The same concepts will apply when looking for sunscreen.
Sunscreen that is marketed towards baby can be a good choice for people with eczema because they tend to be free of irritants including fragrance. Some baby sunscreens also have colloidal oatmeal, which is an awesome ingredient to keep skin moisturized like kids with eczema need.
What to do if your child’s skin gets irritated by sunscreen
As with anything that is put on the skin, a sunscreen product may cause irritation the skin. It is very hard to predict what our bodies will react to in terms of anything foreign that we apply, whether it is natural or synthetic. It can also be hard to pinpoint which ingredient from the sunscreen caused the problem.
I advise you to switch to a sunscreen with a short and simple list of ingredients without bells and whistles. You can use the tips I mentioned about in the “How to choose a sunscreen section”, or one from my recommendations below. If you already are using a formulation meant for sensitive skin, which is fragrance-free (including NO natural fragrances), I encourage you to try a different brand of sunscreen that follows the same basic principles I went over in this article. Sunscreens that use zinc oxide and/or titanium dioxide as the only active ingredient(s) are far less likely to cause irritation.
If a rash appears on your child’s skin, seek evaluation from your child’s pediatrician. After everything is cleared up, sunscreen will still be indicated, but you will likely have to try a different one.
Other sun protection tips
- The strongest sun rays are between 10 am and 4 pm. If possible you should try to avoid the sun completely during these hours. If not possible, always wear sunscreen. Even if the day is cloudy, sun protection must be used.
- Avoid sunburns and tanning beds
- Wear sunglasses that block ultraviolet rays
- Wear wide-brimmed hats or cap with a brim that provides shade to the face
- Reapply sunscreen every 2 hours of sun exposure.
- Keep young babies (under 6 months) away from the sun and tucked in the shade. Also, protect them with clothing and hats. Use sunscreen only if sun exposure is unavoidable.
- Do not use products that combine DEET or picaridin bug repellent with sunscreen. Remember that sunscreen has to be reapplied every two hours but insect repellent does not. Combination products will lead to either over applying repellent or under applying sunscreen.
Pediatrician recommended sunscreen for kids
I will include links to the products for your convenience, some of which may be affiliate links (more info). These products I have either tried myself or recommended to my patients with great results. They all have stellar reviews, although no product will be 100% perfect for 100% of people because everyone’s skin is unique.
More excellent sunscreen recommendations:
- Neutrogena Pure & Free Baby SPF 50 Lotion, Tear-Free Fragrance-Free
- La Roche-Posay Anthelios Kids Gentle Face and Body Sunscreen Lotion SPF 60
- Vanicream Sunscreen, SPF 50+
What is UPF (Ultraviolet Protection Factor) in clothing?
In addition to SPF in sunscreen, I have also mentioned a couple of times in this article the use of sun -protective clothing. Sun protective clothing is that which covers the skin to protect it from the rays of the sun.
The more tightly woven the fabric is, the more likely it is to protect against the sun. A rough estimate is to look at a light source through the fabric to see how much light you see coming through. That will give you an estimate of how tightly woven the fabric is.
A more objective way to measuring how much sun protection you get from clothes is the UPF or ultraviolet protection factor. This number is like SPF but for clothes. Some clothing companies that focus on sun protection will include UPF number on their clothes.
Recommended sun-protective clothing
Here are some recommendations of sun protective clothing and accessories for children.
I will include links to the products for your convenience, some of which may be affiliate links (more info).
- Sun Exposure. Melissa Long. Pediatrics in Review Sep 2017, 38 (9) 446-447
- Wendy Allen-Rhoades, Sarah B. Whittle, Nino Rainusso. Pediatric Solid Tumors in Children and Adolescents: An OverviewPediatrics in Review Sep 2018, 39 (9) 444-453.
- Maida P. Galvez, Sophie J. Balk. Environmental Risks to Children: Prioritizing Health Messages in Pediatric Practice. Pediatrics in Review Jun 2017, 38 (6) 263-279.
- The Surgeon General’s Call to Action to Prevent Skin Cancer. US Department of Health and Human Services. Washington, DC: Office of the Surgeon General; 2014.
- Ultraviolet Radiation: A Hazard to Children and Adolescents. Council on Environmental Health and Section on Dermatology, American Academy of Pediatrics. Pediatrics. 2011;127(3)
- CDC: How can I protect my children from the sun
- CDC: Sun Safety Tips for Families
- CDC: Sun Safety