“It’s only a suntan” or is it?...Is the ‘healthy glow’ of a suntan good for babies and children? Is it good for adults?  Hopefully by the time you have read this article you will have gained the knowledge to make up your own mind.

It was not until the 1920’s that the suntan became fashionable. Coco Chanel made it ‘Chic’ and the ‘must have’ item for individuals; thus denoting that the individual had money and could afford to enjoy the trappings of their wealth in some sunny climbs.  Previous to this ‘revelation’ people went to extreme lengths to look pale, even putting on creams which we now know were highly toxic!  Now the bronzed look in both men and women is seen to denote health; and people go to great lengths to get the right look, from normal sun worshiping, to sunbeds when the weather is not helping, to fake tans, which can be rubbed in or sprayed on.

So what is a tan?  Tanning, the darkening of the skin is produced when ultraviolet (UV) rays from the sun trigger the production of the pigment melanin in the skin.  Many parents say their children look healthier if they have a tan but rather than being a sign of a healthy process, getting a tan through sunbathing actually means that your skin has been damaged and is trying to protect itself.

The skin is made up of two main layers: the epidermis on the outside and the dermis on the inside.  The epidermis is the barrier, while the dermis is the layer containing all the "equipment" - things like nerve endings, sweat glands, hair follicles and so on. Our skin burns when we stay too long in the sun.  Sunburn is our body’s chemical response to over exposure to UV rays. Without protection, UV rays, which cannot be seen or felt, penetrate deep into the skin’s layers, damaging the cells.

Sunburn is not like a normal heat burn. When you get sunburnt the outermost layers of your skin release chemicals that cause your blood vessels to swell and leak fluids. This causes inflammation, pain and redness. Skin becomes hot and painful and severe sunburn can cause swelling and blisters.

Dr. Vivienne Nathanson, from the British Medical Association, writing for BUPA says that, "People need to be educated about the myths of tanning. A suntan is not a sign of good health. A tan, even when there's no burning, always means the skin has been damaged." Even though a tan will fade over time, the damage it has caused the skin remains. This skin damage puts you at a greater risk of skin cancer and it also causes premature ageing.

Even in relatively sun-free countries it can take as little as half an hour to get sunburn and if by the coast where there is normally a slight breeze, the cool feeling hides the fact that your skin is still being exposed to the sun. In the long term, even short bouts of exposure might pose a serious threat to your health, our knowledge of ultraviolet radiation and its effect on skin has increased rapidly in recent years.

What about the winter? Most people assume the Winter sun is weaker and less dangerous than the Summer sun and, therefore, do not wear proper sun protection. However, two recent studies show that if you’re at a higher altitude, for example when skiing you still run the risk of developing sunburn. Studies in America suggest that a person with an average complexion, who is not wearing any sun protection, would burn after only six minutes of sun exposure on a clear day at noon in Vail Colorado at 11,000 feet above sea level. The same person would develop sunburn after 25 minutes of noontime exposure in New York or 14 minutes of unprotected noontime exposure in Orlando.

What are the risks?

• A child's skin is thinner and more sensitive and even a short time outdoors in the midday sun can result in serious burns.
• Epidemiological studies demonstrate that frequent sun exposure and sunburn in childhood set the stage for high rates of melanoma later in life.
• Children have more time to develop diseases with long latency, more years of life to be lost and more suffering to be endured as a result of impaired health. Increased life expectancy further adds to people's risk of developing skin cancers and cataracts.
• Children are more exposed to the sun. Estimates suggest that up to 80 per cent of a person's lifetime exposure to UV is received before the age of 18.
• Children love playing outdoors but usually are not aware of the harmful effects of UV radiation.

Repeated sunburns are now recognized as a major risk factor for malignant melanoma, the most deadly form of skin cancer. Sunlight is the primary cause of skin aging, wrinkles, blotchy pigmentation and skin cancer.

Children are in a dynamic state of growth and are, therefore, more susceptible to environmental threats than adults. Many vital functions such as the immune system are not fully developed at birth, and unsafe environments may interfere with their normal development. But most environmental hazards are preventable: reducing exposure is the most effective way of protecting children's health. As a child, to suffer sunburn, increases the risk of developing skin cancer later in life is much greater than if the sunburn happens to an adult – despite warnings to parents, most seem to ignore the risks and like to see their children with a tan. In fact a survey carried out by Cancer Research UK in 2004 found that 33% of parents questioned admitted that their child had experienced sunburn. The majority also knew of the skin cancer risks to the child.

Caring for children in the sun

According to an Australian study, four out of five cases of skin cancer are preventable by sensible behaviour. Encouraging children to take simple precautions will prevent both short-term and long-term damage while still allowing them to enjoy the time they spend outdoors. Parents should serve as role models, and it is their responsibility to ensure that their children are protected adequately.  Always keep infants of less than 12 months in the shade and babies under 6 months should be kept out of direct sunlight completely; also ensure that your children:

• Cover up with protective clothing, a hat and sunglasses.
  
• Apply broad-spectrum sunscreen of SPF 15+.
  
• Limit their time in the midday sun.
  
• Seek shade – especially between 11am and 3pm
  
• Avoid sunlamps and tanning parlours. (usual age limit is 18)
  

Shade, clothing and hats provide the best protection for children - applying sunscreen becomes necessary on those parts of the body that remain exposed.  Sunscreen should never be used to prolong the duration of sun exposure.  The Cancer Research UK campaign, SunSmart provides valuable stay safe information, they recommend the following sun cream and application advice.

Sun creams

Cheap sun creams are usually just as good as expensive ones if used properly.  They are all tested the same way and it is the level of protection they give you against the sun that matters most.  This is the 'sun protection factor' or SPF.

Do check the 'use by' date.  Most creams will last about 2 or 3 years - so it is OK to use last year's, but not a bottle from 5 years ago!

Sun creams have changed a lot in the past 15 years.  There is a huge range and it can be difficult to know what to buy.  You should choose one that says it protects against both UVA and UVB radiation from the sun.  This may be labelled 'broad spectrum'.

The SPF tells you the amount of protection the sun cream gives against UVB radiation.  Cancer Research UK recommend at least factor 15.  This is because it gives the best balance between protection and cost.  The higher factor creams are more expensive, but do not give much more protection than factor 15.  If you use

• Factor 15, only 7% of the harmful UVB rays will get through
• Factor 30, only 4% of the harmful UVB rays will get through
• Factor 60, only 2% of the harmful UVB rays will get through

So you can see, you are getting some more protection with the most expensive creams, but not that much more.  There is no sun cream that can give you total protection.  98% protection (with factor 60) is about the best you will get.

UVA protection is shown by 0 to 5 stars.  But, this is only a rough guide because it is also affected by the SPF.  A cream with SPF 25 and 3 stars may give more UVA protection overall than a cream with SPF 10 and 4 stars.

Putting your cream on

You should put your sun cream on before you go in the sun.  Then put on another layer to make sure you haven't missed any bits.  Put it on before moisturiser, make up or insect repellent.  It must go on before anything else so it is next to your skin.

Sun creams rub off.  Even if they say they are waterproof, they may come off when you are swimming.  In order to get the best protection, you must re-apply them often - at least every two hours.  And more frequently if it is washed, rubbed or sweated off.

You must apply sun creams thickly.  Nearly everyone puts them on much too thinly so they don't get the protection specified on the bottle. You should be able to see and spread it very easily.  If it all disappears as soon as you start rubbing it on, you haven't used enough.  About a golf ball sized dollop should do for small children.

For further information and advice on staying safe in the sun see the SunSmart campaign at www.sunsmart.org.uk

Although there are negative aspects to the sun, there are positives too.  Sunshine is actually good for you; not only does it promote a feeling of wellbeing but is essential in the production of vitamin D.  This is an essential vitamin that plays a number of important roles including helping regulate the amount of calcium and phosphate in the body, which is needed to help keep our teeth and bones healthy.

So wherever you are and whatever you do this Summer, enjoy the sun safely and have a great time.