Sunburn

Overview

Sunburn is inflamed, painful skin that feels hot to the touch, often appearing within a few hours of being in the sun too long. It is caused by too much exposure to ultraviolet (UV) light, which can be from the sun or artificial sources like sunlamps and tanning beds. UVA penetrates deep layers of skin, causing long-term skin damage, while UVB leads to superficial sunburn. Symptoms of sunburn can include red or pink inflamed skin, warm or hot skin, pain, tenderness, itching, swelling, small fluid-filled blisters, headache, fever, nausea, and fatigue. To prevent sunburn, it is important to wear sunscreen, practice other skin-protection habits, and avoid prolonged sun exposure, especially on cool or cloudy days. Seek immediate medical care if you experience severe symptoms or signs of infection.

Understanding the disease

Symptoms

Symptoms of sunburn include inflamed, painful skin that feels hot to the touch, skin that feels warm or hot, pain, tenderness, and itching, swelling, small fluid-filled blisters that may break, headache, fever, nausea, fatigue, and eye pain or grittiness. Sunburn can affect any exposed part of the body, including the ears, scalp, and lips, and can occur on cool or cloudy days. Symptoms usually appear within a few hours of sun exposure and can take several days to heal.

Risk Factors

The risk factors for developing sunburn include:

1. Having white skin and red hair
2. Having a history of sunburn
3. Living or vacationing somewhere sunny, warm, or at high altitude
4. Working outdoors
5. Swimming or spraying your skin with water or baby oil, as wet skin tends to burn more than does dry skin
6. Mixing outdoor recreation and drinking alcohol
7. Regularly exposing unprotected skin to UV light from sunlight or artificial sources, such as tanning beds
8. Taking a drug that makes you more likely to burn (photosensitizing medication)

Development

Sunburn develops when the skin is exposed to too much ultraviolet (UV) light from the sun or artificial sources, such as tanning beds. UVA and UVB rays penetrate the skin, causing skin damage and inflammation. The immune system responds by increasing blood flow to the affected areas, resulting in redness, warmth, pain, and other symptoms. Sunburn can occur on any part of the body and can vary in severity, ranging from mild redness to blisters and severe pain. Risk factors for sunburn include having white skin, a history of sunburn, living in sunny or high-altitude areas, and spending time outdoors without proper sun protection. Seek immediate medical care if you experience severe symptoms or complications, such as large blisters, severe swelling, signs of infection, worsening pain, or eye pain.

Assessment and Diagnosis

Triage

You should see a doctor if sunburn is suspected when you experience large blisters, blisters on the face, hands, or genitals, severe swelling of the affected area, signs of infection such as blisters with pus or streaks, worsening pain, headache, confusion, nausea, fever, or chills, or if the sunburn does not improve despite at-home care. Additionally, seek immediate medical care if you experience a fever over 103 F (39.4 C) with vomiting, confusion, an infection, dehydration, cold skin, dizziness, or faintness.

Diagnosis

To diagnose sunburn, a health care provider generally conducts a physical exam and may ask about your symptoms, current medications, UV exposure, and sunburn history. They might also perform phototesting, which involves exposing small areas of skin to controlled amounts of UVA and UVB light to determine sensitivity to sunlight. If your skin reacts to phototesting, you may be considered photosensitive.

Management and Treatment

Complications

Sunburn can lead to several complications, including:

1. Peeling skin: As the body works to heal the damaged skin, it may cause the top layer to peel off, revealing newer, healthier skin beneath.
2. Skin darkening: Sunburn can cause increased melanin production in the skin, resulting in long-term skin darkening or hyperpigmentation.
3. Skin thinning: Repeated sunburns can cause the skin to thin and lose its elasticity over time, leading to premature aging and an increased risk of skin cancer.
4. Infections: Sunburned skin can be more susceptible to bacterial, viral, or fungal infections, particularly if blisters develop.
5. Eye damage: Prolonged exposure to UV rays can cause damage to the eyes, including photokeratitis (inflammation of the cornea), cataracts, and ocular melanoma.
6. Heatstroke: In severe cases, sunburn can lead to heatstroke, particularly in children and people with certain medical conditions. Symptoms include high body temperature, headache, nausea, and fatigue.
7. Immune system suppression: Sunburn can weaken the immune system, making the body more susceptible to illnesses and infections.
8. Worsening of pre-existing skin conditions: Sunburn can exacerbate conditions like rosacea, psoriasis, and eczema. If you experience any of these complications or have concerns about your sunburn, it is essential to consult a healthcare provider for appropriate evaluation and treatment.

Prevention

sunburn can be prevented by taking certain measures to protect your skin from the sun's harmful UV rays. Some of the ways to prevent sunburn include:

1. Avoiding sun exposure during peak hours: Limit outdoor activities between 10 a.m. and 4 p.m. when the sun's rays are strongest. Seek shade when possible.
2. Wearing protective clothing: Wear long-sleeved shirts, pants, and wide-brimmed hats to cover your skin. Clothing made from tightly woven fabric offers better protection than loosely woven fabric.
3. Using sunscreen: Apply a water-resistant, broad-spectrum sunscreen with an SPF of at least 30 to clean, dry skin about 30 minutes before going outdoors. Use enough sunscreen to cover all exposed skin and reapply every two hours or after swimming or sweating.
4. Avoiding tanning beds: Tanning beds emit harmful UV rays and increase the risk of skin cancer and premature skin aging.
5. Avoiding sun tanning: Exposing your skin to direct sunlight or using tanning beds to get a base tan does not decrease the risk of sunburn.
6. Staying hydrated: Drink plenty of water to help your body regulate its temperature and reduce the risk of sunburn.
7. Being cautious around water, snow, and sand: These surfaces can reflect the sun's rays and increase the risk of sunburn. By following these preventive measures, you can significantly reduce your risk of sunburn.

Home Remedies

Home remedies for sunburn include taking pain relievers, cooling the skin, and getting plenty of rest. Some additional remedies include:

1. Aloe vera: Applying aloe vera gel to the sunburned area can help soothe the skin and provide some relief from pain and itching.
2. Cold compresses: Applying a cold, damp towel or compress to the sunburned area can help reduce swelling, pain, and heat.
3. Over-the-counter pain relief: Taking over-the-counter pain relievers such as ibuprofen or acetaminophen can help alleviate pain and discomfort associated with sunburn.
4. Stay hydrated: Drinking plenty of water and other hydrating fluids can help replace the fluids lost through sun exposure and promote healing.
5. Soothing baths: Taking a cool bath with baking soda or colloidal oatmeal can help soothe sunburned skin and reduce itching. Remember that while these home remedies can provide some relief, they may not completely eliminate the discomfort associated with sunburn. It's important to protect your skin from further sun exposure, use sunscreen, and seek medical attention if the sunburn is severe or shows signs of infection.

Treatment

Treatments for sunburn involve managing symptoms and promoting healing. Some treatments include:

1. Pain relief: Over-the-counter pain relievers like ibuprofen or acetaminophen can help alleviate pain and reduce inflammation.
2. Cooling the skin: Applying a cool, damp cloth to the affected area can help soothe the skin. You can also take a cool shower or bath.
3. Moisturizing: Applying a moisturizing lotion or cream can help reduce peeling and promote healing of the sunburned skin. Look for products containing ingredients such as aloe vera or glycerin.
4. Hydration: Drinking plenty of water can help prevent dehydration and promote healing.
5. Avoiding sun exposure: Stay out of direct sunlight and seek shade to prevent further sun damage.
6. Soothing baths: Adding baking soda or colloidal oatmeal to a cool bath can help soothe sunburned skin.
7. Skin-specific treatments: Applying hydrocortisone cream (over-the-counter) can help reduce itching and inflammation. Calamine lotion can also help soothe the skin. Remember to consult a healthcare provider if your sunburn is severe, if large blisters develop, or if there are signs of infection.

Preparing for medical consultation

To prepare for an appointment for sunburn, you should:

1. Make a list of your medications and natural remedies: Include any prescription or over-the-counter medications you're taking, as well as all vitamins, supplements, or herbal remedies, as some of these may increase your sensitivity to UV light.
2. Note any personal history of exposure to excessive ultraviolet (UV) light: Inform your healthcare provider about your history of working outdoors, spending time at the beach, or using tanning beds, as this information can help them understand the severity of your sunburn.
3. List your medical history: Be sure to include other conditions you've been treated for, as well as any radiation therapy you may have received, even years ago.
4. Mention any family history of skin cancer: Inform your healthcare provider about any immediate family members who have had skin cancer, as this information can help them assess your risk and provide appropriate guidance. By providing this information during your appointment, your healthcare provider can better understand your situation and provide more personalized advice and treatment recommendations.