​Dr. Shanah Salter
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Medical Articles For
Parents & Caregivers

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​A health-related blog for parents and caregivers of young children,
with Australianisms thrown in for good measure!

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​Back in Australia, the Land Down Under, I worked as a family physician treating snake and spider bites, colds and flus, and everything in between. Well, perhaps the snake bites are a slight exaggeration, but the spider bites are actually true. 

Now that I live in the U.S.A, I've exchanged clinical practice for blogging. So please read on and enjoy my chinwag (Aussie for chat) about all things health-related.
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P.S. If there are any topics you would like to see covered, just give me a bell (Aussie for call/contact).

Sun-sense & Stingers

6/5/2017

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As we head toward lazy summer days filled with smiles and shenanigans, it is important to be thinking about sun protection and avoiding things that sting.

SUN-SENSE
A great Aussie campaign called SunSmart was created to teach Aussies about sun safety- I think everyone should know it. So, here are the 5 S’s of being SunSmart:
SLIP on clothing:
- clothing should cover as much skin as possible (so should bathers*)
- choose clothing with a good UV rating (check the garment label). Generally speaking, dark colored clothing with a tight weave offers good protection. Oh, and don’t forget that the UV rating of fabric drops when it gets wet.
SLOP on sunscreen:
- i.e. a water resistant, broad-spectrum (protects against UVA and UVB) sunscreen with an SPF rating of SPF30 or SPF50+. There is little difference between these two SPF ratings- 30 filters out 97% UVB, 50+ filters 98%.
- Apply 20-30 minutes before sun exposure and re-apply every 2 hours or sooner if excess sweating or swimming.
- Ensure the sunscreen you are applying is within date and not expired.
SLAP on a hat:
- Hats with a large brim so that the whole face, neck, top of head and ears are protected are best (think Crocodile Dundee* style)
SEEK shade:
- Children should not ‘sun-bathe’. Shade can be created with items such as big beach umbrellas, canopies, and tents.
SLIDE on sunglasses:
- Sunnies* should block UVA and UVB light. For kids, sunnies in the style of swimming goggles are great.

What about vitamin D?
The American Academy of Dermatology advises that vitamin D levels should be maintained through diet rather than UV exposure: fish, dairy, and fortified foods/beverages. Supplements can be used if advised by your physician.

What about skin cancer?
1 in 5 Americans will develop skin cancer. For Australians, that number is 2 in 3! Skin cancer is a leading cause of death and most cases are preventable through protected sun exposure, regardless of age.


STINGERS
As well as being irritating, stinging bugs (mozzies*, biting flies, ticks) can pose a serious disease risk (e.g. Lyme disease, Zika virus). So AVOID and if that doesn’t work, REPEL!
Bug avoidance strategies
- avoid use of scented soaps, perfumes, and scented hair products (i.e. don’t smell like a flower!)
- stay away from areas where insects nest/congregate such as stagnant water and blooming flowers
- manage areas near your home that may encourage breeding of stinging bugs such as ponds and damp leaf litter and treat your pets for ticks
- ensure screens are fitted on all windows and repair any holes in old screens
- consider enclosing your verandah* with framed netting
- cover-up as much skin as possible with appropriate clothing when outdoors
- avoid being outdoors in peak stinger time e.g. peak barbie* time- dusk
- after time out-doors, perform a tick-inspection on family members clothing and skin. Remove any ticks promptly with fine-tipped tweezers and flush down the toilet. Ticks on clothing can be killed with a hot machine wash and low tumble dry. Consult a doctor if a rash or fever begins within a few weeks of tick removal to ensure it is not tick-related.

Repellant
- use repellant in addition to bug avoidance strategies when required
- never use a sunscreen/repellant combination as sunscreen needs to be reapplied far more frequently (excess use of repellant can be dangerous)
- do not use any type of repellant on a baby younger than 2 months of age
- products containing 20% DEET (only use <30% DEET on kids) or 20% picaridin will provide the best protection for serious situations (e.g. high risk areas, overseas travel).
- Natural repellants containing various blends of citronella/eucalyptus/mint/lemongrass/pine/other herbal ingredients are in abundance. Unfortunately, to date, there is a lack of high quality evidence to support the effectiveness of these products. Anecdotally, people say they work (especially in the first hour after application) but remember, ‘natural’ isn’t always safe. For example, oil of lemon eucalyptus should not be used on children under 3 years of age.
- Regardless of which repellant you choose, follow these tips for maximizing repellant safety:
     • Only apply repellant to exposed skin.
     • Do not allow children to apply their own repellant. A responsible adult should apply the repellant- avoiding the          hands, eyes, nose, and mouth and applying as per the product label. Repellant should not be applied to broken or          irritated skin.
     • Children should not consume food or drink while wearing repellant if there is a chance that the repellant from            their skin could contaminate the food/drink, resulting in repellant ingestion.
     • After returning indoors, repellant should be washed off the skin immediately and clothes sprayed with repellent          should be promptly removed and laundered.
     • Before using a repellant for the first time, perform a test patch to check for sensitivity/skin irritation

FOR MORE INFORMATION:
American Academy of Dermatology
https://www.aad.org/media/news-releases/sunscreen-remains-a-safe-effective-form-of-sun-protection
Cancer Council Australia
http://www.cancer.org.au/preventing-cancer/sun-protection/
CDC- Bug Bites
https://wwwnc.cdc.gov/travel/page/avoid-bug-bites
Study on natural repellants
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3059459/

AUSTRALIAN-ISMS:
Barbie = short for barbecue = an outdoor grill
Bathers/togs/swimmers = any type of swim-wear e.g. swimsuit, bikini
Crocodile Dundee: if you haven’t heard of this classic Aussie movie, you’re missing out
Mozzie = mosquito (remember Aussies abbreviate everything)
Sunnies= sunglasses (abbreviating again!)
Verandah = porch
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