A 13-Year-Old Girl Is Brought to the Office for Evaluation

A 13-year-old girl is brought to the office for evaluation of sunburn.  She and her family just returned from a 4-day vacation to the Bahamas.  While there, the patient applied sun protection factor 50 sunscreen every morning about 30 minutes before walking to the beach.  She specifically bought "water-resistant" sunscreen so that she could swim.  After 2 days, however, she developed painful redness on her face and shoulders that has started to peel.  The patient is otherwise healthy and takes no daily medications.  Her parents say that "everybody tans easily" in their family, and there is no family history of skin cancer.  Physical examination shows a well-appearing adolescent with tender, blanching erythema on the face, shoulders, and arms.  There is no edema or vesicles.  Appropriate supportive care measures for treatment of her sunburn are discussed with the family.  Which of the following is the most appropriate preventive recommendation to provide this patient?

A) Apply sunscreen immediately before sun exposure
B) Apply sunscreen immediately before swimming
C) Change to sun protection factor 75 sunscreen
D) Continue current sun protection regimen
E) Form a baseline tan with a tanning bed before sun exposure
F) Reapply sunscreen every 2 hours
G) Restrict sun exposure to midday hours only
H) Wear light-colored clothing while outdoors