I Got a Sunburn. Now What?
We know how to prevent a sunburn: correctly apply a good quality sunscreen, seek shade, avoid direct sunlight during peak hours, and wear sun-protective clothing and hats. But if you do get sunburned, what should you do?
What happens in a sunburn
Sunburn results from exposure of the skin to ultraviolet (UV) light. In general, there are two main types of UV light that pass through the atmosphere. UVA, which has a longer wavelength and passes through windows, causes photoaging of the skin but rarely sunburn. In contrast, UVB has a shorter wavelength and can cause sunburn. Both types can cause tanning and are linked to the development of skin cancer and both can be blocked by broad-spectrum sunscreen.
After exposure to UVB above a certain threshold (which varies by individual and is related to skin pigmentation), redness and swelling develop in the skin, with the death of skin cells called keratinocytes. Immune cells are activated and migrate to the skin, resulting in inflammation and pain.
Typically a sunburn appears between 30 minutes to eight hours after exposure to UV radiation, peaks at about 12-24 hours, and resolves over a few days. In severe cases, swelling in the skin can lead to blister formation, and some people may get generalized symptoms such as chills or fatigue. Over time, the pain can change to itching and there is peeling of the skin (desquamation).
How to treat a sunburn
Protect the Skin
The most important thing to do after a sunburn is to protect the skin against further damage. That usually means using plenty of topical moisturizers or Vaseline and reapplying frequently. You need to be especially careful not to allow any further UV damage which can worsen the burn and delay healing, so either strictly avoid the sun or wear a broad-spectrum sunscreen that is SPF 30 or higher, and reapply every two hours and after getting wet.
Stay Hydrated
Be sure to stay well hydrated with water and electrolytes. Water is lost more easily through damaged skin and fluid is shifted into the inflamed skin, combining to cause a fluid deficit.
Address Pain and Itching
Common over-the-counter medications, particularly NSAIDs like ibuprofen (Advil), can be used as needed for the pain of sunburn, keeping in mind not to exceed the maximum doses and any interactions with other medications or underlying conditions.
Topical pain or itch relief medications may also be helpful. Topical pramoxine (Sarna Sensitive) or regular moisturizers can be used frequently throughout the day as needed for relief. Other topical over-the-counter treatments, such as Aloe, can be helpful but should be used with caution as they can occasionally cause allergic contact reactions. Refrigerating topical treatments can provide relief by cooling the skin, but you should avoid putting ice or cold packs directly onto the skin as this can cause further injury. Topical anti-inflammatory medications such as topical steroids are rarely used and have recently been shown to be ineffective in reducing redness due to sunburn.
An opportunity for improved skin care
Sunburns are a painful reminder of our skin’s sensitivity to ultraviolet radiation. However, even in the absence of sunburns, UV radiation has long-term effects on the skin, including accelerated photo-aging and skin cancer. Establishing a basic skin care routine including daily sunscreen and moisturizer is essential to minimize the harmful effects of UV radiation and maintain healthy skin.
Your board-certified dermatologist can give you personalized skin care advice, help identify and treat any underlying skin conditions, and diagnose any concerning skin lesions that may arise, including skin cancers related to sun exposure.
Please contact SSDP to schedule an appointment with Dr. Herman or any of our physicians.
