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More kids than ever before are being diagnosed with the skin cancer melanoma, which used to be almost exclusively a disease of adults. “Melanoma usually develops many years after excessive sun exposure as a child—in fact, 80% of a person’s lifetime skin exposure typically occurs before the age of 18,” reports Joshua Fox, MD, a leading dermatologist and founder of Advanced Dermatology . “But melanoma is no longer waiting to appear in adulthood: It is now being found with alarming increasing frequency in children.”

Citing recent data from the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) database, Dr. Fox notes that between 1973 and 2001, the incidence of pediatric melanoma rose by 2.9% per year—or by about 80% overall. “The risk is greatest for white children, girls, older kids, and those who have had the most exposure to the sun,” he says.

The good news is that the survival rate for pediatric melanoma has increased over the same time period, and now stands at 93.6% at five years after the diagnosis. “Early detection is the key to curing melanoma,” he explains, “so the cancer can be removed before it spreads to the internal organs.”

Unfortunately, because of the many demands on their time, pediatricians don’t appear to be detecting the dangerous skin lesions as often as they could be, requiring that parents take a proactive stance in protecting their children. Here are Dr. Fox’s recommendations:

Ask your child’s pediatrician to do a skin check on your children as part of their annual examinations or refer to a dermatologist if they are not comfortable.

If your children have fair skin or a lot of moles and freckles, take them to a dermatologist for regular skin checks.

If your child has one or several enlarging or irregular moles see a dermatologist for diagnostic evaluation to see if any testing is required.

Avoid taking your kids out in the sun during the peak hours between 10 AM and 2 PM, when ultraviolet (UV) rays are strongest. If you are out then, seek the shade of a tree or sit under an umbrella at the beach.

Dress your kids in sun-protective clothing, such as a hat with a wide brim, sunglasses and dark-colored, long-sleeved shirts and pants. Some manufacturers even make clothing with built-in sun protection.

Apply a broad-spectrum sunscreen which is water proof (one that protects against both UVA and UVB rays) with a sun protection factor (SPF) of 15 or higher to your kids’ skin whenever you plan to be out-of-doors, whether it’s sunny or cloudy out. Products that contain the ingredients titanium dioxide and zinc oxide offer the best protection, and new formulations, such as spray-on sunscreens, make application easier than ever, says Dr. Fox.

Slather on sunscreen 30 minutes before going out. Be sure to coat all exposed areas, including the face, ears, nose, lips, neck and the backs of the hands and feet—and use more than you think you need. “Studies show most people use only a quarter of the sunscreen they actually need,” reports Dr. Fox. “You should use one to two tablespoons per child and more for larger children.”

Reapply sunscreen every couple of hours, especially if your kids are active and perspiring; also reapply after swimming, even if the product is waterproof.

Limit sun exposure for babies under 6 months of age. Their delicate skin can’t handle the sun. While out of doors, make sure they are wearing sunprotective clothing and are shielded from the bright rays.

Discourage teens from going to tanning parlors. Tanning beds are no safer than the sun.
What is melanoma?
Melanoma is the most serious and deadly form of skin cancer (the other two forms are squamous cell carcinoma and basal cell carcinoma). It is rising at an alarming rate among both adults and children. It is estimated that 105,750 new cases of melanoma will be detected in the United States in 2005, a 10% increase over 2004. In addition, close to 8,000 people are expected to die from the disease this year.

Melanoma is often detected near or growing from an existing mole, and on the upper back and legs (although it can occur anywhere on the body). If you notice a mole on your child’s body, check it for the “ABCDs” of melanoma:

Asymmetry: one half of the mole doesn’t match the other half

Border irregularity: The edges of the mole are scalloped, ragged, notched, or blurred

Color: The mole has shades of tan, brown, black, and perhaps dashes of red, white and blue.

Diameter: The mole is larger than a pencil eraser (about 6mm in diameter).

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