Summer Fun: Tick Talk and Sunblock

Summer Fun - Tick Talk & SunblockSchool is out, and summer is here, even though San Francisco fog and wind may keep us
reaching for sweatshirts and jackets a while longer. (Of course, if you’re missing the heat of summer, all you need to do is venture a few miles to the North, East, or SouthBay to find it.) Summer invites us to spend more time outdoors, whether we’re playing, hiking, swimming, or picnicking. Time outdoors not only connects us with awe-inspiring nature but also promotes a healthy microbiome, good vision, and, importantly, lots of fun.

One of the best ways to ensure more fun on big and small outdoor adventures is to be prepared. For summer, that includes using products like sunscreen and insect repellent, and knowing what to do if a tick bites. But how do you choose which ones to use? In this article, I offer suggestions for safer, effective products that allow you to make the most of the outdoors. And, in recognition of how chilly and gloomy some San Francisco summer days can be, I have provided some indoor summer activities that families in our practice enjoy.

If you want to feel overwhelmed, go to any sunscreen aisle. Whether you’re shopping online or in person, all the claims and ingredients can feel impossible to navigate. How do you choose?

First, it’s important to remember why we use sunscreen. We use it primarily to protect our skin from cancer. Sunscreen also helps to protect against signs of photoaging, like wrinkles and hyperpigmentation. From a practical, everyday perspective that kids may find more relatable, it helps prevent painful sunburns.

There are two basic types of sunscreens: mineral and chemical. The Environmental Working Group (EWG) has an extensive database rating the safety of both kinds of sunscreens, and they also have a list of EWG Verified Sunscreens–the ones that meet EWG’s strictest standards for health and safety. Generally, mineral sunscreens (with the physical barrier, zinc oxide) are rated safer than chemical sunscreens. And cream-based mineral sunscreens are rated safer than their spray-based counterparts because using a spray increases the risk of inhaling mineral nanoparticles. Find more information about the specifics of a variety of active ingredients in sunscreen from EWG. Regardless of the type of sunscreen you choose, you’ll need to thoroughly reapply it every 1.5 hours or so in order to maintain its effectiveness.

At GetzWell Pediatrics, we recommend Babo sunscreen. It’s EWG verified, so it’s free from harmful chemicals and crafted with natural ingredients that provide effective sun protection while being gentle on delicate skin. Of course, for babies 6 months old and younger no sunscreen may be safe. These young babies need to be kept out of direct, strong sunlight because their skin is thin and sensitive, and over-exposure can lead to a greater risk of skin cancer later in life. Shade, sun hats, SPF clothing, and lightweight sleeves can be helpful for very little ones.

These additional sun protection options are not limited to babies. We can think about sun protection in 5 layers that, when used together, improve our chances of staying sun-safe: Slip on a shirt, Slop on some sunscreen, Slap on a hat, Seek shade, and Slide on some sunglasses. As always, don’t let perfect become the enemy of good. The best type of sunscreen practice is the one that you (or your kids) will actually use.

Insect Repellent
We tend to think about mosquitoes and biting flies as an itchy, noisy nuisance, which they, of course, are. But mosquitoes also transmit diseases. The mosquito that carries dengue fever (among other diseases), Aedes aegypti, is expanding its geographic range as our global climate warms. It is currently causing a dramatic and concerning rise in dengue fever cases in Latin America and other areas of the world due to warmer temperatures.

Tick-borne diseases, especially Lyme but also coinfections like Bartonella and Babesia, are also on the rise. In fact, it has been reported that Lyme disease diagnoses have increased by 65% in urban areas alone in the last 15 years! I had never even seen an actual tick until very recently when I was out for a much-needed hike in Marin. After a couple of hours, I noticed a fleeting and bothersome sensation on my chest, and much to my chagrin, a tick had begun to embed itself in me. I immediately removed it, put it in a ziplock baggie, and sent it to Tickreport for testing. I’m so glad I did because it was a deer tick, and the test came back positive for Borrelia, the spirochete that causes Lyme. Fortunately, I was able to start prophylaxis before I had any symptoms (fever, rash, joint pain, and headache are common), but it was a reality check, for sure. Had I applied insect repellent before going out and worn a tight-fitting (around the neck) shirt I might have avoided this altogether!

Proper application and use of insect repellent can protect against bites and the life-altering diseases they may carry. EWG reports that researchers have found DEET (at less than 30 percent), IR3535 (at 20 percent), and Picaridin are safe, effective, active ingredients that are key to keeping mosquitoes and ticks away. If repellents with these chemicals are not available or are unacceptable to you, oil of lemon eucalyptus and its synthetic derivative PMD can be effective, but probably for a shorter duration, so you’d need to reapply it frequently. It’s important to remember that, like sunscreen, no insect repellents are safe for children under 6 months old.

There are additional options to help keep insects away, as well. You can cover up in light-colored clothing so tiny ticks are easier to see, use netting over beds during “mosquito times,” clean up areas of standing water that are breeding grounds for mosquitoes, and follow CDC guidelines for reducing your yard’s tick population. When you finish activities in areas with tall grass and tree canopies, make a practice of doing a “tick check” and give yourself and your kids a once-over to see if you spot any. The youngest ticks are literally the size of a poppy seed and may “hide out” under the arms, on upper thighs/groin areas, or behind ears.

Tick Bite Practice
If you find that a tick has bitten your child (or you), I recommend the following practice:
• Take a deep breath and try to remain calm!
• Remove the tick. I recommend keeping on hand either a Tick Key or a Tick Removal Card. Both are effective and easy to use. You can also follow these instructions.
• Save the tick in a plastic bag with a zipper closure.
• Visit and order a test.
• Mail the tick in overnight, if possible.
Call GetzWell to explore a single-dose antibiotic preventive while awaiting results.
• If the results come back positive for Lyme or any other disease, contact us to make an appointment to discuss whether treatment is necessary.

If a tick is just crawling and hasn’t embedded in the skin, simply remove it. There’s no need to have it tested.

Indoor Summer Fun
Ready to hide from the fog for a little bit? You likely already have some favorite spots for indoor fun, but here are some I know many of our families enjoy:

San Francisco Public Library: In addition to books, movies, and audio recordings, SFPL has an extensive list of free summer activities available through its program, Summer Stride. You can also access free passes to a variety of Bay Area museums and attractions through the Discover & Go program.
Cable Car Museum: Get ready to be wowed as you see how the cable cars move around the city. Admission is free.
Randall Museum: Visit with animals and learn about our environment. Admission is free.
Exploratorium: The Exploratorium is a public learning laboratory where you can explore the world through science, art, and human perception.
CuriOdyssey: A bit further afield, in San Mateo, where you can visit with rescued animals and engage with science exhibits, too.

And most of all, enjoy the summer. It is a special time for all of us to connect with ourselves and each other.

Want to know more?

We are committed to providing the best pediatric care in the Bay Area. If you want to learn more about our practice, please contact us.