SKIN PHARMACOLOGY and THERAPEUTICS

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Sunburn

Skin burned by exposure to the sun or other ultraviolet light. See also sunburn first aid.


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.

It is now recognized that sunburn and sun exposure should not be taken as something insignificant. Deaths have resulted from acute sun exposure and significant temporary disability is experienced by millions of sunburned people each year.

Unlike a thermal burn, sunburn is not immediately apparent. 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.

Swelling (Edema) of the skin, especially in the legs, is common. Toxins are released with sunburn, and fever is not uncommon. Skin peeling usually begins between three and eight days after exposure.

The long-term consequences of years of overexposure to the sun are significant. One blistering sunburn doubles the likelihood of developing malignant melanoma. Chronic sun exposure causes premature wrinkling and aging of the skin. Age spots (lentigo) are a result of sun exposure.

Skin cancer (basal cell and squamous cell cancer) is directly related to the amount of sun exposure (determined by skin pigmentation and hours in the sun). Finally, sun exposure and ultraviolet damage have been implicated in the development of cataracts.

Very effective sunscreens have been developed that protect from UVA and UVB (long and short wavelengths of ultraviolet light), which are the components of sunlight responsible for burning and cancerous changes in the skin.

Sunscreen, protective clothing, and ultraviolet-protected sunglasses are all recommended to prevent excessive sun exposure. Wearing a sunscreen with high sun protection factor (SPF) is recommended. The higher SPF numbers indicate greater protection. Unfortunately, there is no way to get a "safe tan" from the sun.

Home Care

Sunburn is better prevented than treated. Effective sunscreens are available in a wide variety of strengths. Most doctors recommend a sunscreen SPF level of 30 or greater.

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. (Aspirin should be avoided in children who are running a fever.)


Call your health care provider

if there is a fever with the sunburn
fluid-filled blisters, dizziness, or visual difficulties accompany the sunburn


What to expect at your health care provider's office

The medical history will be obtained and a physical examination performed.

Medical history questions documenting sunburn may include:

Time pattern
When did it occur?
How often does sunburn develop?
Type of sunburn
Is the skin red?
Are there blisters?
How much of the body was sunburned?
Aggravating factors
What medications are being taken?
Relieving factors
Do you use a sunblock or sunscreen? What type? How strong?
Other
What other symptoms are also present?
Is there fever, dizziness, blisters, or vision problems?

After a complete history and physical exam, your healthcare provider will determine the best treatment for you which may include hospitalization in severe cases of sunburns especially in young children.

 

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