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TEL       301 984 9490
FAX       301 984 9491
EMAIL   johnchoimdpc
Ah, summer, what power you have
to make us suffer and like it.

                                - Russell Baker
I know, I know, this website has been sorely neglected (I guess
advice about skiing is not very pertinent during 90 degree
summer weather).  But here is the latest in news and advice from
yours truly.

That shade of lobster does not become you.
Some of our fondest memories of summer are of the time when we
as children wore our inflamed peeling skin as badges of honor.  We
may well pay a heavy price for that honor later on in life.  The
danger of sun exposure is more than the sting of sunburn.  It is
estimated that 2/3 of all skin cancer is related to sun exposure.  
Every sunburn increases your risk of melanoma!  Furthermore, risk
of skin cancer and sun exposure is cumulative
- meaning that the
more sun you see in your lifetime, the higher the risk.  And the
importance in childhood is that
80 percent of lifetime exposure
occurs before age 18.

How do I decrease the risk?
Take cover!!!  
Dress up and cover as much as you can.  Get used
to sending kids off with a hat on, preferably one with a wide brim.  
sunglasses are not just a fashion accessory - use them to help
protect vision.
Keep children out of the sun during peak sun hours - 10-3.
Make applying sunscreen part of your morning routine
.  Right
after brushing teeth lather it on.  And
do not be cheap with it.   It
is estimated that parents only apply a third of what they should
on their children.  You must remember to
reapply frequently -
every 2 hours throughout the day if your child will be outside.

What sunscreen should I use?
Sunscreens are divided into 2 varieties - chemical and physical.  
chemical varieties are the ones you know and are the more
effective kind. They block certain frequencies of light.  Get ones
that are PABA free (although I think that they do not make any
with PABA anymore) because they are less associated with
allergic reactions.  The
physical sunscreens work by being
indiscriminate about what frequency it blocks.  These are the
ones that are thick and opaque (the ones the surfer dudes put
on their noses).  Some examples are titanium dioxide and plain
zinc oxide (butt cream).
Babies -  Make sure you put a hat on the head.  For the beach,
get one of those
play tents that is UV protected.  
The manufacturers don't recommend sunscreen before 6 months
of age but I think that you should
use them in younger babies if
you know that there will be significant exposure.  Water Babies
and Mustela are examples you can use.  Whatever you use, make
sure that you apply a little on the back the night before you go to
the beach.  If there is no reaction, you can apply to the face.  For
really sensitive skin you can use
zinc oxide cream (you can find it
in the baby section or the first aid section (don't ask me why it's
there (diaper rash emergencies?))).  I used to recommend
titanium dioxide but it is hard to find and head to head, zinc
appears to be more effective than titanium.
Regarding SPF - SPF 15 is good enough.  SPF 5000 doesn't give you
any more protection than SPF 15.  

The Chuch E Cheeses Festering Germ Farm Award goes to -
The Kiddie Pool.  
Hundreds of poopy diapers (don't be fooled by
the so called swim diapers - they do not prevent leakage) in a
concentrated shallow pool of extra warm water (suspiciously
warm) - not a good sterile environment to bring your infant.
E coli (the bad kind) outbreaks and viral infection have all been
associated with pool activities.  
... But it's so much fun!!!  Ok.  
John Choi Pediatrics, 2004