Summer isn't completely carefree. Brilliant blue skies and balmy breezes also can bring on a host of troubles for our little ones' exposed skin.
Increased sun exposure means adequate protection is essential, says Spokane-based pediatric dermatologist Dr. Andrea Dominey.
"This is important because we know that repeated and prolonged sun exposure, whether it is through sunburns or suntans, can result in the formation of skin cancer, and we also know that ultraviolet A will age the skin," she says.
The first line of defense against sunburns is to cover up with loose clothing, a brimmed hat, and sunglasses. Kids should stay in the shade when possible, and limit sun exposure during the peak intensity hours. Sunscreen also can be applied to children older than 6 months.
Some medications can make people more susceptible to burns, or cause a sunburn-like reaction. Antibiotics such as tetracycline or doxycycline often are the culprits when it comes to sun sensitivity, but "even things like Ibuprofen and Aleve can make you more sun sensitive," Dominey says.
A cool compress can soothe a burn, but in more severe cases, medical attention may be needed, she says. Call a doctor for extensive blistering, fever or signs of infection; pain management, IV fluids and antibiotics may be needed.
And forget getting a so-called base tan to protect from getting a burn — it's a myth.
"You do not want to have a tan or a burn, whether it's from natural sun or a tanning bed," Dominey says.
ITCHING
Swimmer's Itch — the common name for cercarial dermatitis — is caused by the larva of a small aquatic parasite that is excreted in the waste of waterfowl such as ducks and geese, and in some aquatic mammals like beaver and muskrat.
It sounds icky, and unfortunately it's common in lakes and ponds throughout the Northwest, but kids can still swim safely by taking some preventive measures.
"If you go in the water, you want to go ahead and rinse off and towel off vigorously," Dominey says.
If a child swims in infested waters, the parasite can burrow into the skin as the water begins to evaporate. Symptoms develop within five minutes to an hour after leaving the water, according to the Spokane Regional Health District, and may include a sharp burning and itching in the affected areas. Small reddish pimples, surrounded by areas of redness, appear within 12 hours.
Itching usually subsides in a week, but can last as long as 30 days. In the meantime, as with many summertime skin ailments, calamine lotion and an antihistamine such as Benadryl can ease the itch.
Urticaria, or "hives," is a fairly common malady that causes raised, itchy welts. A lot of different things can cause hives, including the sun, heat, cold and exertion. "Those are what we call physical hives," Dominey says. "Then you have hives that are caused by allergens."
In the case of hives, Dominey says that doctors usually recommend antihistamines. To prevent future cases, the physical trigger may need to be identified.
Heat exhaustion and heat rash are not uncommon in the summer, either, says Dominey.
Babies are especially susceptible to heat rash, which is caused by blocked sweat ducts trapping perspiration. The bumpy red rash is typically found on the neck, shoulders and chest, and in skin folds and creases.
Heat rash usually clears up on its own, but it could be a warning sign that baby is overheated. To prevent heat rash and heat exhaustion, Dominey says, "minimize exertion during the warm hours, stay hydrated and wear loose clothing."
Poison ivy and oak release an oil called urushiol, causing contact dermatitis, an allergic skin reaction resulting in a painful, itchy, red rash with bumps and blisters. What's even worse is that the oil can spread.
Adequate coverage from clothing and boots are best for protection. Dominey says that indirect exposure can occur from things like camping gear and pets that have come in contact with the plant.
"As you continue to touch those items, if you're not careful to wash it off or remove it, then you'll be re-exposed to it," she says.
Cool compresses, calamine lotion and antihistamines can provide some relief.
BUGS
Ticks and mosquitoes aren't just an annoyance — they can be vectors of disease. Different types of ticks carry different diseases, says Steve Main with the Spokane Regional Health District, which runs a campaign urging people to take precautions against bites in the spring, summer and early fall, when ticks are most active.
"Fortunately, they're pretty rare in our area," Main says of tick-borne diseases.
Relapsing fever, transmitted by soft-bodied ticks, is the most common — though it still affects few. Soft-bodied ticks don't embed in the skin, but they do bite. Early symptoms mimic the flu, and medical treatment is recommended.
The vector for Lyme disease, the deer tick, hasn't been found in this part of the state. Rocky Mountain spotted fever and tick paralysis cases have been reported here, but Main says those cases are very rare.
To reduce tick activity, Main says homeowners should trim their trees and shrubs, keep their lawns mowed, pick up leaf litter, and move brush piles away from the house. A mulch or bark barrier around the home also helps, and children's play structures should be located away from long grass or shrubs.
"They don't jump or fly," he says. "They kind of move their bodies to the tips of the grass blade and wait for you to brush by."
Main says when hiking, cover up with clothing and stay on the trail.
"We encourage everyone to hike with their friends and to check each other fairly frequently to make sure there aren't ticks," he says. "If you shower right after your hike, it really reduces the chances that a tick will embed in your skin."
Repellents also offer good protection, he says, but parents should read the label and never let young children apply it.
If a tick does embed, find the first-aid kit, grab the tweezers and try to remove it using steady pressure, says Sandy Phillips, Living Environment Program technical advisor for the Spokane Regional Health District. After the stowaway is removed, cleanse the area with an antiseptic.
"You don't want to jerk it out, and you don't want the head to break off, either," Phillips says.
Mosquitoes known as container breeders can carry West Nile virus. They feel at home in small pools of water — in a Frisbee, a child's pool, even an indentation on a tarp.
"Those are all excellent breeding ground for mosquitoes, so if those aren't drained regularly, then they can create a mosquito problem on your own property," Main says. "We encourage everyone to take a little time looking around their home for those very small bodies of water."
West Nile virus — which can cause severe neurological disease in humans — has been reported in Washington in the past, but not in Spokane County.
Earlier this year, a pregnant Spokane County mom was diagnosed with the Zika virus, but officials believe she acquired the infection while traveling to a Zika-affected area. The mosquito species known to cause Zika isn't found in northern states.
For many pests, avoiding fragrance, covering up with light-colored woven clothing, and using repellents with DEET on exposed skin as needed can reduce exposure, but even the best preventive measures won't save children from all bug bites and stings. Still, most are mild, causing redness, itching, stinging or mild swelling at the site.
In these cases, some simple measures can ease discomfort, according to the health district. Remove the stinger if there is one left in the skin, wash the area with soap and water, apply a cool compress, and use products containing hydrocortisone and calamine lotion to combat pain and itching. Over-the-counter pain relievers and antihistamines can help, too.
Some reactions could be life threatening, though. Call 911 if the child experiences difficulty breathing, swelling of the lips, eyelids or throat, hives, dizziness, faintness or confusion. ♦
