Alternate Names: Burn from the sun

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. 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.

Home Care:

To relieve sunburn pain, try taking a cool shower or bath or placing wet, cold wash rags on the burn. cold wash rags on. (Aspirin should be avoided in children who are running a fever). Avoid products that contain benzocaine, and avoid the use of Vaseline. If blisters are present, dry bandages may help prevent infection. Ibuprofin may help to alleviate the pain from sunburn. If the skin is not blistering, moisturizing cream may be applied to relieve discomfort.

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.

Call If:

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

What To Expect:

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?

Intervention:
Treatment of sunburn is symptomatic, and prevention remains the key to avoiding the painful consequences of overexposure to the sun.

For first-degree burns (a mild to moderate sunburn): Treat with a cool shower or bath or apply cold, wet washrags. The use of a topical cortocosteriod cream or ointment is not recommended, especially if it contains benzocaine, which may cause an allergic reaction. If there are no blisters, a moisturizing cream may be used to help soothe the burn. Aspirin can be taken to alleviate the pain and inflammation caused by a sunburn.

If the skin is a deep red and there are no blisters present, the use of an anti-inflammatory drug (such as ibuprofen) is recommended. Prednisone helps to decrease the symptoms of sun poisoning (which include a low-grade fever, loss of appetite, nausea, and fatigue. A five-day use of prednisone should be taken as follows:

• Day 1: 80 mg
• Day 2: 60 mg
• Day 3: 40 mg
• Day 4: 20 mg
• Day 5: 10 mg

Note: In order to prevent possible dehydration, it is important to drink balanced electrolyte liquids throughout this five-day treatment.

If the skin is blistering, it is most likely a second-degree burn. Use clean, cool water for pain relief. Never apply ice directly on a sunburn. Clean and dry the burn and cover with cloth or gauze bandages.