"Most teenagers don't really worry about sunburn, they're just really concerned about how their tan looks," 13-year-old Kelsey says.

Still, many young people admit they know the dangers.

Fourteen-year-old Chris recites: "Skin cancer, sun damage …" and Bianca, 13, follows up: "… and maybe in the future your skin will get all wrinkly."

Kelsey says her parents, "tell me to wear sunscreen or wear a hat if I'm gonna be out in the sun."

The truth of the matter is that the warnings about the dangers of too much sun exposure and not enough protection often fall on deaf teenage ears.

"Skin cancer is really becoming an epidemic these days," says Dr. Tiffani Hamilton, a dermatolgist.

In a survey of more than 10,000 youth published in the journal Pediatrics, two thirds said they don't use sunscreen, and 10% regularly visited a tanning bed. Those habits put them at risk for various skin cancers, including melanoma.

"Melanoma is, of course, the most devastating cancer and the one that can spread and lead to death," Dr. Hamilton says.

And research shows that most skin cancers are caused by exposure to the sun before the age of 18!

"And so all of this sun exposure that we have accumulated in our childhood just gradually adds upon itself until when we're older and our immune system is not as strong, we then get skin cancer," Dr. Hamilton says.

Experts warn that parents should make sure their kids take several precautions: Stay away from tanning beds, avoid the mid-day sun and always use sunscreen.

And Dr. Hamilton says to remind them over and over of "how important it is to protect their skin because lifetime risk of skin cancer is increasing dramatically."

Still, what may impact teens the most, says 13-year-old Nigel, is "to see someone they care about have something bad happen to them because of the sun."

By Kim Ogletree
CWK Network, Inc.

The Centers for Disease Control and Prevention reports that more than 1 million Americans are diagnosed with skin cancer each year, and the leading cause of such cancers is excessive exposure to the sun. But according to a new study, these warnings are not stopping teens from spending too much time in the sun. Consider the startling findings of the Boston University study, published in the journal Pediatrics, which surveyed boys and girls aged 12 to 18 about their "tan-seeking" behaviors during 1999 and the previous summer:

• Only a third of the 10,079 youth surveyed said they routinely used sunscreen during the previous summer.
• Girls were much more likely than boys to report sunscreen use - 40% vs. 26% - but they also were more likely to have been sunburned at least three times.
• Most reported having at least one sunburn during the previous summer.
• Half who experienced multiple sunburns said it was worth it to get the tan that followed.
• Nearly 10% said they had used a tanning bed.
• Girls were far more likely to have used a tanning salon or tanning bed, 14% vs. 2% for boys.
  

The U.S. Federal Drug Administration says that sunburns and blistering are the most obvious - and painful - results of sun damage. But exposure to both ultraviolet A (UVA) and ultraviolet B (UVB) rays can result in cumulated damage that leads to skin aging, cataracts, corneal burns and irregular skin pigmentation. And recent research shows that severe sunburns in childhood can significantly increase the risk later in life of developing melanoma, the most serious type of skin cancer. Consider these additional statistics about sunburns and sun exposure from the University of Texas M.D. Anderson Cancer Center:

• Eighty percent of lifetime exposure to sunlight occurs before the age 18.
• Sixty percent of the day's sun-burning radiation occurs between the hours of 10 a.m. and 4 p.m.
• Eighty percent of damaging rays can get through clouds.
• Under normal circumstances, children receive three times the annual sun exposure of adults.
• Even one blistering sunburn during childhood could result in the development of melanoma later in life.
• Three or more episodes of sunburn before the age of 20 that require more than three days to heal increase the risk of contracting melanoma by two to five times.
• Children born today have a four to five times greater risk for developing melanoma in their lifetimes than their parents have.

First and foremost, the American Academy of Dermatology (AAD) says that you can help your child avoid future sun-related health problems by insisting that he or she wear sunscreen while exposed to the sun. Secondly, make sure your teen knows how to use sunscreen effectively. The experts at Harvard Medical School offer the following tips for sunscreen application:

• Start early. Apply sunscreen early in the season, well before the dog days of summer. And apply it early in the day. In addition to offering better protection, diligent use of sunscreen offers protection during moments of spontaneity - for example, you may suddenly decide to take a swim or go on a bike ride.
• Indulge in excess. You can always buy more sunscreen, so don't be bashful when applying it. For example, if you are at the beach (a place with lots of direct sunlight), use approximately one ounce per application.
• Cover up. Cover all areas of your exposed skin, including under your chin, with sunscreen. And don't forget to use a lip balm that has an SPF (sun protection factor) of 15 or more.
• Dry before you fly. Let the sunscreen dry for 15 to 30 minutes on all exposed areas before you go outside.
• Apply and apply again. One application of sunscreen is rarely enough. Gels wash off easily with sweat or water, so they need to be applied frequently. Even water-resistant heavy creams should be applied every one and a half to two hours and after activities, such as swimming.

And after spending a day in the sun, even with sunscreen, your teen will still need to pamper his or her skin:

• Balm your body. The sun beats up on your skin. At the end of the day, rinse your skin and apply moisturizer immediately, while your skin is still wet. The drier your skin, the more greasy the moisturizer needs to be.
• Use the gentle cycle. When you wash your skin, use lukewarm water, not hot, and avoid scrubbing. Use a mild skin cleanser with a soft washcloth, or just your fingers.
• Be sure to save face (and legs). Because the sun dries your skin, be especially careful when you shave. Use an aloe-based shaving cream, etc., on your face or legs to avoid irritation.
• Keep the lights out. Don't smoke. Smoking causes skin to age much faster. Add that to sun damage and drying, and the wrinkles come on quickly.

Your teen can also take other steps besides using sunscreen to protect his or her skin from being damaged by the sun. Pass along to your teen the following sun safety tips from the AAD and the Oregon Health & Science University's Department of Dermatology:

• As a general rule, avoid the sun between 10 a.m. and 4 p.m.
• Use wrap-around sunglasses that block 99% of UVA and UVB rays.
• Select hats with a 3- to 4-inch brim or front and back flaps.
• Wear tightly woven clothing that covers all exposed skin.
• Avoid tanning booths. Sun-bed use is a risk factor in the formation of melanoma.
• Topical creams for artificial tan do not protect from the sun's rays unless they contain sunscreen.

If you believe that your child or teen has already suffered sun damage, the AAD gives the following advice:

• Seek medical attention from your child's dermatologist to evaluate if he or she received skin or eye damage from the sun or if he or she experienced an allergic reaction to the sun.
• See your child's dermatologist if he or she develops an unusual mole, a scaly patch or a sore that doesn't heal. Your child may have developed a pre-cancer or a skin cancer.

American Academy of Dermatology
Centers for Disease Control and Prevention
Harvard Medical School
Oregon Health & Science University's Department of Dermatology
Pediatrics
University of Texas M.D. Anderson Cancer Center
U.S. Federal Drug Administration