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child health Dr. Karl Neumann Experts seasons summer sun exposure

Sun-protective Clothing has Gone High-tech

Sun-protective Clothing

Sun-protective clothing has replaced sunscreens as the first line of defense for protecting your children (and yourself) from the harmful rays of the sun. However, rarely, excessive sun protection can itself lead to health issues.

1. The UV rays of the sun are as damaging to children’s skin as tobacco smoke is damaging to adult’s lungs.

Estimates are that we get 50 to 75% of our lifetime sun exposure before we are 18 years old. Children’s skin is thinner and contains less melanin to block UV rays. Infants less than 6 months of age should be kept out of the sun entirely. Damage is cumulative for life. About 3.7 million skin cancers are diagnosed in the US annually, the vast majority sun-related.

2. Sunscreens have numerous shortcomings.

Most parents apply too little and too infrequently for optimal protection. The degree and duration of protection is reduced by wind, water, towel drying, and excessive perspiration, to mention just a few. A recent report suggests that more sunscreen is absorbed into the body than previously thought, a finding that is under further study.

3. Sun-protective clothing has gone high-tech.

Such garments consist of recently-developed, lightweight fabrics that absorb or reflect UV radiation. Fabrics are woven tightly, leaving practically no space for sun penetration. Many garments are dyed in colors, usually red or black, which also absorb or reflect UV rays. Garments should cover as much skin as possible (the back of the neck, for example) and fit loosely to allow air to circulate. Overly tight fits stretch fibers, allowing some sun through.

4. Familiarize yourself with the rating system for protective clothing.

It’s called UPF (ultraviolet protection factor) and is somewhat similar to SPF (sun protection factor) for rating sunscreens. A UPF rating of 25 means that only 1/25th (4%) of UV radiation penetrates the fabric. The higher the UPF, the greater the protection. Fabrics rated below UPF 15 are not considered protective. UPFs of more than 50 add little additional protection.

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5. Some sun protective clothing is pre-treated with solutions containing UV-inhibiting ingredients, further enhancing their effectiveness.

See “UV blocking additives” on the Internet and check labels. These additives can also be purchased at stores or online and used at home on any garment, increasing the garment’s UPF. Protection withstands numerous washings. After using additives, light may shine through garment when held up to the light. This does not mean that the fabric has lost its protective ability.

6. Hats should have brims at least three inches (7.5 centimeters) wide and extend around the head to shade the face, neck, and ears.

Baseball-type and straw hats offer little protection. Brims of 6 or more inches (15 cm) are becoming popular. Every additional inch of brim reduces the lifetime skin-cancer risk by about 10 percent. Consider hats with attached drapes that hang over the back of the neck.

7. Sunscreens remain essential for uncovered skin.

Ears are a common location for skin cancer in later life. The more clothing-covered skin, the less need for applying sunscreen. Follow the instructions that come with the sunscreen. For more information on applying sunscreen to children, see http://kidstraveldoc.com/protecting-infants-and-young-children-from-the-sun/ and https://www.aap.org/en-us/about-the-aap/aap-press-room/news-features-and-safety-tips/Pages/Sun-Safety-and-Protection.aspx

8. Sunglasses protect the skin around the eyes.

Five to 10 percent of skin cancers occur on the eyelids. Sunglasses should block 99 to 100% of UV radiation and consist of large lenses that wrap around the face and have UV-protective side shields.

9. Rarely, children who receive maximum sun protection may need vitamin D supplements.

The reasons: children require calcium to develop and maintain healthy bones. Simplistically, UV radiation activates vitamin D in the skin. Vitamin D then helps the intestines to absorb calcium from food. Maximum sun protection results in less sun radiation reaching the skin, and in turn, less vitamin D to absorb calcium. One solution: continue maximum sun protection to prevent skin cancer and supplement diets with vitamin D and calcium. Discuss the need for supplements with your pediatrician.

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10. Miscellaneous:

Sun-protective clothing is especially important for children with fair skin, for those spending much time at beaches and pools, and for children with sun-related medical conditions or who are taking medication that increases sun sensitivity. Sun-protective shades and umbrellas with high UPF numbers are available for strollers and for large umbrellas that create shade at the beach. Some high-tech fabrics may lose half their sun protection ability when wet. Check with manufacturers regarding how many washings protective clothing can undergo before losing its protective abilities.

UPF Chart for Sun-protective clothing

Questions
Protecting children from the sun:
Why is sun-protective clothing replacing sunscreens?
What do UPF (not SPF) numbers tell you?
Why may some children need calcium and vitamin D supplements?

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Dr. Karl Neumann

Karl Neumann MD, FAAP, CTH is a Pediatrician, Travel medicine practitioner, Journalist Clinical Associate Professor of Pediatrics, Weill Medical College of Cornell University (retired) Clinical Associate Attending Pediatrician, New York Presbyterian Hospital–Cornell & Columbia Medical Center, New York, New York. (retired) Attending Pediatrician, (retired) Long Island Jewish Hospital Private pediatric practice, Forest Hills, NY (retired). Director, (formerly) Family Travel and Immunization Clinic of Forest Hills, Queens, NY Former Co-editor, International Child Health Newsletter, American Academy of Pediatrics Author/Editor/Writer Chapters on traveling with children in major textbooks on travel medicine. DuPont and Steffen. Textbook of Travel Medicine and Health, 1st and 2nd editions Jong and Zuckerman. Travelers’ Vaccines. Schwartz, Wilder-Smith, Shaw. Travel Medicine: Tales Behind The Science. CDC Health Information for International Travel 2012, 2014, 2016, 2018. (The Yellow Book) U.S. Department of Health and Human Services, U.S. Public Health Service Editorial Board: Travel Medicine and Infectious Diseases (Elsevier) (2000-2008) Writer: The Healthy Traveler (1980-1992.) Weekly newspaper column. Appeared in Los Angeles Times, New York Newsday, Washington Post, Chicago Tribune, Miami Herald, San Francisco Chronicle, Toronto Star, Philadelphia Enquirer, and many other leading newspapers. Feature articles about travel/health in the New York Times, Travel & Leisure, Travel Holiday, McCall’s, Child, and numerous other publications. Traveling Healthy Newsletter (1987-2002). Widely read by physicians around the world. Medical Editor, American Druggist, 1979-1989 Author, Kidstraveldoc, the website for traveling with children Chairman and Editor Emeritus, Publication Committee, Wilderness Medical Society. Former Editor, International Society of Travel Medicine Newsletter. Former ISTM Webmaster Frequent lecturer on travel medicine in the United States.

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