Did you know that one-quarter of an individual's lifetime sun exposure happens during childhood and adolescence? With longer days and more time spent playing outside this time of year, children are at risk for overexposure to the sun's harmful rays, leading to sunburns and potential long-term skin damage. Sensitivity to the sun varies individually, primarily based on the amount of melanin in the skin, but the young skin of children is generally thinner, more delicate, and produces less melanin. Therefore, as the school year wraps up, it's essential to educate parents and children about the risks of sun exposure and how to prevent and implement effective treatments for sunburn while also being prepared to provide support and care for visits to the school nurse associated with sunburn discomfort.

Risks

Prolonged exposure to ultraviolet (UV) radiation has been shown to cause skin, eye, and immune system damage, and there is strong evidence that sun exposure and sunburns during childhood leads to increased rates of skin cancer, including melanoma, later in life.

UV radiation from the sun is classified as a human carcinogen by the U.S. Department of Health and Human Services and the World Health Organization. The prevalence of skin cancer in the United States makes it the most common cancer and the incidence has been rapidly increasing worldwide. Basal and squamous cell cancer are the two primary forms of skin cancer, which usually develop on the face, neck, head, hands, and arms due to frequent UV radiation exposure. The major cause of melanoma, the most fatal skin cancer, is exposure to UV radiation. While this deadly form of skin cancer rarely occurs in individuals younger than 20, the incidence in children and adolescents is rising. Other UV-related skin disorders include actinic keratoses and premature aging of the skin.

Research has revealed that excessive exposure to UV radiation can also hinder the immune system's functioning and hamper the skin's natural defenses. Typically, the skin provides substantial protection against foreign substances like cancer and infections, but UV radiation overexposure can compromise this function, leading to a weakened immune system and reduced capacity to guard and protect against these types of threats.

Lastly, sun exposure makes children's eyes vulnerable to future vision issues. This is due to the sun's ability to cause conditions like sunburned corneas, eyelid cancer, cataracts, and macular degeneration. Moreover, children have less UV protection due to their lenses' inability to block UV as effectively as adults.

 Prevention

The American Academy of Pediatrics recommends covering up as the first and best defense against the sun's harmful rays. Seeking shade, avoiding peak UV hours between 10 a.m. and 4 p.m., and wearing protective cotton clothing/hats and sunglasses with UV protection can all reduce exposure and safeguard against the risks. A sunscreen with a minimum SPF of 15-30 and labeled "broad spectrum" is also recommended, and school nurses should encourage application before school or outdoor activities. Sunscreen in the school setting is an issue that is regulated by specific state guidelines, and Nurse Practice Acts and policies must consider whether it's deemed a medication as well as who should apply it and when.

 Treatment

Students suffering from sunburn at school may have difficulty concentrating or staying on task due to discomfort or itching. Cool, damp compresses or ice packs can alleviate pain and reduce inflammation, and OTC pain relief medication may be administered when appropriate and authorized. Blistering skin should be covered with gauze (avoid breaking blisters!), and moisturizing with lotion or aloe vera can prevent skin drying. Finally, students burned by the sun should be encouraged to drink plenty of water to avoid dehydration.

By educating students and families about the risks of overexposure to the sun, promoting sun safety behaviors, and advocating for sun-safe environments and routines, schools and school nurses can help reduce the risk of skin damage and other health problems associated with excess sun exposure.