February 23, 2018 by John Fernandez and Tanya Racoobian
When Sunburn Requires a Visit to the Doctor
Despite best intentions to protect yourself from the sun’s harsh rays, you’ve likely experienced at least one sunburn over your lifetime. The red skin that’s warm and painful to the touch is a reminder that you should have done more to protect your exposed skin when outdoors. And while you know that prolonged exposure to the sun is not healthy, do you know when to seek medical attention for a burn that goes beyond a typical sunburn?
Mild to Moderate Sunburns
Christopher da Fonseca, M.D., a family medicine physician with Baptist Health Primary Care at Kendall Breeze, says most mild to moderate sunburns reach their peak redness within the first day of prolonged exposure to natural sunlight or artificial sources, such as tanning beds. And they tend to go away in three to seven days.
“A sunburn is an inflammatory response to excessive ultraviolet, or UV, light,” he said.
The American Academy of Dermatology explains that sunburns and suntans result from the skin producing more melanin, essentially a dark pigment, to protect the deepest layers of the skin from harmful UV rays. This extra melanin creates a change in the skin’s color. Light-skinned people will turn red, and dark-skinned people will reach a deeper, darker shade of their original skin color. After a few days of healing, the inflammation resolves and the extra melanin remains, creating a suntan. Suntans, too, will fade as exposure to sunlight or artificial UV rays subsides – a process often described as “losing our tans.”
Dr. da Fonseca warns that no sunburn is good for our health, but severe sunburns – ones that result in blisters or peeling skin and other unusual symptoms – may require medical attention.
“Patients who have blistering on the skin or systemic symptoms such as fever, dehydration, vomiting, and severe pain should consider seeking medical attention,” he said. “Sometimes, patients may require hospitalization for IV fluids and pain control.” These symptoms may not be initially linked to sun exposure. But if you’ve spent time in the sun or in a tanning bed and experience these symptoms, Dr. da Fonseca recommends consulting a physician.
Whether sunburn is mild to moderate or severe, requiring medical attention, Dr. da Fonseca says some temporary relief measures include:
- Soothing the affected skin with cool compresses to cool-water soaks.
- Applying Calamine lotion to relieve the pain and irritation of sunburn.
- Treating reddened skin with aloe-vera based gels or moisturizing creams, lotions or ointments.
- Gently cleansing ruptured blisters with mild soap and water.
- Controlling pain with oral nonsteroidal anti-inflammatory drugs, or NSAIDs, such as ibuprofen.
Many people may mistakenly refer to the fever, dehydration and vomiting of a severe sunburn as “sun poisoning.” Dr. da Fonseca says that sun poisoning, or polymorphous light eruption (PMLE), is a distinct reaction to UV light.
“Similar to an allergic reaction, sun poisoning usually presents as an itchy rash, hives or eczema-like lesions in sun-exposed areas hours to days after the UV exposure,” he said. Like sunburn, sun poisoning can last for several days. It, too, may be accompanied by fever and nausea, along with headaches. While it can and often does subside on its own, sun poisoning requires medical attention, dermatologists say. Treatments can include applications of moisturizing creams, ointments, lotions and gels, as well as topical steroids and antihistamines, to slow the body’s immune reaction to the overexposure.
Skin Cancer Risk
Dr. da Fonseca stresses the importance of minimizing overexposure to UV light to prevent the development of skin cancer, a known result of repeated sunburns over time. If the threat of an increased risk of basal cell carcinoma, squamous cell carcinoma and melanoma – the deadliest form of skin cancer – doesn’t resonate, overexposure also causes premature aging, according to the American Academy of Dermatology.
Prevention is Key
No matter what motivates you to avoid overexposure to the sun, Dr. da Fonseca says preventing sunburn in the first place makes the greatest impact. He recommends the following to minimize your chance of a sunburn:
- Use a broad-spectrum, water-resistant sunscreen with a minimum of SPF 30 daily to prevent incidental exposure, as when driving or sitting by a window at work.
- Apply a broad-spectrum, water-resistant sunscreen with an SPF 30 or higher, for outdoor activities and reapply according to label instructions or at least every two hours – more frequently with sweating or if in the water. Protective clothing such as long sleeves and pants also help protect from harmful UV rays.
- Wear a hat, preferably with a wide brim, to protect the scalp, face and neck, and remember to wear sunglasses.
- Avoid sun or reduce exposure to sunlight between 10 a.m. and 4 p.m., especially during the summer months, when the sun is closest to the earth.
- For infants less than 6 months old, avoid sun exposure.
When in Doubt, Seek Help
If your sunburn becomes worrisome or you recognize unusual symptoms, Dr. da Fonseca recommends consulting a medical professional. And he says it’s important to share with that caregiver whether you’ve had any exposure to sunlight or artificial UV rays.
“Sunburn, and even sun poisoning, are generally temporary conditions,” he said. “But immediate treatment may ward off any longer-term damage, such as preventing infection. Unfortunately, we don’t have a treatment to prevent permanent skin damage, premature aging and skin cancer, though. Your best prevention tool in those cases is to avoid exposure altogether.”