Sunburn

What is a sunburn?

Sunburn is an acute condition related to excess exposure to ultraviolet rays. It usually resolves over the course of a few days and acute symptoms can be managed; however, it can have morbid long-term effects if the sunburn is particularly severe. Symptoms include reddening of the skin (erythema), fluid-filled bumps on the skin or blisters, and possibly nausea, fever, vomiting, and headache. Treatment options include taking NSAIDs for pain, treating burns in a professional setting (if necessary) as well as measures to protect the skin from further sun exposure. The application of sunscreen, as well as wearing protective clothing, are important steps to avoid sunburn.

Although there is not much clinical evidence to support its effectiveness, moisturizers like aloe vera and oil-based lotions, creams, and ointments provide a protective layer on the damaged skin, speeding up healing. Cool compresses are also useful. Ibuprofen or other similar NSAIDs are effective in reducing inflammation and pain. Wearing sunscreen when going back out in the sun is also key to reducing further damage.

Sunburn symptoms

Main symptoms

The main symptoms of a sunburn include the following.

• Erythema: This term is used to describe reddening of the skin. As a sunburn is a condition that causes inflammation, the inflammatory reaction and increased blood flow to the affected skin can make it appear red. The redness is usually noticeable within three to five hours and resolves within 72 hours.
• Vesiculation: Moderate to severe sunburns may be accompanied by the formation of fluid-filled vesicles apparent on the skin.
• Blisters: Similar in presentation to vesicles, the appearance of blisters indicates a partial or full-thickness burn.

Other symptoms

Symptoms of sunburn often depend on the severity of the damage to the skin. Less common symptoms include:

• Nausea
• Fever
• Vomiting
• Headache

Sunburn causes

Ultraviolet rays from the sun, especially UVB rays, have sufficient energy to damage the DNA in our bodies. This damage to cells leads to a process called apoptosis, whereby the dead cells are being cleared from the body. During the apoptosis process, there is increased swelling and redness due to dilation of the blood vessels. Blood vessels dilate so that the body’s reactive inflammatory cells can reach the damaged skin.

Epidemiology

In nationwide questionnaires, 70 percent of adolescents and 50 percent of adults reported at least one sunburn in the previous year. Individuals with fair skin, red or blond hair, and blue eyes are particularly susceptible to sunburn.

Treatment options and prevention for sunburn

Treatment

Once an individual has been sunburned, treatment is aimed at management of symptoms as the reversal of skin damage is not possible.

• Pain: The pain associated with burned skin is best managed with non-steroidal anti-inflammatory drugs (NSAIDs).
• Blistering burn: People with severe sunburns (blisters, vesicles) and severe pain may require hospitalization for fluid replacement and intravenous pain medication. If you have open blisters, topical antibiotics may be applied to prevent super-infection.

Prevention

Sunburns can be very painful in the short term and can have severe health consequences in the long term including an increased risk of skin cancer. Fortunately, this condition is very preventable with the following measures:

• Skin coverage: You can avoid getting burned by covering your skin while spending time outdoors. Dark fabrics provide greater sun protection than lighter fabrics.
• Sun avoidance: Avoidance of sun exposure during the summer months when the sun is closer to the earth and between the hours of 10 a.m. to 4 p.m.
• Sunscreen: Topical sun protection should be used year-round but especially during the summer months. Sunscreen should be applied 15 to 30 minutes prior to sun exposure and should be reapplied after swimming. Sunscreens with a sun protection factor (SPF) greater than 30 should be used.
• Avoidance of tanning beds

When to seek further consultation for sunburn

If you have experienced a sunburn, it will likely self-resolve, and a visit to the doctor will probably not be necessary. If you develop extreme pain or extensive blistering as a result of sunburn, you should quickly seek consult from your physician.