Parents of preschoolers are more likely to be concerned about a school's educational philosophy and the credentials of its teachers than its policy regarding sun protection. Staffers at early childhood programs are also likely to consider applying sunscreen far less important than helping kids learn to share, eat right or cooperate with others, but a recent study shows that getting young children used to the idea that they need to protect their skin from too much exposure to the sun is an important early health lesson.

“More education is needed about making sun protection as much a priority as other health habits,” the authors of the study say. “Schools often don’t emphasize adequate sun protection, despite evidence linking damage from ultraviolet (UV) radiation to skin cancer.”

Good health habits are best established when kids are young. Parents can be important role models for sunscreen use, June Robinson, lead author on the study, told TheDoctor in an email. “By properly applying sunscreen, parents set an example of good sun safety practices for their children,” Robinson said.

Researchers from Northwestern University's Feinberg School of Medicine used surveys of managers from 102 Head Start and Early Head Start programs in Illinois and 100 day care programs in the state. They also conducted short phone interviews to determine how important a program viewed sun protection and other health behaviors.

“Schools often don’t emphasize adequate sun protection, despite evidence linking damage from ultraviolet (UV) radiation to skin cancer.”

The managers responding to the survey said the most important health habits were good nutrition, adequate exercise and dental hygiene. Sunscreen was provided for students’ use by 109 programs, although 84 programs did not allow the children to apply sunscreen themselves. About half of the programs used a spray sunscreen to avoid unnecessarily touching the children. Few of the Head Start and Early Head Start programs scheduled outdoor activities to avoid peak sun intensity compared to day care programs.

In some states sunscreen is considered an over-the-counter medication regulated by the U.S. Food and Drug Administration. The only way students in these states can use sunscreen during school and school-sponsored activities is if they have a doctor’s note and the sunscreen is applied by the school nurse. In these cases, it is up to parents to put sunscreen on at home, before dropping their children off at school.

Many parents also choose a spray sunscreen because it is the easiest to apply to squirming kids, and Robinson offered some hints about spray sunscreen use.

  • Be sure to overlap the areas where the sunscreen was just sprayed. “It is easy to miss a spot with spray sunscreen because you cannot see where you just put it,” said Robinson. And remember to reapply every 80 minutes, or after swimming or sweating and toweling off the moisture.

  • Do not spray the sunscreen directly onto children’s faces since it can get into their eyes. It is easiest to buy a sunscreen stick, and let children apply it themselves.

  • Keep in mind that sun protection is about more than sunscreen. Children should have hats and wear rash guards when playing water sports.

  • When planning outdoor activities, don’t just check the heat index. Check the UV index as well. If the UV index is greater than three, take precautions. The UV index is especially important in the spring, when the sun may be bright (high UV index), but the temperature is lower than in the summer (lower heat index).

    • The study is published in JAMA Dermatology.