Use of sunscreen is linked with elevated naevi counts in Israeli school children and adolescents

Epidemiological evidence indicates that a fair complexion and exposure to s olar radiation in early years contribute to the proliferation of naevi and subsequent melanoma risk. To determine whether protection from sunlight is associated with lower naevi counts, we examined the prevalence and risk fac tors of naevi in a sample of Israeli school pupils. Whole body counts of na evi were recorded in 974 out of 1312 (74.2%) recruited pupils (7 and 12 yea r olds) from Ramat-Gan and Jerusalem. Host characteristics and habits of su n exposure were obtained using questionnaires. In each age group and geogra phic area, the mean whole body naevi counts, adjusted for confounders, were higher among males, pupils of European-American descent, and those suscept ible to sunburn. The contributions to naevi risk of fair skin colour and fr equent recreational sun exposure were higher among 7 year olds. Regular sun screen use contributed to the naevi risk for both age strata in Ramat-Gan ( at age 7, rate ratio [RR]= 1.7, 95% confidence interval [CI] = 1.3-2.2; at age 12, RR = 1.5, 95% CI = 1.1-2.1). Among the younger age group in Ramat-G an, even seldom compared with no use of sunscreen was associated with highe r naevi counts (RR = 1.5, 95% CI = 1.2-2.0). Similar patterns were noted wi th the pupils from Jerusalem. In conclusion, the elevated naevi count with increased sunscreen use indicates that sunscreens apparently do not modify the genetic predisposition to naevi proliferation. For better protection of children and adolescents, including those who use sunscreens, from the nae vogenic effect of solar radiation, they should be encouraged to limit their exposure and wear protective clothing when in the sun. (C) 2000 Lippincott Williams & Wilkins.