Should we put sunscreen on infants? If yes, then which one? If no, then why? A case report of an allergic reaction to sunscreen in an infant!
Parents brought a 1-year-old boy to the outpatient department with complaints of an erythematous eruption on the face. Gradually, over the next 3 hours, the lesion spread to the rest of the body. The first lesion had appeared after the application of Isdin® cream, an SPF 15 sunscreen, without any sun exposure. Besides the eruption, the infant had no other symptoms. Moreover, his eruption resolved in 5 days without any treatment.
However, another similar eruption appeared a month later with another sunscreen. Although the parents avoided the previously used sunscreen to prevent any reaction, the infant developed an eruption on the contact area with the alternate sunscreen too. This time they had used SPF 50 sunscreen. Similar to the previous episode, his eruption resolved without any management and without any long-term sequelae.
The doctors made a diagnosis of allergic contact dermatitis. The reaction was secondary to the chemicals in the sunscreen, i.e., Parsol and octocrylene, as confirmed by the patch testing.
Patch testing with these 2 sunscreens gave a positive reading (+++) at 48 and 96h. Moreover, patch testing with other sunscreens containing butylmethoxydibenzoylmethane 2% (Parsol) or octocrylene gave a positive reading (++) at 48 and 96h too.
Sunscreens can be either chemical or mechanical.
Skin absorbs the chemical sunscreens, consequently, the chemical compounds in it protect the skin from ultraviolet sun rays. Although the active chemical compounds in the sun lotion protect against harmful sun rays, these can lead to allergic reactions. These can cause allergic contact dermatitis and photoallergy. Individuals who have a history of photo-contact allergy to topical ketoprofen are at an increased risk.
Octocrylene is an organic, colourless, thick common sunscreen ingredient that also has skin moisturizing properties. Octocrylene was considered a safe, non-allergenic, non-irritant compound. However, recently, there have been reports of allergic reactions with its use.
Mechanical barriers include zinc or titanium dioxide that create physical barrier and prevent the skin from the sun rays.
It is imperative to raise awareness regarding the risks of applying chemical filters in infants. It is advisable to use physical sunscreen in younger individuals as an infant’s sensitive skin is vulnerable. Additionally, infants’ skins have an increased risk of having side effects of the chemical compounds in the sunscreen, therefore, if need be, physical sunscreens are the best bet.
