MOST OF US ASSOCIATE SKIN CANCER WITH ADULTS— people who have spent years exposed to the sun. But over the years, Dr. Andrea Hayes-Jordan, director of Pediatric Surgical Oncology at Children’s Memorial Hermann Hospital, has witnessed many cases of melanoma in kids. 

“Melanoma is the most common skin cancer in patients 20 years and younger,” she says. Admittedly still rare—of the 55,000 cases diagnosed each year, 5 percent occur in patients younger than 20, and .3 percent in patients under 14—“the area known as the Sunbelt,” says Dr. Hayes-Jordan, “has seen a higher incidence over the years.” 

Although prolonged sun exposure is a factor in all skin cancers, including melanoma, it’s not the only cause. “Physicians and pediatricians are still unaware of what exactly causes it,” says the doctor, “because it has been found in children as young as two years old.” In certain cases, it’s congenital.

Melanoma lesions tend to be between 1 and 4 millimeters in diameter and are often mistaken for warts, moles, or freckles. Parents should watch for changes in the color and shape of existing moles, new lumps, and, at the beginning of manifestation, itching or bleeding. 

Given its serious nature and the misperception that skin cancer is an adult disease, parents should get in the habit of inspecting their children’s skin closely, and take them to a dermatologist if anything abnormal is found. Early detection is the key with any form of cancer.

The good news: melanoma is very treatable. After surgeons remove the lesion, the patient continues to have post-op follow-up for a full year, and over the following five years, there are periodic checkups to monitor for relapse.

It’s most important for parents to be proactive, says Dr. Hayes-Jordan. If you think you’ve spotted something, get it checked out. “Remember that no problem is too small to seek the help of your pediatrician,” she says. 

 

 

WHEN IT COMES TO PROTECTING YOUR CHILDREN from the sun’s ultraviolet radiation, a sure-fire option is, of course, simply staying in the shade. But as any parent knows, that’s easier said than done. Hence the need for protective clothing, sunglasses, and sunscreen. But which products and which SPF numbers are best? 

“You really want to choose a sunscreen with an SPF from 15 to 30 for protection,” says Dr. Hayes-Jordan. “Sunscreens with an SPF higher than 30 are not necessarily increasing your protection against UV rays, but anything less than an SPF of 15 isn’t doing enough.” 

Beyond that, it’s important to read the label. Some sunscreens are intended exclusively for use on the face, while some may contain allergens. Remember to apply it 15 to 30 minutes before exposure, reapply a liberal amount every two hours or as instructed on the label, and reapply again after swimming.

Everyone should wear sunscreen, Dr. Hayes-Jordan emphasizes. Darker skin pigments face the same dangers as lighter ones. “No matter what your skin pigment, just because you don’t feel the burn, doesn’t mean it’s not hurting you,” she says. “Everyone should practice safe skin protection against the sun’s UV rays.”

 

 

IT HAPPENS TO ALL PARENTS EVENTUALLY: a child suddenly becomes ill, or has an accident, and you call the pediatrician looking for guidance. But the pediatrician is in Hawaii, or otherwise unreachable, or maybe it’s midnight and the doctor’s office is closed. When should you wait till morning and when should you visit the ER?

We asked that same question of Dr. Patti Savrick of Bootin & Savrick Pediatric Associates, who is affiliated with Children’s Memorial Hermann Hospital. The following is for educational purposes and should not be construed as a substitute for consulting with a medical professional. 

 

Go to the ER? Rarely
“Fever alone is rarely a reason to go to an ER. The exception is a child less than six weeks old with any temperature 100.5 or more. An older child or infant with fever can almost always be managed at home. For the best indicator of how sick a child is, wait to see how the child looks when the fever goes down. All children tend to look listless and miserable when the fever is high, but if you bring the temp down, and your child perks up and looks much better, you can continue to control the fever and see your pediatrician the next day in the office. Reasons to go to the ER for fever have only to do with other symptoms accompanying the fever, not the fever itself.”

“This can generally be managed at home. If your child has just vomited, wait at least 30 minutes and then offer small sips of clear liquids (rehydrating solution is best). Do not allow your child to guzzle the drink, or he will likely vomit again. Reasons to head to the ER would include vomiting after head trauma; vomiting accompanied by severe abdominal pain with or without fever; or green vomit, which could mean there is something deeper than just belly issues. Diarrhea is very rarely a reason to go to the ER; go only if your child has high fever, refuses to drink, is listless, or has copious bloody stool. Diarrhea usually just has to resolve itself and requires no treatment except to maintain hydration. Do not give juices to your child with diarrhea, as this makes the stool looser.”

 

Go to the ER? Yes 
“Actual difficulty breathing is an appropriate trip to the ER; however, congestion causing the breathing to be noisy through the nose is not. Severe nasal congestion that makes it hard for your child to sleep is not ‘trouble breathing.’ If your child is struggling, especially if the spaces between the ribs are sinking in, nostrils are flaring, or skin is pale or gray, the child needs to be immediately seen.”

 

Go to the ER? Yes 
“Broken limbs are a reason to go the ER. If the pain is severe, or if the limb is not straight, or accompanied by an open wound, that is an appropriate ER visit. However, if your child falls while playing and then complains of pain, treat first with ice and pain reliever. If your child settles down and is fairly comfortable, he can be seen by his doctor the following day.”

“Cuts and lacerations only need to be seen at the ER if the parent cannot control the bleeding, if the wound is deep and requires stiches, or if it’s significant and to a soft body part like the eye, back of the throat, or genitalia. Milder wounds can be treated with soap and water, application of antibacterial ointment, and a bandage as needed.”

 

Go to the ER? Rarely 
“Animal bites that are not actively bleeding can be seen in your pediatrician’s office the next day for possible antibiotic treatment and tetanus booster, if needed. Violent animal bites with torn flesh, especially to the face, should be treated at the ER.”

 

Go to the ER? Rarely 
“A cough does not need to be seen in the ER unless accompanied by signs of respiratory distress. If your child has a bad cough, but his breathing is okay in between, you are okay to see your doctor the next day.”

 

Go to the ER? Rarely 
“An allergic reaction that involves rashes to the skin should be treated with Benadryl. You only need to go the ER if the reaction includes respiratory symptoms such as coughing, wheezing, swelling of the mouth or tongue, or difficulty breathing.”

 

Go to the ER? Yes 
“If your child has an episode of unconsciousness after head trauma, she needs to be seen in the ER. If she faints but is fine afterward and is otherwise healthy, she can be seen by the doctor the next day.”

 

Go to the ER? Rarely 
“Unless the child is drooling uncontrollably or having difficulty breathing, a child who has swallowed something can be seen by his doctor the next day. Note that swallowing small watch or camera batteries is especially dangerous, and the child should be watched closely to ensure it passes in the stool. Your pediatrician should know this has happened and may do an X-ray to make sure the object has passed or will pass.”

 

Go to the ER? Rarely 
“Small burns (less than the size of a pack of cards) can be treated with pain medicine. However, larger burns on small children or any third-degree or electrical burns should be seen in the ER.”

 

Go to the ER? Rarely
“Headaches should only be seen if accompanied by persistent vomiting, following head trauma, or if there are associated neurologic symptoms, such as blurred vision or weakness in an extremity. Also, a headache with a seizure should be seen in the ER.”