DHC Pediatric Webinar - Pediatric Sun Protection: Safe Fun in the Sun

Thursday, April 11, 2024, 8:00 AM - Sunday, April 11, 2027, 9:00 AM

AMA PRA Category 1 Credits™ (1.00 hours), ANCC Nursing Contact Hours (1.00 hours), CME-Designated Participation Credit (1.00 hours)

This Pediatric Lecture Series will discuss important pediatric topics that may lead to the improvement of child health from an individual, health care system and/or societal level.

Presenter
Katherine A. Su, MD, Pediatric Dermatology, Dartmouth Hitchcock Clinics Manchester, NH

About our Presenter
Dr. Su earned her undergraduate degree at Yale. She attended medical school at Johns Hopkins. She completed her internship in internal medicine at Mount Auburn Hospital, followed by her dermatology residency and pediatric dermatology fellowship at the University of Massachusetts. She joined Dartmouth Health in September and currently sees both adult and pediatric patients in the Manchester office.

1. Describe strategies for protecting kids’ skin from the sun.
2. Explain the meaning of sunscreen labeling (e.g., “broad spectrum,” “sun protective factor [SPF],” “water-resistant”).
3. Discuss controversies surrounding sunscreen safety.

In support of improving patient care, Dartmouth Health is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. 

American Medical Association (AMA)
Dartmouth Health designates this Enduring Material for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

American Nurses Credentialing Center (ANCC)
Dartmouth Health designates this Enduring Material for a maximum of 1.00 ANCC contact hours.

All other learners may claim CME-designated participation credit. Consult your professional licensing board regarding the applicability and acceptance of CME-designated participation credit for programs certified for credit by organizations accredited by Joint Accreditation for Interprofessional Education.

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Bibliographic Material

• American Academy of Dermatology. Sunscreen FAQs.  Accessed March 27, 2024.  https://www.aad.org/media/stats-sunscreen#:~:text=In%20addition%20to%20applying%20a,%2Dbrimmed%20hat%2C%20and%20sunglasses.
  
  
• American Academy of Dermatology. Infant Sun Protection: How Parents Can Keep their Baby Safe.  Accessed March 27, 2024.  https://www.aad.org/public/diseases/skin-cancer/prevent/sun-babies.
  
  
• American Cancer Society. Ultraviolet (UV) Radiation. Accessed March 29, 2024. https://www.cancer.org/cancer/risk-prevention/sun-and-uv/uv-radiation.html.
  
  
• Balk SJ. Sun Protection. Pediatr Rev. 2023 Apr 1;44(4):236-239. doi: 10.1542/pir.2022-005545. PMID: 37002351.
  
  
• Bolognia, Jean, L. et al. Dermatology. Available from: Elsevier eBooks+, (4th Edition). Elsevier - OHCE, 2017.
  
  
• Cancer Council NSW. How UV radiation increases skin cancer risk. Accessed April 4, 2024. https://www.cancercouncil.com.au/cancer-prevention/sun-protection/understanding-uv-radiation/how-uv-radiation-increases-skin-cancer-risk/.
  
  
• Dadlani C, Orlow SJ. Planning for a brighter future: a review of sun protection and barriers to behavioral change in children and adolescents. Dermatol Online J. 2008 Sep 15;14(9):1. PMID: 19061583.
  
  
• Darvin ME, König K, Kellner-Hoefer M, Breunig HG, Werncke W, Meinke MC, Patzelt A, Sterry W, Lademann J. Safety assessment by multiphoton fluorescence/second harmonic generation/hyper-Rayleigh scattering tomography of ZnO nanoparticles used in cosmetic products. Skin Pharmacol Physiol. 2012;25(4):219-26. doi: 10.1159/000338976. Epub 2012 May 30. PMID: 22653438.
  
  
• Druml L, Ilyas AM, Ilyas EN. Sunscreen Label Marketing Towards Pediatric Populations: Guidance for Navigating Sunscreen Choice. Cureus. 2023 Oct 10;15(10):e46785. doi: 10.7759/cureus.46785. PMID: 37954729; PMCID: PMC10634137.
  10. Environmental Working Group. Nanoparticles in Sunscreens.  Accessed March 29, 2024. https://www.ewg.org/sunscreen/report/nanoparticles-in-sunscreen/.
  
  
• Food and Drug Administration. Consumer Updates: Should You Put Sunscreen on Infants? Not Usually. Accessed March 27, 2024. https://www.fda.gov/consumers/consumer-updates/should-you-put-sunscreen-infants-not-usually.
  
  
• Food and Drug Administration. Tips to Stay Safe in the Sun: From Sunscreen to Sunglasses. Accessed March 27, 2024. https://www.fda.gov/consumers/consumer-updates/tips-stay-safe-sun-sunscreen-sunglasses
  
  
• Food and Drug Administration. Questions and Answers: FDA posts deemed final order and proposed order for over-the-counter sunscreen. Accessed April 4, 2024. https://www.fda.gov/drugs/understanding-over-counter-medicines/questions-and-answers-fda-posts-deemed-final-order-and-proposed-order-over-counter-sunscreen.
  
  
• Fox JD, Benesh G, Abrouk M, Kirsner RS. Controversies in Sunscreens: A Practical Approach. Am J Med. 2020 Dec;133(12):1378-1379. doi: 10.1016/j.amjmed.2020.06.012. Epub 2020 Jul 16. PMID: 32681830. 
  
  
• Gulson B, McCall M, Korsch M, Gomez L, Casey P, Oytam Y, Taylor A, McCulloch M, Trotter J, Kinsley L, Greenoak G. Small amounts of zinc from zinc oxide particles in sunscreens applied outdoors are absorbed through human skin. Toxicol Sci. 2010 Nov;118(1):140-9. doi: 10.1093/toxsci/kfq243. Epub 2010 Aug 12. Erratum in: Toxicol Sci. 2011 Apr;120(2):530. PMID: 20705894.
  
  
• Gulson B, Wong H, Korsch M, Gomez L, Casey P, McCall M, McCulloch M, Trotter J, Stauber J, Greenoak G. Comparison of dermal absorption of zinc from different sunscreen formulations and differing UV exposure based on stable isotope tracing. Sci Total Environ. 2012 Mar 15;420:313-8. doi: 10.1016/j.scitotenv.2011.12.046. Epub 2012 Feb 7. PMID: 22316633.
  
  
• Leite-Silva VR, Le Lamer M, Sanchez WY, Liu DC, Sanchez WH, Morrow I, Martin D, Silva HD, Prow TW, Grice JE, Roberts MS. The effect of formulation on the penetration of coated and uncoated zinc oxide nanoparticles into the viable epidermis of human skin in vivo. Eur J Pharm Biopharm. 2013 Jun;84(2):297-308. doi: 10.1016/j.ejpb.2013.01.020. Epub 2013 Feb 28. PMID: 23454052.
  
  
• Lyons AB, Trullas C, Kohli I, Hamzavi IH, Lim HW. Photoprotection beyond ultraviolet radiation: A review of tinted sunscreens. J Am Acad Dermatol. 2021 May;84(5):1393-1397. doi: 10.1016/j.jaad.2020.04.079. Epub 2020 Apr 23. PMID: 32335182.
  
  
• Matta MK, Zusterzeel R, Pilli NR, Patel V, Volpe DA, Florian J, Oh L, Bashaw E, Zineh I, Sanabria C, Kemp S, Godfrey A, Adah S, Coelho S, Wang J, Furlong LA, Ganley C, Michele T, Strauss DG. Effect of Sunscreen Application Under Maximal Use Conditions on Plasma Concentration of Sunscreen Active Ingredients: A Randomized Clinical Trial. JAMA. 2019 Jun 4;321(21):2082-2091. doi: 10.1001/jama.2019.5586. PMID: 31058986; PMCID: PMC6549296.
  
  
• Matta MK, Florian J, Zusterzeel R, Pilli NR, Patel V, Volpe DA, Yang Y, Oh L, Bashaw E, Zineh I, Sanabria C, Kemp S, Godfrey A, Adah S, Coelho S, Wang J, Furlong LA, Ganley C, Michele T, Strauss DG. Effect of Sunscreen Application on Plasma Concentration of Sunscreen Active Ingredients: A Randomized Clinical Trial. JAMA. 2020 Jan 21;323(3):256-267. doi: 10.1001/jama.2019.20747. Erratum in: JAMA. 2020 Mar 17;323(11):1098. PMID: 31961417; PMCID: PMC6990686.
  
  
• Paller, Amy, S. and Anthony J. Mancini. Paller and Mancini - Hurwitz Clinical Pediatric Dermatology. Available from: Elsevier eBooks+, (6th Edition). Elsevier - OHCE, 2021.
  
  
• Pflücker F, Wendel V, Hohenberg H, Gärtner E, Will T, Pfeiffer S, Wepf R, Gers-Barlag H. The human stratum corneum layer: an effective barrier against dermal uptake of different forms of topically applied micronised titanium dioxide. Skin Pharmacol Appl Skin Physiol. 2001;14 Suppl 1:92-7. doi: 10.1159/000056396. PMID: 11509913.
  
  
• Raymond-Lezman JR, Riskin S. Attitudes, Behaviors, and Risks of Sun Protection to Prevent Skin Cancer Amongst Children, Adolescents, and Adults. Cureus. 2023 Feb 13;15(2):e34934. doi: 10.7759/cureus.34934. PMID: 36938200; PMCID: PMC10016731.
  
  
• Sadrieh N, Wokovich AM, Gopee NV, Zheng J, Haines D, Parmiter D, Siitonen PH, Cozart CR, Patri AK, McNeil SE, Howard PC, Doub WH, Buhse LF. Lack of significant dermal penetration of titanium dioxide from sunscreen formulations containing nano- and submicron-size TiO2 particles. Toxicol Sci. 2010 May;115(1):156-66. doi: 10.1093/toxsci/kfq041. Epub 2010 Feb 15. PMID: 20156837; PMCID: PMC2855360.
  
  
• Schlumpf M, Cotton B, Conscience M, Haller V, Steinmann B, Lichtensteiger W. In vitro and in vivo estrogenicity of UV screens. Environ Health Perspect. 2001 Mar;109(3):239-44. doi: 10.1289/ehp.01109239. Erratum in: Environ Health Perspect. 2001 Nov;109(11):A517. PMID: 11333184; PMCID: PMC1240241.
  
  
• Skin Cancer Prevention: Behavioral Counseling. US Preventive Services Task Force. Accessed March 27,  2024.  https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/skin-cancer-counseling. 
  
  
• The Surgeon General’s Call to Action to Prevent Skin Cancer. Office of the Surgeon General. Washington, DC: US Department of Health and Human Services; 2014
  
  
• Wang SQ, Burnett ME, Lim HW. Safety of oxybenzone: putting numbers into perspective. Arch Dermatol. 2011 Jul;147(7):865-6. doi: 10.1001/archdermatol.2011.173. PMID: 21768493.
  
  
• Williams JD, Maitra P, Atillasoy E, Wu MM, Farberg AS, Rigel DS. SPF 100+ sunscreen is more protective against sunburn than SPF 50+ in actual use: Results of a randomized, double-blind, split-face, natural sunlight exposure clinical trial. J Am Acad Dermatol. 2018 May;78(5):902-910.e2. doi: 10.1016/j.jaad.2017.12.062. Epub 2017 Dec 29. PMID: 29291958.
  
  
• Wirecutter. The Best Sunscreen. https://www.nytimes.com/wirecutter/reviews/best-sunscreen/. Accessed April 4, 2024.
  
  

Provider Contact Information
Provider contact information for questions regarding accreditation of the activity:

Center for Learning and Professional Development
CE Office
Dartmouth Health
[email protected]

Mitigation of Relevant Financial Relationships

Dartmouth Health adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Education.  Any individuals in a position to control the content of a CE activity, including planners, faculty, authors, or others are required to disclose all financial relationships with ineligible companies^.  All relevant financial relationships have been mitigated prior to the commencement of the activity.

^Ineligible Company is any entity whose primary business purpose is producing, marketing, selling, re-selling or distributing healthcare products used by or on patients.