In the commentary, "Sunburns, Melanoma, and the Pediatrician," by Williams and Sagebiel (Pediatrics 1989;84:381-382), three lines were omitted from the bottom of p 381. The whole paragraph is reprinted here.
It is clear that a change is required in social perceptions in which a suntan is equated with health and beauty—not because suntans per se are unhealthy (the deleterious effects of ultraviolet light at suberythemogenic levels are not wellestablished), but because the persistent and often futile efforts of those who constitutionally have less pigment to achieve a tan have serious long-term health consequences. Ideally, there should be a social norm of beauty in which the natural differences in skin color are appreciated and black, tan, pink, and all shades in between are celebrated. Similarly, we need to change our thinking about freckles and solar lentigines. These are not "cute" but represent the ineffective efforts of melanocytes in genetically underpigmented skin to provide protective pigmentation in response to solar stress. Although pediatricians alone cannot change social concepts of beauty, we can instruct our patients and their families about sun protection and we can monitor them for early signs of excessive sun exposure. Weinstock et al demonstrated an increased risk of melanoma for those who had blistering sunburns in adolescence. Although they did not address the risk associated with sunburning prior to ages 15 years, it seems likely that these data can be applied to children of all ages. Therefore, instruction and sun protection should begin in infancy. Moreover, teenagers are known to be both highly conditioned by peer concepts of beauty and relatively impervious to the counsel of their elders. It is essential, therefore, that they enter these years with skin that has been well protected and with minds well indoctrinated.
- Copyright © 1989 by the American Academy of Pediatrics