The Sun, a star full of beauty, energy and adored throughout the whole History what does it hide? How does it influence our children’s? Is Sun health? Is it necessary for our newborn children? How much “Sun” can be considered as healthy?
When our children are born, they have a season-ticket for biological points as we have our driving license. As we expose them to the Sun, they are losing these points. As time goes by, as it happens with our driving licenses, if they do not have important infractions they gain points. But, where do they lose these points? Playing in the Sun, in the swimming pool, in the beach, in the court of the school, having the bronze-coloured tan that makes them so handsome and with so healthy aspect according to the beauty cannons.
The Sun is a source of energy, a lamp that issues light of all “colors” (frequencies), included “colors” that our eyes are not capable to see. Among the “colors” that have more energy, we must state the so called Ultraviolet (UVs) ones. The invisible Ultraviolet colour one is not the one that gives more heat and its quantity can be important in the fresh days or when it is cloudy, but its color has the sufficient energy to produce chemical alterations in our body. One of them is the oxidation of a substance of the skin called melanin that supplies us with this dark color of skin so wished in summer. But others alterations produced are changes in the biochemistry of our cells, reducing these “biological points” about which we were speaking before; they predispose us or even they provoke serious diseases once we lose them.
What happens when these points get lost? Well, it is an analogy and it is not mathematical, it depends on many factors, but yes, we can be sure that we will have increased tragically the risk of contracting cancer.
It is long time ago that the scientific community is clear on this point. Apart from very specific cases about which we will speak later, the ultraviolet radiation, or what is the same thing, the exposure to the sun, is synonymous of high risk of skin cancer and of others as that of lip. We can establish parallelisms with tobacco, which is consumed during the adult life under our individual right, and we expose our children to the smoke. Or probably we do the healthy thing and decide not to smoke, and do not allow that our children are exposed in early age to the smoke, avoiding the high risk it entails.
Concerning the Sun we become more permissive, probably because we associate the activities outdoors like healthy ones, the absorption of vitamin D as necessary and wealth-producing, and esthetically the bronze-colored skin is an added value. Doing the things this way, the ultraviolet radiation (UV) comes, which throughout years of studies has been proof to increase the risk of many pathologies, fundamentally cutaneous and especially, for its importance, of the skin cancer. The relationship becomes more intense the smaller the exposed child is.
As we ban tobacco in minors, we must consider to carry out a drastic control to the exposure of UV radiation for minors and an educational base and of control in teenagers.
Types of UV radiation:
The radiations UVs provoke harmful effects, for their photochemical power, and they change according to the length of wave, the intensity and the time of exposure. There are three basic types (classified by its energy):
· UVA, which affects basically the dermis, altering its vascularization and the collagenous fabric; they induce reactions of photosensibility and dehydration, leaving a slightly elastic and dry skin, of aged aspect.
· UVB with actions melanogenic and erythemagenic. Their power of penetration allows them to alter the cellular DNA, so they are the principal carcinogenic. Its incidence increases immediately after the decrease of the layer of ozone ·
· UVC, has germicide and erythemagenic power. They provoke desquamation, which eliminates the protective layers that still have melanin, and in addition they are carcinogenic. They do not get into the atmosphere.
Basic injuries due to UV radiation
· Solar Eritema: its slight form is the reddening of the skin. It begins after 2-6 hours after the exposure, its intensity in maxim after 12-24 hours and it disappears after 4-7 days with the desquamation. The UV radiation does not produce heat so it can produce serious burns even without excessive environmental heat. Fundamentally it is the UVB beams the ones that produce the burns.
· Cutaneous premature Aging: The frequent exhibition for years causes an important damage which becomes a premature aging of the skin. The UVA radiation causes fewer sharp damages, but as penetrating deeper in the skin, the molecular damages caused to DNA are more intense. Indeed, this nice suntan got in every season provokes wrinkles and that our skin becomes older.
· Skin cancer: it is one of the most frequent diseases worldwide, supposing up to 10 % of all the cancers. There are several types: the basocellulare carcinoma, the squamous and the cutaneous malignant melanoma.
· Eyes Injuries, keratitis and keratoconjunctivitis, and it has an influence on the development of cataracts and ocular melanoma. The use of due approved sunglasses becomes indispensable even for babies who are exposed to the sun, no matter how ridiculous this practice looks like.
· It is also known that it alters the skin immunitary barrier, decreasing its efficiency for modifying the activity and distributions of the cells in charge. This is why the number and re-activation of lips herpes increases, for example.
Factors on which the risk depends:
The risk is associated both to the duration of the exposure and to the intensity with which the radiation is received.
The level of radiation changes according to the geographical location and the season of the year; apart from atmospheric factors, the hour and more local factors as the reflection (the sand in the beach reflects up to 20 % of the radiation, the snow 80 %). In the web of the Spanish Agency of Meteorology (http://www.aemet.es) we can find daily information and given regarding the geographical zones of the Index of Radiation UV (IUV), which is an agreed by consensus indicator throughout the world of the intensity, indicating the danger to produce injuries in the skin.
The worst hours and geographical zones to be exposed are those where the Sun enters more perpendicular to the surface of the Earth. In Spain the worst hours are from 12:00 to 16:00, and the more in the southern the area is the more radiation we can find. In general we must bear in mind that the worse hours are that ones when our “shade” is smaller since we will have the Sun on our heads and the quantity of ultraviolet radiation is major and more harmful.
Another factor that has an influence on the possibility of development of pathologies is the phototype of skin. There are skins more resistant than others, we all know that. The difference is in the aptitude to activate the preexisting melanina, generating different answers in front of the solar exposure. It is important to identify in what phototype we and our children are in order to get a suitable protection. Six prototypes are established:
· Phototype I, of very white skin with freckles, normally red-haired. They always burn easily, being able to be very intense, and they never get a tan.
· Phototype II, white skin, normally clear eyes, which burns easily, it also can be intense it tans minimally.
· Phototype III, white skin, with minimal brown tonality. It includes the Caucasian people. It can burn, even in a moderated way and it can manage to tan gradually.
· Phototype IV, brown more or less intense tone, it is a more Mediterranean phototype, with possibility of some burn, and it always gets a tan.
· Phototype V, of dark enough skin, which rarely burns and gets an intense tan.
· Phototype the VI, black skin of intense tonality, which never burns.
Besides this, it is necessary to know that the age in which we expose ourselves more to the Sun determines our development of injuries. Our children’s skin still is immature. The number of hours of Sun accumulated in the skin of children and teenagers, and the intensity and frequency of the burns is linked to the probability of development of skin cancer.
Benefits of solar radiation
Not everything is bad in the UV radiation. There exist medical beneficial indications of the ultraviolet radiation, but they are used in certain clinical situations and under strict medical control. They are in use for treating pathologies as the vitiligo or the psoriasis.
Also for the correction of the jaundice in the newborn child. In addition, it is known by everybody that the low doses of UV radiation are essential for the development and strengthening of the musculoskeletal system, since it is necessary for the activation of the vitamin D.
The World Health Organization (WHO) gives us a few general advices for the protection of the solar radiation and the prevention of the associated pathologies. Though it is necessary to add that the prevention of the problems for the heat excess in summer time are also important. Certainly, we must make every effort taken care in case of our children.
· To avoid the exhibition in the central hours of the day, in Spain even from 11 a.m. to 18 o’clock.
· To get used to stay in the shade.
· After the bath, to dry off our skin well, since the water amplifies the intensity of the radiation on the skin.
· To use protective clothing, in our head, and much better if you protect from the radiation your face and your neck.
· To use sunglasses, much better if they are closed and do not allow the entry of light without filter from the sides and that assures complete protection against the A and B ultraviolet radiations.
· In the areas of our skin that are not covered by clothes, creams with high solar filter of wide spectrum Factor of Solar protection should be used minimal (FPS) of 15, depending on the phototype and age. To minor ages and clear phototype (I or the II) the FPS must be of at least 30. It is necessary to be used again every 2 hours and after each bath drying the skin thoroughly.
· To avoid the Cabins of Ultraviolet: WHO says to us that the use of these devices before 35 years of age is linked to an increase of 75 % of the risk of malignant melanoma. The cabins and the tanning lamps should not be used unless it is under medical supervision. The use is banned in the 18-year-old minors. Unfortunately in Spain crisis stopped very much the putting in force the Royal decree 1002/2002.
· To protect the babies and the small children: it is always necessary to keep the children in the shade.
· A fresh environment is much better:
- To play, to sleep or to coexist, the ideal thing is to use the freshest room in the house. Avoid rooms with ceilings made with material characteristics enlargers of the heat (plastic, crystal …)
- If you use the air conditioning, the temperature must be enough to avoid the heat, not in order that it is cold.
- Be careful with the sudden changes of temperature; babies and the small children have a lesser capacity of adjustment to the above mentioned changes.
- Give the baby or child a shower or a bath several times a day, if it is necessary.
- Avoid the excess of clothing and the closed rooms and exposed to the sun, without air conditioning such as cars or camping tents.
- If the car is parked under the sun, remember to open the doors and windows before the child comes into the car. You should wait until the temperature inside the vehicle gets lower.
- The humid towels also help to refresh the skin.
· What to give to children for drinking and eating:
- Up to 12 months, it is enough to drink near 1 liter of water a day, which is present in the mother’s milk, in juices, fruits and vegetables.
· If your baby is less than 6 months old and he or she is fed with the mother’s milk, he or she has no need of water. In case of high environmental heat or losses of liquids because of diarrhea or vomits, increasing the number of times we give them liquid will be enough. One thing is important: the mother must have a good hydration.
· If your baby feeds exclusively on milk prepared in baby bottle, remember not to alter the relation between the water and the number of doses of powder, as the manufacturer advises. In this case you can give him/her water (boiled or in bottle) in the time between the different ingestions of milk. When it is hot, the baby bottles must be prepared just before the consumption.
- From one year on, increase the ingestion of liquids, preferably water, up to almost 3 liters, and natural juices.
- Increase the consumption of fruits and vegetables and avoid copious meals and meals rich in fats as well as the very sugary drinks.
- Increase moderated and transitorily the salt.
Symptoms and treatments of the overexposure to the Sun
It is one of the most frequent and despised symptoms in children and adults. The exposure for hours to the Sun not only does weaken with suntan lotions. Especially if we are developing a physical activity, the loss of liquid can be very important, and only with the bath is enough to allow us to recover. It is very important to take care of the ingestion of liquids much more often than usual and drink until our wishes of liquid disappear, since this can be a slightly trustworthy indicator. If the dehydration is high it can be treated with oral saline solution or isotonic drinks; if it is extreme, and it is accompanied by other symptoms, the patint can need medical assistance.
- Sunstroke / heat blow.
Also very frequent in minors and sometimes it is difficult to detect. It is accompanied and multiplied by the dehydration. It is revealed from minutes until hours after the exhibition to the Sun. Among the symptoms there are alterations of behavior and dream between the smallest, nauseas, motion sicknesses, headache and low pressure. If we divide it in stadiums: Cramps or pulls (for activity under the Sun and descent of electrolytes), sunstroke, collapse and finally heat blow that entail a multi-organic failure.
Children are more vulnerable to the excess of environmental heat because their weight is lesser, they produce less sweat than the adults, reasons why their corporal temperature rises faster and they adapt worse to the high temperatures.
The best tool is the prevention, in case it happens, fighting the dehydration with water ingestion; some thermic-regulator can be taken as well (paracetamol, for example). Consult with a pharmacist in slight cases and request medical help in extreme cases.
- Solar burns.
Many familiar routines in summer, though it can seem incredible, begin for the first burn in July and the retreat of the dead skin. The erythema or reddening sometimes cannot be estimated up to past a time of the exposure (between 2 to 6 hours). Especially when we bath we lose the references of Sun’s quantity, which meets reflected by the water, apart from losing the possible solar protection that we have taken. The treatment is similar to that one used in any burn. Consult with a pharmacist (there are products to soften the reddening) or medical assistance in extreme cases. It is essential to avoid the exposure during the extreme hours and, in general, in the shade, and to use often high factor solar protection (it depends on the phototype and age) after each bath or once out of two hours.
After all of this, we probably think that we spoil our children regarding this matter, but studies that the Spanish Association against the Cancer (AECC) has carried out during the latest years in our country say that statistically as our children grow up, we are relaxing this supervision. Solar protection is used less, only we do it when the Sun is warming more intensely and with factor of minor protection. And in addition we are leaving aside the use of other most effective measures of protection, such as clothes, glasses and to protect ourselves in the shade.
In our country, the major solar exhibition is in summer, during the holidays, and the most frequent destination is the beach, and provided that in this time of the year we do perceive a major risk, we use more measures of protection. But the measures should be extended not only during our holidays, but also throughout all the activities that we practice with our children outdoors, be daily in summer or holidays and it is necessary to bear in mind that our children keep on being very sensitive to the radiation and to the heat, in spite of the fact that they grow so fastly.
It is essential to take care of every point in the licence of our children’s skin.
Practicing the given advices on our children, stimulating and taking care of the big ones and control the teenagers so that they take the simples measures of precaution described above, will avoid injuries at short and long term, without preventing them from enjoying during the hours they spend in the open air. Avoiding to them a non suitable exposure is our responsibility.