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Dermatologists are used to receiving a large number of patients at this time of year, both adults and children, with various skin disorders caused as a direct consequence of acute sun exposure: sunburn, sun allergy or skin reactions due to contact with plants and subsequent sun exposure, among others.

We already know the many positive effects of the sun, mainly on vitamin D synthesis and its influence on mood and on the regulation of the sleep-wake cycle. But we also know that to benefit from all this we only need a few minutes of exposure per day.

However, the damage that can be caused by sunburn or intense sun exposure will be irreversible, forever, and will be stored in the genetic information located inside the nucleus of the cells of the human body. Over the years this damage will manifest itself in the form of spots, wrinkles and skin cancer.

Why are the first exposures to the sun the most dangerous?

1. We are not aware that in spring the intensity of ultraviolet radiation (UVI) increases to a level similar to that of summer. It is necessary to be informed every day before going out about the UVI forecast in the locality where we are: AEMET and WHO
2. We are eager for sun after the winter and we do not value the time or the schedule in which we expose ourselves.
3. We forget or underestimate the need to use sunscreen: we must use sunscreen from April to September (both included), especially in the midday hours: from 12 to 17h.

Brown and brown people have the ability to create melanin and tan after the first exposures to the sun. If this is achieved gradually and during hours of low radiation intensity, the tan is considered “healthy” because it is actually a “natural protection” against solar radiation. Melanin sits on top of the cell nucleus like a “hat” protecting the DNA inside the cell.

However, people with fair skin lack the ability to synthesize “quality melanin”, i.e., they do not tan or tan irregularly and their skin is always exposed to sun damage. For them, the sun is much more dangerous and precautions must be extreme.

When we are talking about children, all precautions are few, considering that they have the most delicate skins and need extraordinary care to avoid serious problems in the future.

The common comment that “children should be put in the sun because it is very healthy” or “so they get a little color”, actually makes very little sense… Let us explain why:

1. Neither tanning is a clinical manifestation of health nor is pale skin indicative of ill health or disease. Skin color is genetic and so is the ability to tan.
2. “Healthy” is that which occurs in a beneficial and wholesome manner, without harm to any organ of the body. Intense exposure to the sun does not produce any benefit, only irreparable damage, especially to children.
3. Sun exposure in children under four years of age has been shown to lead to a high incidence of skin cancer in adulthood. It is not advisable to expose children to direct sunlight before this age. It should only be done indirectly and at times of low ultraviolet radiation intensity (UVI 1 or 2).
4. Children are even more bothered by the sun than adults. Their skin is thinner and does not yet have the necessary amount of melanin to protect against ultraviolet radiation.
5. Children’s eyes are more exposed to sun damage because their eyelashes are shorter and thinner. The iris is usually lighter and the eyes are more sensitive to radiation.
6. Children dehydrate more easily than adults due to the heat of the sun.
7. Children are more exposed to sun damage as they depend on the sun protection measures used by their parents and caregivers: sun exposure schedules, use of awnings, shades, sunglasses, sunscreen, long-sleeved shirts, long pants, hat…

One of the main risks in the spring occurs in school playgrounds. Many children go to school without sunscreen, and without a cap, and without sunglasses… And in many schools, there are recesses after 12 noon and there is no shade for everyone… Some children have a high phototype (IV or higher) and therefore their skin can resist ultraviolet radiation without being damaged. However, in a country like Spain, the majority have a brown phototype (III) that will develop sun damage in the form of “red skin”, freckles or peeling at the first sun exposures. Subsequently, they will produce the melanin necessary to protect themselves from the following exposures, i.e., they will turn brown. The other group of children have a red or blond phototype (phototype I-II) and therefore do not have the ability to create enough melanin to protect themselves from the sun, i.e. they always burn and never get a tan.

Parents should send their children to school every day with a good dose of sunscreen on and another to be reapplied (by themselves or their caregivers) inside their backpack. Children should also be taught the importance of sun protection in all senses: healthy schedules, sunscreens, appropriate clothing, sunglasses, hats, etc…

Dr. Virginia Sánchez