Injury: Sunburn

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Injury: Sunburn

Definition
Description
Demographics
Causes and Symptoms
Diagnosis
Treatment
Prognosis
Prevention
The Future
For more information

Definition

Sunburn is an inflammation of the skin caused by overexposure to ultra-violet (UV) radiation, usually from the sun.

Description

Sunburn is an uncomfortable skin condition marked by reddening and soreness in its milder forms and peeling or blistering with longer periods of exposure to sunlight or tanning lamps. The skin is hot and painful to the touch. Sunburn can also affect the eyes, causing a dry or gritty feeling inside the eyelid.

Demographics

Sunburn is very common in the general population in North America. According to a survey carried out by the Skin Cancer Foundation, 42 percent of the people who answered the survey reported getting sunburned at least once in the preceding year.

Some people are at greater risk of sunburn than others. Risk factors include:

  • Fair skin. Fair-skinned people with red or blond hair and light-colored eyes are at particularly high risk of sunburn.
  • Infants and children of all races.
  • People with diabetes or thyroid disease.
  • People who live at high altitudes or close to the tropics, and people who are traveling to those parts of the world.
  • People who take certain types of antibiotics, tranquilizers, or birth control pills; these drugs make the skin more sensitive to sunlight.
  • People who enjoy swimming or boating in the summer or skiing in the winter. Sunlight reflected from water or snow can damage the skin as well as sunlight falling directly on the skin.
  • People whose work requires them to spend a lot of time in the sun.

Causes and Symptoms

Sunburn is caused by ultraviolet (UV) radiation from the sun or a tanning lamp. The UV radiation causes damage to the DNA (genetic material) in the cells of the skin. The body responds to this damage by repairing the DNA and by increasing production of melanin, a brownish-black pigment that protects the skin from further sun damage. Melanin is responsible for the changes in skin color known as a suntan.

Over time, repeated episodes of sunburn can lead to dry skin, premature wrinkling of the skin, patches of scaly skin known as actinic keratosis, and various types of skin cancer. Repeated exposure to sunlight over a period of years can also lead to changes in the lens of the eye known as a cataract.

The symptoms of mild sunburn are:

  • Redness and pain in the affected skin. The intensity of the pain is directly proportional to the length of time the person was exposed to UV radiation and the intensity of the radiation. A person can get sunburned in as little as fifteen minutes. The redness usually develops within thiry minutes to six hours after exposure. The pain is most intense from six to forty-eight hours after exposure.
  • The skin becomes swollen.
  • The skin becomes itchy.
  • The skin is hot to the touch. This warmth is caused by the dilation of blood vessels in the injured area.
  • The area may exhibit peeling after several days.

More severe sunburn causes the formation of blisters on the affected skin. Skin usually begins to peel about three days after exposure and may continue for another week or ten days.

People who are severely sunburned sometimes develop a condition called sun poisoning. The symptoms of sun poisoning include fever, chills, dizziness, fluid loss, extreme tiredness, and a skin rash as well as the sunburn.

Diagnosis

Most people do not need to consult a doctor to diagnose sunburn. Mild sunburn can be treated at home (see sidebar). However, people who notice any of the following symptoms should see a dermatologist (a doctor who specializes in skin problems) because they may be early signs of skin cancer:

  • A growth on the skin that was not there before the sunburn.
  • A sore that bleeds, crusts over, keeps reopening, and does not heal within two weeks.
  • A change in the size, color, or texture of a mole.
  • A dark flat spot on the skin that is gradually enlarging.

First Aid for Sunburn

The discomfort of sunburn can be relieved at home by the following treatments:

  • Taking a cool (not cold) bath or shower, adding baking soda to the water if desired.
  • Soothing the skin with a washcloth soaked in cold skim milk. The skim milk contains protein that helps to ease the pain.
  • Applying a non-greasy lotion moisturizing lotion to the burned area. Products containing aloe vera gel are a good choice.
  • A non-aspirin pain reliever like Advil or Motrin helps relieve the irritation.

There are also some home remedies and cosmetic cover-ups that should be avoided:

  • Do not apply a self-tanning lotion to sunburned or peeling skin; it will stick to the injured skin and make it look worse.
  • Do not use petroleum jelly, butter, or products containing local anesthetics to the burned area. They will make the discomfort worse and slow healing.
  • Do not use harsh soap to wash sunburned skin.
  • If blisters form, do not cover them with ointments; allow them to heal in the open air. If they break open to form sores, cover them lightly with clean gauze and apply an antibacterial lotion to prevent infection.
  • Do not give aspirin to children or teenagers to relieve the inflammation of sunburned skin; use a non-aspirin pain reliever instead.

Treatment

Home treatment of mild sunburn is described in the sidebar. Most mild cases of sunburn

eventually heal without special attention from a doctor. Blisters, however, may require medical treatment if they break open and become infected. A person with sunburn blisters that are oozing, hot, red, swollen, and painful should see their doctor.

A patient with any of the following symptoms may be suffering from sun poisoning, heat exhaustion, or shock as well as sunburn. A doctor should be contacted at once:

  • Dizziness or a faint feeling
  • A fast pulse or rapid breathing
  • Sunken eyes, no urine output, extreme thirst
  • Pale, cool, or clammy skin
  • Severe or painful blisters
  • Eyes hurt or are sensitive to light
  • Nausea, fever, chills, or a skin rash

Prognosis

Most mild cases of sunburn heal without problems in the short term. Blisters that become infected usually heal completely once the infection is treated. The long-term prognosis is of greater concern, as a history of repeated sunburn increases a person's risk of melanoma (the most serious form of skin cancer) as well as cataracts and other eye disorders.

Prevention

Sunburn can be prevented by taking the following steps:

  • Avoiding tanning booths and sun lamps.
  • Staying out of the sun between 10 a.m. and 4 p.m.
  • Using a sunscreen with a sun protection factor (SPF) of 15 or higher every day. People with very fair skin should use a product with an SPF of 30 or higher.
  • Applying sunscreen over the entire body thirty minutes before going outside, and reapplying the product every two hours.
  • Using a lip balm that contains sunscreen.
  • Wearing clothing that covers as much of the body as possible, including a broad-brimmed hat and sunglasses to protect the eyes.
  • Keeping infants under six months out of the sun altogether, and using sunscreen on infants older than six months.

The Future

Sunburn is a common health problem that is not likely to go away any time soon. One reason is that it can easily happen accidentally to someone who may not have planned to be outside in the sun for more than a few minutes. Another reason is that the long-term risks of sunburn, such as skin cancer and cataracts, usually take years to appear. This time lag means that a teenager who wants a glamorous tan right now may not think much about what will happen to his or her skin twenty or thirty years in the future. Prevention of sunburn is an important health measure for people of all ages.

SEE ALSO Burns and scalds; Cataracts; Dermatitis; Heat exhaustion

WORDS TO KNOW

Actinic keratosis: A patch of thickened or scaly skin caused by sun exposure. It is not itself a form of skin cancer but may develop progressively into a skin cancer.

Dermatology: The branch of medicine that deals with skin problems and disorders.

Melanin: A brownish-black skin pigment.

Melanoma: The most serious form of skin cancer.

Sunburn increases the risk of melanoma.

Sun poisoning: A term sometimes used to refer to a severe reaction to sunburn, consisting of fever, chills, fluid loss, dizziness, and nausea.

For more information

BOOKS

Gordon, Sharon. Sunburn. Danbury, CT: Children's Press, 2002.

Royston, Angela. Why Do I Get Sunburn? And Other Questions about Skin. Chicago: Heinemann Library, 2002.

WEB SITES

American Academy of Dermatology (AAD). Public Center: Sun Safety. http://www.aad.org/public/# (accessed April 17, 2008). This is a gateway to several sets of skin care tips and articles about the long-term health risks of sunburn.

American Academy of Dermatology (AAD). SkinCancerNet. http://www.skincarephysicians.com/skincancernet/index.html (accessed April 17, 2008). This is a gateway to many articles on types of skin cancer, prevention methods, and treatment options.

Nemours Foundation. Kids Health: How to Be Safe When You’re in the Sun. Available online at http://www.kidshealth.org/kid/watch/out/summer_safety.html (accessed April 17, 2008.)

Skin Cancer Foundation. Preventing and Treating Sunburn. Available online at http://www.skincancer.org/preventing-&-treating-sunburn/(accessed April 17, 2008).

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Injury: Sunburn

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