by Joel L. Cohen, MD, Owner of AboutSkin Dermatology and DermSurgery, Aspen Academy parent
As we begin having warmer days, UV avoidance education for young people (and their parents) is as important as ever. The best weapon we have against skin cancer is prevention, and prevention has to start at a young age. Over the past several months, the American Academy of Pediatrics and the US Preventive Services Task Force have affirmed the need for and benefit of UV education for children and adolescents. Hopefully, pediatricians are responding to the publications and across the board maximizing/enhancing/redoubling their efforts to instill healthy behaviors in youngsters.
Dermatologists should also take these recommendations to heart, particularly in light of the data in our literature that confirm the harsh realities of skin cancer among younger people. A recent study, discussed in the last edition (available online at CutaneousOncologyToday.com), found an eight-fold increase in the incidence of melanoma among young women (ages 18-39) and a four-fold increase among young men from 1970 to 2009 (Mayo Clin Proc. 87(4):328-34)—quite possibly attributed to tanning among youths. A recent publication showed that 73.3 percent of females and 38.3 percent of males previously tanned indoors; the median age of initiation for women was 17.0, compared to 21.5 for men (BMC Public Health. 10;12:118). In a study that appeared in JAAD last year, 69 percent of adolescents revealed that they were sunburned in the previous summer, and less than 40 percent practiced sun protection. Indoor tanning was prevalent (65(5 S1):S114-23) among this specific adolescent cohort as well.
We should make a point to discuss UV avoidance with our younger patients and, of course, parents of young children. Another important opportunity is to reach out to schools in the community. I have worked with schools in Colorado to encourage early recess, so that students are not out in the midday sun. Schools should also ask students to bring sunscreen to school and allow time for application or re-application before going outdoors. Because teachers of young children will have to help apply sunscreens, dermatologists may offer to educate these individuals about sun safety and issues of concern, like the very small incidence of allergy to sunscreen ingredients. Requiring parents to supply their own sunscreen for their kids (clearly marked with the student's name with permanent marker) along with a parental permission slip indicating the request for sunscreen before recess (as well, noting the type sent with their child; download a sample at CutaneousOncologyToday.com) highly reduces the likelihood of allergy. Also, teachers should encourage boys and girls to wear hats, and schools should install shade structures. The sun safety message cannot be provided too early or too often. We're making strides in treating skin cancer, but there's no "cure" on the horizon. Building good habits now may be the best way to reverse the alarming trend of increasing skin cancer rates across the US and around the world. Finally, we can also visit schools as educators to teach children about proper skincare, including hand-washing.