Sun Exposure
Some dermatologists estimate that 80% of a person’s lifetime skin damage occurs before the age of 18. The American Academy of Dermatology recommends the following guidelines for sunscreen:

• Use a broad spectrum sunscreen of at least SPF 15 and apply every time you’re going to be in the sun for at least 20 minutes.
• Apply the sunscreen to dry skin 15-30 minutes before going outside.
• Pay particular attention to the face, ears, and hands, and generously coat skin not covered by clothing. One ounce of sunscreen is needed to completely cover the exposed areas of an adult.
• Reapply every two hours or immediately after swimming or strenuous exercise.
• Limit sun exposure between 10am-4pm.
• Avoid deliberate tanning, wear protective clothing, and seek shade.

Beware the Bugs
Insects enjoy the outdoors too, but a few of them can cause disease, and most areas of the country have certain bugs that spread infections. In Oklahoma, we are susceptible to West Nile Virus, Rocky Mountain Spotted Fever, and, to a lesser extent, Lyme disease.

West Nile Virus is contracted from the bite of an infected mosquito. In 2004, there were 22 probable or confirmed cases in Oklahoma clustered in the northeast, panhandle, and north central parts of the state. The peak incidence is July through October and the median age of patients was 67 years. Fever, headache, weakness, and confusion are some of the prominent symptoms; however, some infected people may have mild symptoms and may not be diagnosed with the disease. There is no specific treatment or vaccine for West Nile. Reducing standing water around the home can help minimize mosquito breeding sites. To reduce the risk of infection, apply insect repellents containing DEET and wear protective clothing, especially during the evening and early morning hours.

Rocky Mountain Spotted Fever is a bacterial infection caused by the bite of an infected tick. In Oklahoma, the American dog tick is the usual cause of the bite. The highest numbers of cases are reported in the eastern half of the state. In 2004, 190 cases were reported in Oklahoma, with most of the cases occurring in April through September. Cases occur in all ages. Symptoms include fever, muscle pain, and headache within 3-14 days of a tick bite. A characteristic rash may not always be present. Certain antibiotics are effective in the treatment of this infection. Insect repellants that contain DEET are also effective against ticks. Do a daily tick check on family members—if the tick is promptly removed, it is less likely to cause disease. Use gloves and tweezers, not bare hands, to remove a tick.

Lyme Disease, also a tick-borne disease, has been reported in Oklahoma, primarily in the eastern part of the state. The number of cases of Lyme disease peaked in 1994 at 100 reported, but in the last few years it has rarely been seen.

DEET and Children
* Do not use maximum-strength DEET repellents on children.
* Do not spray DEET repellents on the face, close to the eyes or mouth, on irritated skin, or cuts.
* Apply only onto clothing (not under clothing) or on exposed skin.
* Wash the repellant off after coming indoors.

Finally, remember the importance of bike helmets and water safety and you will be ready for a great spring and summer.

Colleen Dooley, MD completed medical school and residency at the University of Minnesota. She is board certified in pediatrics and is a member of the American Academy of Pediatrics. She has been in pediatric practice in Oklahoma City since 1987. She is on the medical staff at Mercy, Integris Baptist, Deaconess, and Lakeside Women's Hospital.