Featured pediatric expert
Maria G. Buethe, MD, PhD
Dr. Maria G. Buethe is double board-certified in Dermatology and Pediatric Dermatology. She brings a wealth of expertise and passion for treating children with rare and complex dermatologic conditions. In addition to her role as Chief of the Pediatric Dermatology Division at Children’s Hospital of Orange County (CHOC), she also serves as the Director of Pediatric Dermatology at the University of California, Irvine.
Transcription
Maggie McKay (Host): Welcome to Long Live Childhood, a pediatric health and wellness podcast presented by Rady Children’s Health. I’m Maggie McKay, and here to help us understand UV safety and awareness is Dr. Maria Buethe, Division Chief of Dermatology at Rady Children’s Health Orange County. Thank you so much for being here today, Dr. Buethe.
Maria G. Buethe, MD, PhD: Thank you so much for inviting me.
Maggie (Host): A lot of parents associate UV exposure with hot, sunny days. How can families better understand UV risk on cloudy days, cooler days, or during different seasons?
Maria G. Buethe, MD, PhD: Yes, that’s a great question.
Unfortunately, the temperature itself is not a proxy for UV exposure. We have UV exposures even across mild days, and that’s actually been associated with families, and all of us, honestly.
We think that if the sun is not out there and maybe the need of applying sunscreen, or, generally speaking, sun protection habits may not be relevant. But what we know is that the sun and UV exposure really goes through clouds. So, even a cloudy sky, you can still get sun exposure, as well as altitude.
Even if you are experiencing a nice cooler day in the mountains, that’s actually a prime scenario for UV exposure. The main take home message is that clouds, unfortunately, do not eliminate UV exposure, and we should really be trying to attempt sun protection, and sunscreen, across different temperatures.
Maggie (Host): Every single day, right?
Maria G. Buethe, MD, PhD: Yes, every single day
Maggie (Host): What are some of the environments where children receive significant UV exposure without parents even realizing it?
Maria G. Buethe, PhD: Well, we can think about school, especially during recess, and really between 10:00 AM and 2:00 PM where recess most often happens. Those are some of the times in the days with the highest peak in UV exposure.
Another place is definitely water parks and pools.
UV light goes through the water up to, we’ll say, like one meter in depth. So, a child that is swimming may still not be protected from the sun. Also, we should remember that swimming can quickly wash out the sunscreen, and that protection that maybe we have just applied may not be there after a few minutes after swimming.
So, those are all factors that are very important. And as we said before, high altitude, the snow, going skiing, that’s also an environment with a higher rate of UV exposure.
Maggie (Host): Are there certain ages or developmental stages when UV protection is especially important, and why?
Maria G. Buethe, MD, PhD: Yes. Let’s start from birth. In the first six months of life, the skin barrier is not as mature yet. That means that is a particularly delicate time in a child’s life. On top of that, we also, at least up to now, do not have sunscreen that is approved before six months of age.
According to the CDC, for example, the recommendation is to really not expose that young child before six months of age to direct sunlight in the first place. But I would say that, for the infant, from the first year and toddler, the skin barrier and ability to fight UV exposure is still immature.
So it really keeps developing in the first two months of life. I would really be cautious or at least be even more mindful about practicing sun protection
Maggie (Host): With many children participating in outdoor sports, camps, and recreational activities, what practical strategies can help ensure constant UV protection throughout the day? Like they go to the beach with their friends and you’re not there.
Maria G. Buethe, MD, PhD: Absolutely. Something that we always recommend is not just thinking about sunscreen when we think about sun protection, but also about sun protective clothing. With sunscreen, this should really be reapplied every two hours, and most of the time that is not really realistic and feasible, that every two hours application.
Adding some protective clothing that can allow that stable and more continuous protection that may not be as easily pursued with just sunscreen. There are several brands that develop from regular clothing to rash guards which are suitable for daily life and for the pool.
Maggie (Host): What are your thoughts on the type of sunscreen? Like, you know, there’s spray, which is so convenient, but I always think like, is that as effective as putting lotion on? Because it seems like half of it would be going into the air. I mean, what do you think?
Maria G. Buethe, MD, PhD: Yes. When we think about sunscreen, the main categories that we characterize are chemical sunscreen and mineral sunscreen. We have chemical sunscreen that has to be applied at least 15 minutes before sun exposure, and they are the ones that have a level of penetration into the skin, while the mineral sunscreen sits on top of the skin and reflects the light.
Now, with sunscreen, it also comes different types of formulation. Of course, the spray maybe is definitely easy, and what we like about those is that, especially if you are by yourself, it allows application to, for example, like the mid-back, which are areas that we cannot easily reach.
I would say that that is definitely better than not applying sunscreen at all. But to your point, yes, it does have the caveat that, like you may not achieve as much sun protection as you think you are.
Maggie (Host): Is there anything else in closing that you’d like to add that you’d like to leave people to think about?
Maria G. Buethe, MD, PhD: Well, yes. One thing that we haven’t mentioned is that UV exposure can also be indoors. So unfortunately, we have UV exposure through glasses, especially UVA, which is that type of UV light that is also more connected with chronic skin damage, and eventually also like skin aging.
Regarding the glasses and the side windows in the car, many models now offer some protection against UVB, but again, it’s that UV light that is UVA that is really challenging to eliminate. We also want to remember that you do want to practice some protection throughout the day and throughout different environments indoor and outdoor
Maggie (Host): Well, thank you so much for sharing your expertise. This has been so useful and helpful and a lot of good information to remember, especially for summertime, but year-round, like we said. So, thank you again
Maria G. Buethe, MD, PhD: Thank you very much.
Maggie (Host): Again, that’s Dr. Maria Buethe. To find out more, please visit choc.org/dermatology. Thank you for tuning in to Long Live Childhood, a pediatric health and wellness podcast brought to you by Rady Children’s Health. For more insightful conversations about kids’ health and wellbeing, be sure to subscribe wherever you listen to your podcasts.
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I’m Maggie McKay, and thank you so much for joining us today. Until next time.
