- The Washington Times - Sunday, June 10, 2001

Before Alise Schor sends her children, ages 4 and 2, outside on a sunny day, she covers their fair skin with sunscreen. However, the 36-year-old Herndon woman does not wear it herself.

"I lived near the beach growing up," she says. "We used to sit out all day with just baby oil. I figure the damage has already been done."

Mrs. Schor is correct, says Dr. Walter Giblin, a Rockville dermatologist. The American Academy of Dermatology (AAD) estimates that 80 percent of a person´s lifetime sun damage occurs before age 18. Even one bad sunburn as a child or teen-ager can lead to skin damage as an adult.

Mrs. Schor also is typical of many adults who skimp on the sunscreen for themselves but usually make sure their children are protected, Dr. Giblin says.

"I think we are at least getting the message to parents about sun safety," he says. "They, in turn, are protecting their children."

More than 1 million cases of skin cancer are diagnosed annually, so the AAD and the American Cancer Society have spent the better part of the past decade promoting safe sun behavior. Most people have heard the message that exposure to the sun´s ultraviolet rays is a leading cause of melanoma, the deadliest form of skin cancer.

People might be hearing, but they´re not always listening, says Dr. Clay Cockerell, a professor of dermatology at University of Texas-Southwest Medical Center and an AAD board member.

"It is like smoking or driving without a seat belt," he says. "It seems like people are getting the message about sun damage, but the number of people changing their behavior is surprisingly low. If you stay in the sun all day without protection, it is irresponsible."

The AAD stepped up its warnings about safe sun behavior after it conducted a 1998 survey that found just four in 10 Americans felt it was very important to protect themselves from the sun.

In interviews with 1,000 people, 15 percent said they wore a sunscreen whenever they went outside. More than a quarter said they never wore sunscreen. More than one-third of respondents said they believed only people who burn easily needed to wear sunscreen with an SPF of 15 or higher.

Nearly 90 percent of the respondents said they agreed that sunscreen can protect against the harmful effects of the sun. Yet 70 percent also agreed that most people look better with a tan.

Answers such as these are proof that Americans need more sun education, Dr. Cockerell says.

The sun emits visible and invisible rays. The invisible ones, known as ultraviolet-A (UVA) and ultraviolet-B (UVB), cause the most damage. While the harmful rays can do greater damage on a sunny day, they are always present, even through cloud cover or a car windshield, he says.

"You should wear sunscreen every day, even in winter," Dr. Cockerell says.

Protecting the children

Instilling good sun habits now may pay off in a downturn in the number of skin cancers a generation from now, says Dr. David McLean, a Canadian dermatologist and author of a study published last October in the Journal of the American Medical Association.

Dr. McLean followed 458 Vancouver children for three years. Parents of 222 children received a supply of broad-spectrum SPF 30 sunscreen and instructions for parents to apply it when the child was expected to be in the sun for 30 minutes or more. Parents of the 236 children in the control group did not receive sunscreen or advice on sunscreen use but were free to use sunscreen as they normally would.

At the study´s end, children in the sunscreen group had developed significantly fewer moles than children in the control group. The study also found a relationship between freckling and sun exposure, Dr. McLean said. Freckles and moles are risk factors in the future development of melanoma.

"Our data suggest that children assigned to a broad-spectrum sunscreen would develop 30 to 40 percent fewer moles than children assigned to the control group," he says. "Sunscreen use is important for all children, but it is especially necessary for children with freckles. This study may indicate that people who freckle and develop moles have an underlying instability in their skin cells."

Marketers are reaching out to parents who want even more protection for their children. A host of child-friendly sunscreens in neon hues and fun spray bottles have hit the market. Pampers is test-marketing baby wipes with UV protection. The maker of Rit clothing dye recently began selling Sun Guard, powder that can boost clothing´s SPF protection when it is added to a load of laundry. Sun Guard contains Tinosorb FD, a chemical that stays in clothes for up to 20 washes.

Two sun-safe playgrounds also opened recently in Phoenix and New York City. Both playgrounds added tarplike shade structures to help block out UV rays.

Teens still a tough sell

It seems universally tough to get a healthy-habit message across to teens, be it advice about junk food, drunken driving or sun protection, says Charles Green, a spokesman for the Centers for Disease Control and Prevention (CDC).

That is why the CDC is looking for ways to make sun protection cool or at least cooler.

"We have done focus-group research in 24 cities," Mr. Green says. "And we found that 13- to 18-year-olds are getting most of the sun exposure. They still are not getting the connection that a few serious sunburns can increase your risk of skin cancer. So many activities for that age group focus on being outside. Teens seem to be aware that you should wear sunscreen if you are at the beach or pool, but they are also hanging out in the park or outside at school. We need to make them aware that you don´t necessarily have to be at the pool to be in sun."

Until sunburns are accepted as bad and sun hats are seen as hip, teens will be a tough audience, he says.

The CDC has sponsored a photo contest with Seventeen magazine the past three years. The object of the assignment is to show why you need to protect your skin.

"The contestants will show sun protection as socially acceptable," Mr. Green says. "It is a great way to reach adolescent girls. It seems young women are easier to convince than young men."

An effective way to reach young men would be to portray sunburn as goofy looking, he says.

"It is embarrassing to walk into school as red as a lobster," Mr. Green says. "We need to reinforce products to be used as prevention, not after the fact. Realistically, though, to be a part of everyday life, it is going to be a long haul."

That is why the CDC is presenting teens with options. As part of the Choose Your Cover campaign, which targets teen-agers, the CDC advises them to seek shade, wear a hat, wear sunglasses, wear protective clothing, cover exposed skin and use sunscreen with an SPF of 15 or higher.

However, Mr. Green does not expect any teen-ager with a shred of image consciousness to do all of the above.

"If we could get them to do sunscreen and one of the other options, we would be elated," he says.

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