Three-year-old Jo-Jo knows a lot about sun safety. And he also knows the danger of not protecting his skin when playing outside. “Mommy got sunburned when she was a little girl, and now she has to go to the ‘dermatopologist’ to get her spots checked,” he explains.

Jo-Jo’s mom, Faith, was diagnosed with malignant melanoma. Because of her history, Faith began teaching Jo-Jo sun safety when he was a toddler. He has learned to wear sunscreen, big hats, and sunglasses when outdoors. By teaching Jo-Jo these habits at such an early age, Faith has made sure that he will grow up sun smart and continue to take care of himself into adulthood.

Good for Faith. The incidences of skin cancer are on the rise in adults as well as in children Jo-Jo’s age. The National Cancer Institute reports that although still rare, pediatric melanoma cases have more than doubled since 1982.

Research shows a link between sunburn in childhood and an increased risk of skin cancer later in life. Research also shows that much of the damage to skin is done in the first 18 years of life. Avoiding sunburn during childhood is very important in reducing this risk.

Even a suntan is harmful to children as tanning is an outward sign to internal skin damage. Approximately 80 percent of skin cancers could be prevented by protecting the skin and eyes from the sun’s rays, so starting toddlers on a lifetime of sun safety habits can decrease their chances of skin cancer as an adult.

Sun safe practices in the childcare setting not only help with sun prevention, but also can instill healthy habits in young children. Toddlers are very susceptible to sun damage because their skin is very sensitive and is still in the process of developing. A bad sunburn in a small child can be very serious and have lifelong consequences.

Regular use of sunscreen during the childhood years can tremendously reduce the risk of skin cancer later in life. The sunscreen product should have an SPF (Sun Protection Factor) rating of at least 15; and the Sun Safety Alliance now recommends sunscreen with SPF of 30+ for children.

It also is suggested to make sure the sunscreen provides both UVA and UVB protection, or offers broad-spectrum protection--it will state this on the label. But because of the sensitive skin of infants and toddlers, sunscreen alone does not provide adequate protection.

The best defense is to keep sun exposure to a minimum. One sure way to avoid sun damage is to “stay in the shade.” Avoid being in the sun during the hottest part of the day; generally 10 a.m.-4 p.m. Play areas in your childcare program should have adequate shade.

Another great way to decrease sun exposure is to have children wear hats that shade the face, ears, and neck. Toddlers should wear shirts and slacks made of tightly woven fabrics that you cannot see through when held up to the light. A tank top and shorts might seem like the perfect outfit for warm weather days but the best clothing actually is to cover more of the skin to protect against the sun’s rays.

The summer months are not the only time to be concerned about sun protection. Sun safety is just as important in the winter months when a toddler’s skin can burn easily from the sun’s rays reflected off the snow. Sand, snow, concrete, and water can reflect as much as half the sun’s rays onto the child’s skin. Cover up on cloudy days, too, as the sun’s rays can be as strong on cloudy, hazy days as on sunny days.

Modeling sun safety to toddlers is important so remember to put on sun screen with the children and wear appropriate sun protective clothing and sun glasses when going outside.

To adequately protect toddlers’ skin, caregivers and parents should practice sun safety. But they should also know the ABCDs of early detection, the key to more successful treatment of skin cancer.

Early detection refers to identifying moles or skin irregularities as early as possible so they can be examined by a professional. The ABCDs of early detection are:

• Asymmetry: One half of the mole looks different from the other half. If it were folded in half, it would not match.
• Border: The border is irregular, or the edges of the mole may be scalloped or uneven.
• Color: The color varies from one area to another in the mole. There may be shades of tan or brown, black or blue.
• Diameter: As a general rule, moles larger than 6mm (the diameter of a pencil eraser) should be checked by a doctor. If you or a child in your care has any of the above symptoms, a doctor’s visit is in order.

In addition to the ABCDs, some doctors think skin cancer may look different in children so they also suggest parents and teachers watch for moles that itch bleed, or do not heal. Parents and caregivers should become familiar with the child’s birthmarks and existing moles so it will be easier to detect changes. Any moles that change in shape or appearance should always be seen by a doctor.

Encourage parents to perform monthly skin checks on toddlers. To perform skin checks, do so after the child has had a bath. Look at the toddler from head to toe, front to back. Look at the child’s scalp underneath the hair. When examining their child, parents should keep in mind the ABCDs of early detection and also watch for any changes in moles.

Since toddlers’ moles may look different from adults, doctors suggest applying the “ugly duckling” method of detection; if one of the child’s moles looks different from all the rest, it should be checked by a doctor.

Practicing sun safety is very important when it comes to protecting the young skin of toddlers. And as caregivers and parents become aware of the ABCDs of early detection and the importance of monthly skin checks, toddlers will be well on their way to healthy skin and healthy living in the sun. Just ask Jo-Jo.

Cynthia D. Sprouse, BA, Professional Development Assistant
Child Care Resource and Referral, Western Kentucky University

American Academy of Dermatology, 1350 I Street NW, Ste. 870, Washington, D.C. 20005-4355; 202-842-3555; www.aad.org

American Cancer Society, 599 Clifton Road, NE, Atlanta, GA 3032, 800-ACS-2345, www.cancer.org

National Cancer Institute, 9000 Rockville Pike, Bethesda MD 20892; 800-4-CANCER: www.nci.nih.gov

Sun Safety Alliance, 413 N. Lee St., Alexandria, VA 22314; 703-837-4202; www.sunsafetyalliance.org

Shade Foundation of America, Virginia G. Piper Cancer Center, 10510 N 92nd St., Ste. 100, Scottsdale AZ 85258; 866-41-SHADE; www.shadefoundation.org

SunSafe Preschool Curriculum
The Curt and Shonda Schilling Melanoma Foundation has available a free sun safety curriculum. Fill out a preschool application on the website to receive the curriculum: www.shadefoundation.org