Now that we’re finally starting to see signs of spring and summer, I wanted to get some recommendations on the best (most effective and safest) bug spray and sunscreen for kids. There are so many types on the market and so many studies out there — it sounds like the “natural” versions would be better, but is this really the case? Any recommendations on particular types, what to avoid, etc.?

Any guidance would be great – thanks so much!



Safe in the Sunshine

By Elizabeth Cutrell, D.O., Pediatric Alliance — Jefferson Hills




There is no better time of the year than spring and summer, when the weather gets warm and people spend more time outside. With all of the fun things to do around Pittsburgh, it is likely that you and your family will be out in the sunshine in the coming months. While sun exposure gives our bodies good things, such as Vitamin D, there are harmful ultraviolet (UV) rays from the sun that we should minimize exposure to. Any change in skin color, whether it’s a sun tan or a sun burn, indicates damage to the skin from UV rays. Research has shown that sunburns in childhood leads to an increased risk of skin cancer as an adult, and therefore protecting the skin needs to occur from an early age. May is Skin Cancer Awareness Month, and a great time to think about sun safety.

There are three ways to protect both you and your children from the sun’s harmful rays — sun avoidance during peak hours, sun protective clothing, and sunscreen. Let’s discuss all three in more detail.

Sun avoidance: The sun’s harmful UV rays are strongest between 10am-4pm. It is best to avoid the sun during this time. Stay in the shade, and if shade isn’t available try to make your own shade, such as with an umbrella or the canopy of a stroller. And it’s not only on sunny days that you need to worry about UV rays, as they can still penetrate on gray and foggy days. Also remember that car windows don’t protect from all types of UV rays, so children need to have protection from the sun while also in the car.

Sun protective clothing: For infants, it is best to dress them in lightweight long sleeves and pants with a tight weave. In general, clothing with bright colors (compared to white or pastel colors) block UV rays better. While baseball caps look very cute on babies, they do little to protect the sensitive areas of the back of the neck and ears. It is best to have babies wear a brimmed hat to protect the face, neck, and ears. Sunglasses are good for protecting the eyes. Many companies make clothing with UV protection in them, so there are a lot of options to protect your skin.

Sunscreen: The first thing to note is that babies under 6 months of age should NOT wear sunscreen. The reason for this is that they have a higher body surface area to weight ratio, and are therefore more likely to absorb the chemicals in the sunscreen or experience side effects from sunscreen (such as a contact dermatitis). The safest way to protect babies less than 6 months of age is to not expose them to the sun during peak hours, and to have them wear protective clothing. The American Academy of Pediatrics does recommend putting sunscreen in limited areas, such as back of the hands and face, IF you cannot give the baby adequate shade. But it is really best to avoid sun exposure as much as possible in this age group.

For those infants and children older than 6 months, sunscreen is safe and strongly recommended. There are two types of sunscreen to choose from- physical vs chemical. The physical sunscreens are those that contain zinc oxide or titanium dioxide. These active ingredients are recommended for use in babies because they are less likely to have an adverse reaction compared to the ingredients in chemical sunscreens. Most sunscreens made for young children use either zinc oxide or titanium dioxide as the active ingredient. The chemical sunscreens are those that have active ingredients such as oxybenzone and oxtinoxate, and are found in the majority of sunscreens available over the counter. Buy sunscreens that come in whatever form will get you to most likely to apply it. However, be cautious with spray sunscreens in young children, as they can be accidentally inhaled while applying.

The sunscreen should have a sun protective factor (SPF) of 15 or greater and have “broad spectrum” protection, meaning it protects against both UVA and UVB rays. There is no evidence that SPF greater than 50 offers additional protection, so there is no need to buy sunscreen with an SPF greater than 50. Apply the sunscreen liberally to skin 15-30 minutes before going out in the sun so that it has time to form its protective barrier. Sunscreen should be reapplied every 1-2 hours, particularly if the child spends a lot of time in water. While some sunscreens are advertised as “water resistant”, all sunscreens are washed off upon swimming or sweating so reapplication is necessary. Just because a sunscreen has a higher SPF does not mean that it increases the time allowed in the sun (it only means it protects against more UV rays), so regardless of SPF, sunscreen needs to be reapplied. Since sun time can happen unexpectedly, it’s a good idea to keep sunscreen handy, such as in your bag or car, so that it’s available at all times.

Also remember that one of the most effective ways to teach your child to stay safe in the sun is to practice what you preach — so parents should follow these tips as well. Enjoy your time in the sun and stay safe!


(Dr. Elizabeth Cutrell sees patients at the Pediatric Alliance — Jefferson Hills office.)


Dr. Sarah Kohl covers insect repellents tomorrow, on The PediaBlog.


(Read more about sun safety on The PediaBlog here.)