V dnešním článku bych se chtěla věnovat základním pravidlům při pobytu dětí na slunci, dále bych se ráda rozepsala o tom, jak jsem děti chránila já a poté bude následovat rozhovor s dermatologem MUDr. et Bc. Lucií Jarešovou. Na závěr napíšu i něco k tomu, jak a proč se chráním před sluncem já.
Dlouhý pobyt na sluníčku bez ochrany poškozuje pokožku (spáleniny) a může způsobit i rakovinu kůže. Proto bychom měli chránit nejen děti, ale i sebe. Téměř všude se dočtete, že kojenec na přímé slunce nepatří a to nejen kvůli ochraně kůže, ale také kvůli zvýšenému riziku přehřátí a úpalu. Se Samíkem jsem se ve vedrech snažila chodit na procházky pouze ráno nebo později odpoledne. Často jsem také využívala toho, že se u našeho kočárku dala u hlavičky rozepnout korba a tak se do ní dostávalo více vzduchu. Vždy jsem vyhledávala stín, ale pokud to nešlo, používala jsem slunečník na kočárek a látkovou plenu, kterou jsem Samíka vždy přikryla když bylo potřeba.

Vyhýbat se sluníčku se Sárinkou, bylo dost obtížné, protože Samíkovi byly 2 roky a chtěl být venku pořád. Nicméně jsem opět vždy vyhledávala stín, používala clonu na kočárek a když jsem měla Sáru v nosítku (což bylo prvních 6 měsíců jejího života), tak měla vždy čepičku a přes nosítko jsem opět přehodila látkovou plenu (můžete si ji přivázat za popruhy), případně jsem ji oblékala do merina, které v létě chladí.

U batolat stále platí, že by na přímém slunci měla pobývat s rozumem a vždy s pokrývkou hlavy. Já jsem obě děti začala mazat opalovacím krémem když jim byl jeden rok (doporučuje se nejdříve od 6 měsíců), do té doby jsem se snažila je přímému slunci nevystavovat. U dětí do 3 let jsou doporučovány opalovací krémy s minerálním (fyzikálním) filtrem, které se nevsakují do pokožky a UV záření odrážejí, takže působí okamžitě. Tím, že s kůží nereagují, tak ji ani nedráždí a měly by tedy být vhodné i pro atopiky. Jejich nevýhodou je, že se hůře roztírají a zanechávají bílý film. My jsme vyzkoušeli snad všechny krémy z řady Photoderm Kids od Biodermy a jako první jsem používala právě ten s minerálním filtrem. Teď ho nosím v přebalovací tašce jako takovou SOSku, protože je hezky kompaktní a zachrání mě, když to ráno na sluníčko nevypadá, ale odpoledne se vyjasní.

Ačkoliv měl Samík do 3 let atopický ekzém, opalovací krém s minerálním filtrem mu úplně nevyhovoval a tak jsme přešli na krém s chemickým filtrem, který se vsakuje do kůže, kde pohlcuje UV záření. Výhodou těchto krémů je, že se dobře roztírají, ale je potřeba myslet na to, abychom děti namazali 20 minut předtím než je budeme slunci vystavovat. Mně pro děti nejvíc vyhovuje tento krém ve spreji, který se snadno nanáší i roztírá a nezanechává bílé stopy na oblečení. Samíka jsem navíc i v létě oblékala převážně do dlouhých legínek, protože měl kůži často podrážděnou od trávy, květin apod. U atopiků je obzvlášť důležitá i péče po opalování – já jsem vždy promazávala krémem Atoderm, aby se pokožka nevysušovala.

Důležitý je také opalovací faktor, který by se u dětí měl pohybovat mezi 30-50 (já pro děti používám vždy faktor 50), množství krému a frekvence mazání. Tady se vyplatí nešetřit, opakovat (především po koupání, i když máte voděodolný krém) a nezapomínat na uši, rty, nos, nárty a u holčiček na pěšinku vlasů. Další možnou ochranou před sluncem je oblečení s obsahem UV filtru, ale s tím já nemám žádnou zkušenost. Jako samozřejmost vnímám fakt, že nejen děti, ale i my dospělí bychom se neměli vystavovat slunci mezi 11:00 – 15:00 hodinou.

Často se děti nechtějí nechat namazat a tak bych ráda věnovala pár slov i motivaci. U nás asi nejvíc platí a pomáhá fakt, že příklady táhnou – já jsem co se mazání týče velice důsledná i u sebe a mažu se vždy před dětmi tak, aby to viděly. Jim pak přijde přirozené to, že se musí namazat také. U nás je to něco, bez čeho prostě v létě neodcházíme ven. Občas také nechám děti, aby se namazaly navzájem – užijí si legraci a já je pak vždy ještě domažu. Motivačně u nás zapůsobil také krém v konzistenci pěny, která dětem přijde zábavná (jedinou nevýhodu spatřuji v tom, že rychleji ubývá).

A teď už pojďme na vaše otázky ohledně pobytu dětí na slunci, na které odpovídala dermatoložka MUDr. et Bc. Lucie Jarešová.
Je teď slunce opravdu agresivnější než dříve?
Ano, UV záření je nyní intenzivnější, ozonová díra se zvětšuje a ozonová vrstva je slabší – tím je vyšší dopad na zemský povrch. UVA záření proniká hlouběji do kůže (do dermis) a poškozuje ji, UVB záření působí v povrchové vrstvě kůže a způsobuje její spálení a karcinogenezi (rakovinotvorné).
Za jak dlouho po namazání mohou děti do vody, aby se krém nesmyl?
Obecně se doporučuje aplikovat krém nejméně 30 minut před koupáním. Výhodou UV minerálních filtrů je, že fungují ihned, jsou voděodolné.

Mění nějak chemický filtr strukturu kůže?
Chemické filtry záření absorbují a jeho energii mění na teplo nebo předávají do svých vazebných struktur, čímž mění svou strukturu. Změněná struktura může následně vyvolat alergické reakce.
Vznikají znaménka jen ze sluníčka? Od kolika let chodit s dětmi na kontrolu znamének? A dá se jejich vzniku předcházet?
Pihy neboli znaménka vznikají na základě genetické dispozice a slunečního záření. Pokud tedy rodiče mají velké množství pih nebo jeden z nich, tak je vysoká pravděpodobnost, že dítě je bude mít ve větším počtu také. Kontroly pigmentových projevů jsou doporučovány jednou za rok. Samozřejmě, pokud dítě znaménka nemá, tak to není nutné. Vyšší počet projevů vzniká tehdy, pokud je kůže opakovaně vystavována slunci a spálena.
Jaké jsou nejlepší opalovací krémy pro atopiky? A jak o atopickou pokožku v létě pečovat?
V dnešní době je možné zakoupit přípravky přímo pro děti s atopickým ekzémem. Samozřejmě je potřeba krémy vyzkoušet, každý je individuální a každému vyhovuje něco jiného. Doporučují se krémy s minerálním faktorem. Do 3 let věku dítěte je kůže více propustná a citlivější. Je možné také provést vyšetření na kontaktní alergeny na minerální faktory.

Jak rozeznat alergii na sluníčko od potravinové alergie? V případě, že jde o alergii na slunce, jaká je prevence, čím mazat?
Reakce na sluníčko může být různá. Nejčastěji se projevuje jako vznik červených pupínků v oblasti dekoltu, ale také v obličeji. Svědění nemusí být přítomno. Někdy vznikají projevy, které vypadají jako akné, ale nejedná se o typické projevy akné. Zanícené pupínky jsou tzv. sterilní a neobsahují bakterie (pokud nejsou ložiska rozškrábána, pak může být infekce zanesena). Potravinové alergie se projevují vznikem růžových až červených fleků, které někdy vypadají jako popálení kopřivou nebo jsou hladké a kůže svědí. Mohou se vyskytovat kdekoliv na těle a jednotlivá ložiska mohou splývat.
Jak chránit před sluncem kojence, když to ne vždy jde vyřešit stínem?
V dnešní době existují přípravky pro miminka od narození. Jsou doporučovány především krémy s minerálním faktorem. Kůže miminek je citlivá a látky z krémů mohou být vstřebávány ve vyšší míře. Nesmíme zapomínat, že dítě není zmenšený dospělý. Další ochranou je oblečení. Vhodné jsou přípravky z bavlny, aby se dítě nepotilo. Doporučení: Kojenec do 6 měsíců by neměl být vystavován slunci vůbec, batole do 2 let s oblečením.
Minerální versus chemické filtry – co je lepší?
Kůže dítěte je citlivá na působení různých přípravků. Ochranná kožní bariéra ještě není plně vytvořena, a proto je nutné používat u dětí přípravky, které jsou pro ně určené a jsou testovány na dětskou pokožku. Výhodou minerálních filtrů je jejich působení. Nevstřebávají se do kůže a sluneční paprsky jsou odráženy od kožního povrchu. Pro dětský věk se doporučují sunscreeny s čistými minerálními filtry. Kůže je citlivá a chemické přípravky se vstřebávají rychleji, je riziko vzniku alerginizace.
Pro kterou věkovou skupinu dětí platí nevycházet na přímé slunce mezi 11-15 hodinou?
Toto doporučení platí nejen pro děti, ale také pro dospělé, v tuto dobu je působení slunečního záření nejvyšší.

Jak je to s vitaminem D, když děti mažeme vysokým faktorem?
K tvorbě vitamínu D stačí malé množství UVB záření 3-8 minut denně a stačí ¼ kožního povrchu.
Je nutné mazat i dítě, které má snědou pleť a nespálí se? Jaké důsledky může mít nemazání dětí opalovacím krémem?
I když má dítě tmavší pleť, tak se může kůže poškodit. Nemusí se jednat vždy o spálení kůže. UVB záření působí přímo na buňky a zasahuje do struktury buněk. Je významným karcinogenem. Dávka UV záření se sčítá a potíže se mohou vyskytnout v pozdějším věku, vznik seborrhoických veruk, solárních keratoz a kožních nádorů.
Jakým faktorem mazat děti v ČR?
Záleží na aktivitě, kterou s dítětem provádíme. Pokud budeme celý den na hřišti nebo se budeme koupat, tak doporučuji faktor 50 +. Zásadní je to, že se dítě nesmí spálit. Faktor nám říká, o jak delší dobu můžeme být na slunci. Kůže, která není namazána, může být na slunci 15-20 minut, pokud použiji faktor 30, tak si prodlužuji bezpečný pobyt na slunci 30x 15-20 minut, u faktoru 50 mohu být 50x 15-20 minut.
Jaký máte názor na UV oblečky do vody?
Já sama oblečky pro děti nepoužívám, aplikuji krémy s UV faktorem 50+, přes den musí být aplikován opakovaně, pokud se dítě koupe. Obecně jsou oblečky doporučovány, chrání kůži před UV zářením. Je nutné myslet na části kůže, které jsou nekryté, tam je potřeba aplikovat krémy, aby nedošlo ke spálení.

Jaký je rozdíl mezi levnými a dražšími opalovacími krémy?
Samozřejmě záleží na výrobci, na značce a faktorech, které jsou použity. Ale neznamená, že dražší krém je více účinný než levný, jak bylo dokázáno DTestem.
Je pravda, že u vysokých faktorů je víc škodlivé chemie?
Není to pravda. Záleží na složení a typu použitých látek.
Děkuji moc paní doktorce Jarešové za její čas a zaslané odpovědi na vaše nejčastější dotazy.
Co se týče mě a opalování, tak přiznávám, že ještě před 10 lety jsem se smažila na sluníčku, co to šlo a natírala se olejíčkem s opravdu nízkým faktorem. Ale asi před 6 lety nastal zlom (tuším, že za to vděčím dámským časopisům) a já jsem začala být poctivější – tehdy jsem objevila opalovací krémy od Biodermy, se kterou jsem pak o pár let později navázala spolupráci a začala ji používat i pro děti. Na tělo jsem jako první používala Photoderm Bronz ve spreji, ale loni jsem přešla na opalovací mlhu, která mi vyhovuje v tom, že se nemusí roztírat. Letos jsem měla možnost vyzkoušet i opalovací mlhu od značky Institut Esthederm, ale musím přiznat, že na mě je příliš navoněná, takže zůstanu věrná Biodermě.

Co jsem ale trochu i nadále šidila, to byla ochrana obličeje, který jsem si mazala stejným krémem jako tělo a víc neřešila. Naštěstí se v poslední době hodně poukazuje na to, že pokud chcete mít pleť co nejdéle bez vrásek, tak bez vysoké ochrany tváře před slunečními paprsky to nepůjde. Já jsem navíc byla „vyškolená“ loni, kdy jsem ochranu obličeje zandebávala a pleť se začala bouřit. Na to jsem zareagovala tím, že jsem téměř přestala používat make-up v domnění, že si pleť odpočine a uzdraví se. Nebudu vás napínat, můj obličej byl tak posetý pupínky, že jsem musela navštívit kosmetičku (předtím jsem u ní byla asi jen 2krát).

Kosmetička mi řekla, že mám podkožní akné a že to opravdu může být způsobené nedostatečnou ochranou před sluncem. Také mi vyvrátila moji představu o tom, že pleti je lépe bez líčení – naopak make-up tvoří další ochranou vrstvu pokožky. Po ošetření se stav mé pleti asi na týden zhoršil a pak se vše začalo krásně hojit i díky čistícím přípravkům, které mi byly doporučeny. Letos už jsem tedy byla mnohem obezřetnější a na pleť jsem používala krém pro pleť netolerující slunce od Institut Esthederm a žádné problémy s pletí jsem neměla. Krém je sice dražší, ale nahradí i váš běžný denní krém a mně vydržel i při denním používání celé léto, takže se k němu za rok určitě vrátím.

Co se týče mojí péče po opalování, tak mám opět možnost srovnání produktů od Biodermy a Institut Esthederm a tady je za mě vítězem druhá zmiňovaná značka a její tělové mléko prodlužující opálení, které dle mého názoru skutečně udržuje pokožku déle snědou a vyhovuje mi i jeho lehká konzistence.
Doufám, že vám byl článek nápomocný a že sebe i své děti před slunečními paprsky chráníte, protože zdraví máme jen jedno.
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