Sunburn

Alternative Names

Burn from the sun

Considerations

The first signs of a sunburn may not appear for a few hours. The full effect to your skin may not appear for 24 hours or longer. Possible symptoms include:

• Red, tender skin that is warm to touch.
• Blisters that develop hours to days later.
• Severe reactions (sometimes called "sun poisoning"), including fever , chills, nausea, or rash.
• Skin peeling on sunburned areas several days after the sunburn.

While the symptoms of sunburn are usually temporary (such as red skin that is painful to the touch), the skin damage is often permanent and can have serious long-term health effects, including skin cancer. By the time the skin starts to become painful and red, the damage has been done. The pain is worst between 6 and 48 hours after sun exposure.

In severe sunburns, blistering of the skin may occur. Deaths have resulted from acute sun exposure, and significant temporary disability is experienced by millions of sunburned people each year.

Common Causes

Sunburn results when the amount of exposure to the sun or other ultraviolet light source exceeds the ability of the body's protective pigment, melanin , to protect the skin. Sunburn in a very light-skinned person may occur in less than 15 minutes of midday sun exposure, while a dark-skinned person may tolerate the same exposure for hours.

Keep in mind:

• There is no such thing as a "healthy tan." Unprotected sun exposure causes premature aging of the skin.
• Sun exposure can cause first and second degree burns .
• Skin cancer usually appears in adulthood, but is caused by sun exposure and sunburns that began as early as childhood. You can help prevent skin cancer by protecting your skin and your children's skin from the harmful rays of the sun.

Factors that make sunburn more likely:

• Infants and children are especially sensitive to the burning effects of the sun.
• People with fair skin are more likely to get sunburn. But even dark and black skin can burn and should be protected.
• The sun's rays are strongest during the hours of 10:00 a.m. to 4:00 p.m. The sun's rays are also stronger at higher altitudes and lower latitudes (closer to the tropics). Reflection off water, sand, or snow can intensify the sun's burning rays.
• Sun lamps can cause severe sunburn.
• Some medications (such as the antibiotic doxycycline) can make you more susceptible to sunburn.

Home Care

Sunburn is better prevented than treated. Effective sunscreens are available in a wide variety of strengths. Most doctors recommend a broad spectrum sunscreen of at least SPF 30.

Sunscreen should be generously applied. If out in the sun for a prolonged period of time during the day, wearing a hat and other protective clothing is recommended. Light clothing reflects the sun most effectively.

If you do get a sunburn:

• Try taking a cool shower or bath or placing wet, cold wash rags on the burn.
• Avoid products that contain benzocaine, lidocaine, or petroleum (like Vaseline).
• If blisters are present, dry bandages may help prevent infection.
• If your skin is not blistering, moisturizing cream may be applied to relieve discomfort.
• Over the counter medications, like ibuprofen, may help to relieve pain from sunburn. DO NOT give aspirin to children.
• Cortisone creams may help reduce the inflammation.
• Loose cotton clothing should be worn.

Call your health care provider if

Call a health care provider immediately if you have a fever with sunburn or if there are signs of shock, heat exhaustion, dehydration, or other serious reaction. These signs include:

• Feeling faint or dizzy
• Rapid pulse or rapid breathing
• Extreme thirst, no urine output, or sunken eyes
• Pale, clammy, or cool skin
• Nausea , fever , chills, or rash
• Your eyes hurt and are sensitive to light
• Severe, painful blisters

What to expect at your health care provider's office

The doctor will perform a physical exam and look at your skin. You may be asked questions about your medical history and current symptoms, including:

• When did the sunburn occur?
• How often do you get sunburn?
• Do you have blisters?
• How much of the body was sunburned?
• What medicines do you take?
• Do you use a sunblock or sunscreen? What type? How strong?
• What other symptoms do you have?

Prevention

• Avoid sun exposure during hours of peak sun ray intensity.
• Apply generous amounts of sunscreen with a sun protection factor (SPF) of at least 30. Pay special attention to your face, nose, ears, and shoulders. The higher the SPF, the greater the protection.
• Apply sunscreen 30 minutes prior to sun exposure to allow penetration. Re-apply after swimming and every 2 hours while you are outdoors.
• Wear sun hats. There is also SPF clothing and swimwear available.
• Wear sunglasses with UV protection.
• Use a lip balm with sunscreen.

References

Kaplan LA. Exposure to Radiation from the Sun. In: Auerbach PS. Wilderness Medicine. 5th ed. St. Louis, Mo: Mosby; 2007: chap. 14.