What's the right sunscreen protection for kids? Is spray sunscreen safe?

AND PLENTY OF TIME IN THE SUN. IF WE CAN GET A FULL SUN DAY. JOINING US IS DOCTOR SCOTT HADLAND. HE’S THE CHIEF OF ADOLESCENT MEDICINE AT MASS GENERAL FOR CHILDREN. DOCTOR HADLAND, THANKS FOR COMING IN. HOPE YOU HAD A GREAT 4TH OF JULY. I DID. THANK YOU ALL RIGHT, SO KIDS WANT TO BE OUTSIDE HAVING FUN THIS TIME OF THE YEAR, AND THEY DON’T REALLY THINK ABOUT PROTECTING THEMSELVES FROM THE SUN. BUT HOW IMPORTANT IS IT TO MAKE SURE THAT THEY’RE WEARING SUNSCREEN AT THIS YOUNG AGE? YEAH, IT’S REALLY CRITICAL IF YOU THINK ABOUT WHAT UV RAYS ARE DOING TO OUR BODY, THEY’RE CAUSING DNA DAMAGE TO THE CELLS OF OUR BODY, AND THAT DAMAGE IS CUMULATIVE, MEANING THAT IT BUILDS OVER TIME AND SO DAMAGE THAT A CHILD ACCUMULATES WHEN THEY’RE YOUNGER IS GOING TO STAY WITH THEM FOR THE REST OF THEIR LIFE. SO IT BECOMES A REALLY IMPORTANT TO PREVENT IT EARLY ON IN LIFE. THE OTHER THING I WOULD SAY IS THAT KIDS SKIN IS REALLY A LOT THINNER THAN ADULT SKIN. IT DOESN’T YET HAVE THE SAME PROTECTION THAT ADULT SKIN DOES. AND SO KIDS ARE JUST MUCH MORE LIKELY TO BURN. SO WE REALLY RECOMMEND, AS PEDIATRICIANS, KIDS UNDER THE AGE OF SIX MONTHS SHOULD REALLY STAY OUT OF THE SUN ALTOGETHER. KIDS SIX MONTHS AND OLDER CAN START TO APPLY SUNSCREEN, AND WE WANT TO DO THAT REALLY KIND OF CONSISTENTLY EVERY TIME THEY’RE GOING OUTSIDE. YOU KNOW WHAT? THERE’S SO MANY OPTIONS TOO FOR SUNSCREEN, ESPECIALLY FOR ADULTS TOO. SO WHAT SHOULD PARENTS LOOK FOR WHEN IT COMES TO CHANGE AS THEY GET OLDER? THE TYPES THAT THEY SHOULD BE LOOKING TO GET? YEAH, IT’S REALLY OVERWHELMING. I TOTALLY GET THIS AS A PARENT AS WELL. WHAT YOU WANT TO LOOK FOR IS AN SPF OF AT LEAST 30, AND IDEALLY AT LEAST 45 FOR KIDS, BECAUSE THAT’S GOING TO PROVIDE THEM THE BEST SUN PROTECTION. AND THEN THERE’S TWO TYPES OF SUNSCREENS THAT WE THINK ABOUT. THERE ARE WHAT WE CALL PHYSICAL SUNSCREENS. AND THEN CHEMICAL SUNSCREENS AND PHYSICAL SUNSCREENS ARE THE KINDS THAT HAVE TITANIUM DIOXIDE OR ZINC OXIDE IN THEM. WHEN YOU APPLY THEM, THEY SOMETIMES LEAVE A LITTLE BIT OF A WHITE CAST BEHIND, WHICH CAN BE A LITTLE BIT FRUSTRATING. ARE THOSE THE ONES THAT PEOPLE REFER TO AS MINERAL SUNSCREEN? MINERAL SUNSCREENS, AND THOSE ARE PROBABLY SAFER FOR THE YOUNGER KIDS IN PARTICULAR. AS KIDS GET OLDER, YOU CAN START THINKING ABOUT THE CHEMICAL SUNSCREENS, AND THOSE ARE THE ONES THAT DON’T LEAVE THAT WHITE CAST TO THE SAME EXTENT. BUT THEY HAVE A LOT OF COMPLICATED INGREDIENTS IN THEM. AND ONE INGREDIENT THAT WE WORRY ABOUT A LOT AS PEDIATRICIANS IS SOMETHING CALLED OXYBENZONE, WHICH IS IN SOME CHEMICAL SUNSCREENS. AND THAT ACTUALLY MIGHT CAUSE SOME PROBLEMS BECAUSE IT GETS ABSORBED INTO THE SKIN AND CAN CAUSE SOME PROBLEMS WITH HORMONES. AND SO WE RECOMMEND PARENTS STAY AWAY FROM SUNSCREENS THAT HAVE OXYBENZONE IN IT. ALL RIGHT. WE HAVE A BIN IN OUR MUDROOM WHEN THE KIDS GO OUTSIDE THERE’S LIKE PROBABLY EIGHT HALF USED BOTTLES OF SUNSCREEN IN THERE. RIGHT. THEY ALWAYS GO FOR THE SPRAY. YEAH. IS THERE A CONCERN ABOUT KIDS USING SPRAY VERSUS THE CREAM OR THE LOTION? YEAH. ONE WORRY THAT WE HAVE ABOUT THE SPRAY IS THAT, YOU KNOW, ALL OF THESE SUNSCREENS HAVE A RANGE OF CHEMICALS IN THEM THAT AREN’T FULLY UNDERSTOOD. NOW, DON’T GET ME WRONG. LIKE THE STUDIES THAT HAVE BEEN DONE SO FAR DEMONSTRATE THAT THESE ARE SAFE, BUT WE’RE STILL LEARNING MORE AND MORE ABOUT THE CHEMICALS AND SUNSCREENS. AND SO I SORT OF EXERCISE A LITTLE BIT OF CAUTION AS A DAD, AS A PEDIATRICIAN, ABOUT THE SPRAY SUNSCREENS, BECAUSE I WORRY THAT THEY CAN GET INHALED IF YOU HAVE A CHILD WHO CAN HOLD THEIR BREATH OR BREATHE OUT, AND YOU CAN DO IT OUTSIDE IN A WELL-VENTILATED SPACE, I THINK IT’S PROBABLY OKAY. AND YOU JUST WANT TO MAKE SURE YOU RUB IT IN AFTER RUBBING IT IN IS KEY, RIGHT? AND YOU MENTIONED AT LEAST 45. I HAD HEARD YOU KNOW, MAYBE IT’S, YOU KNOW, AN OLD TALE OR URBAN MYTH THAT ONCE YOU GET ABOVE LIKE 45 OR 50, YOU KNOW, YOU SEE SUNSCREENS THAT ARE 75 OR 100. IS THERE REALLY DO YOU REALLY NEED THAT MUCH PROTECTION OR IS THERE THAT DIFFERENCE REALLY IN THE PROTECTION ONCE YOU GET TO SUCH A HIGH NUMBER? YEAH, THERE ARE SOME DIMINISHING RETURNS AS YOU GET UP TO THOSE REALLY HIGH SPF VALUES. THERE IS A BIG DIFFERENCE BETWEEN 30 AND 45. AND SO 45 IS BETTER THAN 30. ABSOLUTELY. BUT WHAT’S ACTUALLY REALLY KEY IS MORE THAN THE NUMBER IN THE SUNSCREEN IS ACTUALLY MAKING SURE THAT YOU REAPPLY. YOU WANT TO REAPPLY AT LEAST EVERY TWO HOURS. WHEN A CHILD IS OUTSIDE BECAUSE A HIGH SPF SUNSCREEN ISN’T GOING TO DO ANY GOOD ONCE IT’S WORN OFF. AFTER A COUPLE OF HOURS. EVERY TWO HOURS, REAPPLY. YEAH. GOOD ADVICE, DOCTOR SCOTT. WE ALWAYS APPRECIATE WHEN YOU’