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Sunburn

Solar erythema; Burn from the sun

 

A sunburn is reddening of the skin that occurs after you are exposed to the sun or other ultraviolet light.

Considerations

 

The first signs of a sunburn may not appear for a few hours. The full effect to your skin may not appear for 24 hours or longer. Possible symptoms include:

  • Red, tender skin that is warm to the touch
  • Blisters that develop hours to days later
  • Severe reactions (sometimes called sun poisoning), including fever, chills, nausea, or rash
  • Skin peeling on sunburned areas several days after the sunburn

Symptoms of sunburn are usually temporary. But the damage to skin cells is often permanent, which can have serious long-term effects, including skin cancer. By the time the skin starts to become painful and red, the damage has been done. Pain is worst between 6 to 48 hours after sun exposure.

 

Causes

 

Sunburn results when the amount of exposure to the sun or other ultraviolet light source exceeds ability of melanin to protect the skin. Melanin is the skin's protective coloring (pigment). 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.

Keep in mind:

  • There is no such thing as a "healthy tan." Unprotected sun exposure causes early aging of the skin and skin cancer.
  • Sun exposure can cause first and second degree burns.
  • Skin cancer usually appears in adulthood. But it is caused by sun exposure and sunburns that began as early as childhood.

Factors that make sunburn more likely:

  • Infants and children are very sensitive to the burning effects of the sun.
  • People with fair skin are more likely to get sunburn. But even dark and black skin can burn and should be protected.
  • The sun's rays are strongest during the hours of 10 a.m. to 4 p.m. The sun's rays are also stronger at higher altitudes and lower latitudes (closer to the tropics). Reflection off water, sand, or snow can make the sun's burning rays stronger.
  • Sun lamps can cause severe sunburn.
  • Some medicines (such as the antibiotic doxycycline) can make your skin easier to sunburn.
  • Some medical conditions (such as lupus) can make you more sensitive to the sun.

 

Home Care

 

If you do get a sunburn:

  • Take a cool shower or bath or place clean wet, cool wash cloths on the burn.
  • DO NOT use products that contain benzocaine or lidocaine. These can cause allergy in some persons and make the burn worse.
  • If there are blisters, dry bandages may help prevent infection.
  • If your skin is not blistering, moisturizing cream may be applied to relieve discomfort. DO NOT use butter, petroleum jelly (Vaseline), or other oil-based products. These can block pores so that heat and sweat cannot escape, which can lead to infection. DO NOT pick at or peel away the top part of the blisters.
  • Creams with vitamins C and E may help limit damage to skin cells.
  • Over-the-counter medicines, such as ibuprofen or acetaminophen, help to relieve pain from sunburn. DO NOT give aspirin to children.
  • Cortisone creams may help reduce the inflammation.
  • Loose cotton clothing should be worn.
  • Drink lots of water.

Ways to prevent sunburn include:

  • Use a broad spectrum sunscreen of SPF 15 or higher. A broad spectrum sunscreen protects from both UVB and UVA rays.
  • Apply a generous amount of sunscreen to fully cover exposed skin. Reapply sunscreen every 2 hours or as often as the label says.
  • Apply sunscreen after swimming or sweating and even when it is cloudy.
  • Use a lip balm with sunscreen.
  • Wear a hat and other protective clothing. Light-colored clothing reflects the sun most effectively.
  • Stay out of the sun during hours when the sun's rays are strongest between 10 a.m. and 4 p.m.
  • Wear sunglasses with UV protection.

 

When to Contact a Medical Professional

 

Call a health care provider right away if you have a fever with sunburn. Also call if there are signs of shock, heat exhaustion, dehydration, or other serious reactions. These signs include:

  • Feeling faint or dizzy
  • Rapid pulse or rapid breathing
  • Extreme thirst, no urine output, or sunken eyes
  • Pale, clammy, or cool skin
  • Nausea, fever, chills, or rash
  • Your eyes hurt and are sensitive to light
  • Severe, painful blisters

 

What to Expect at Your Office Visit

 

The provider will perform a physical exam and look at your skin. You may be asked questions about your medical history and current symptoms, including:

  • When did the sunburn occur?
  • How often do you get sunburn?
  • Do you have blisters?
  • How much of the body was sunburned?
  • What medicines do you take?
  • Do you use a sunblock or sunscreen? What type? How strong?
  • What other symptoms do you have?

 

 

References

Krakowski AC, Kaplan LA. Exposure to radiation from the sun. In: Auerbach PS, ed. Wilderness Medicine. 6th ed. Philadelphia, PA: Elsevier Mosby; 2012:chap. 14.

Lim HW, Hawk JLM. Photodermatologic disorders. In: Bolognia JL, Jorizzo JL, Schaffer JV, eds. Dermatology. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 87.

 
  • Sun’s effect on skin

    Sun’s effect on skin

    Animation

  •  

    Sun’s effect on skin - Animation

    This animation enlarges a section of skin to illustrate melanocytes producing melanin in response to sun exposure. Also depicted on this enlarged section is sunburn and skin cancer.

  • How to treat a sunburn

    Animation

  •  

    How to treat a sunburn - Animation

    We all know that preventing sunburn is the best. But what do you do if you get sunburn? I'm Dr. Alan Greene. Let's talk about that together. When you have a burn from the sun, a radiation burn from the sun, there are a couple of things going on. One is that there's a heat injury. The skin gets hot. You can feel it when you touch it. You can feel it in the burn itself. And another is the outer protective layer is damaged, so the skin can dry out too easily. So the keys to treating a sunburn are to keep the skin cool and moist. So, one great way to do that is with what we call a cool compress. Just take a washcloth. Put some cool water in there and press gently onto the skin. Or you might do a shower - frequent, cool, and lukewarm showers. Either way right afterwards you want to slather on a good moisturizer to try to seal some of that water in, moisture in, preferably a moisturizer that doesn't contain alcohol or any other drying agent. Another time-honored remedy is the Aloe vera plant. And there's some recent studies questioning how effective it really is, but many people swear by it. You cut a little tip off the end of the plant and that gel you rub just directly onto the sunburn itself. And it certainly feels soothing and may help beyond that. Aloe vera Another piece of treating sunburn is to deal with the pain and the inflammation. And for that you might try acetaminophen for the pain or ibuprofen for the pain and inflammation both. Hopefully that will at least take the edge off. But also hopefully that discomfort will help remind you next time to take extra steps to prevent sunburn.

  • Burns

    Burns - illustration

    The depth of a burn determines its severity. First degree burns damage the outer layer of skin (epidermis) and cause pain, redness and swelling (erythema). Second degree burns damage the epidermis and the inner layer, the dermis, causing erythema and blistering. Damage from third degree burns extend into the hypodermis, causing destruction of the full thickness of skin with its nerve supply (numbness). Third degree burns leave scars and may cause loss of function and/or sensation.

    Burns

    illustration

  • Sun protection

    Sun protection - illustration

    Clothing which blocks or screens the harmful rays of the sun (UVA and UVB), in combination with wide-brimmed hats, sunglasses, and sunscreen, are all helpful in preventing damage to the eyes and skin. Any one of these by itself, even the sunscreen, may not be enough to prevent sun damage.

    Sun protection

    illustration

  • Skin cancer, melanoma on the fingernail

    Skin cancer, melanoma on the fingernail - illustration

    Malignant melanoma is the most dangerous type of skin cancer. Melanomas beneath the fingernail appear as a black or bluish black discoloration. This type of malignancy spreads (metastasizes) readily.

    Skin cancer, melanoma on the fingernail

    illustration

  • Skin cancer, close-up of lentigo maligna melanoma

    Skin cancer, close-up of lentigo maligna melanoma - illustration

    Increased risk for skin cancer, especially melanoma, is associated with chronic exposure to sunlight, blistering sunburns, and a family history of skin cancer.

    Skin cancer, close-up of lentigo maligna melanoma

    illustration

  • Skin cancer, close-up of level III melanoma

    Skin cancer, close-up of level III melanoma - illustration

    Malignant melanoma is the most dangerous type of the skin cancers. Typical features of melanomas include irregular borders, multiple colors within the lesion, rapid growth, and susceptibility to easy injury with bleeding. Any mole that exhibits any of these changes should be evaluated immediately by your physician.

    Skin cancer, close-up of level III melanoma

    illustration

  • Skin cancer, close-up of level IV melanoma

    Skin cancer, close-up of level IV melanoma - illustration

    Malignant melanoma is the most dangerous type of the skin cancers. Typical features of melanomas include irregular borders, multiple colors within the lesion, rapid growth, and susceptibility to easy injury with bleeding. Any mole that exhibits any of these changes should be evaluated immediately by your physician.

    Skin cancer, close-up of level IV melanoma

    illustration

  • Skin cancer, melanoma superficial spreading

    Skin cancer, melanoma superficial spreading - illustration

    Malignant melanoma is the most dangerous type of the skin cancers. Typical features of melanomas include irregular borders, multiple colors within the lesion, rapid growth, and susceptibility to easy injury with bleeding. Any mole that exhibits any of these changes should be evaluated immediately by your health care provider.

    Skin cancer, melanoma superficial spreading

    illustration

  • Sunburn

    Sunburn - illustration

    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. A serious sunburn is as serious as a thermal burn, and may have the same systemic effects such as blistering, edema and fever.

    Sunburn

    illustration

  • Sunburn

    Sunburn - illustration

    When the skin is overexposed to the ultraviolet rays of the sun a sunburn can occur. The symptoms of a sunburn can take up to 24 hours to appear. The skin can be red, warm, tender, blistered, and swollen.

    Sunburn

    illustration

  • Sun’s effect on skin

    Animation

  •  

    Sun’s effect on skin - Animation

    This animation enlarges a section of skin to illustrate melanocytes producing melanin in response to sun exposure. Also depicted on this enlarged section is sunburn and skin cancer.

  • How to treat a sunburn

    Animation

  •  

    How to treat a sunburn - Animation

    We all know that preventing sunburn is the best. But what do you do if you get sunburn? I'm Dr. Alan Greene. Let's talk about that together. When you have a burn from the sun, a radiation burn from the sun, there are a couple of things going on. One is that there's a heat injury. The skin gets hot. You can feel it when you touch it. You can feel it in the burn itself. And another is the outer protective layer is damaged, so the skin can dry out too easily. So the keys to treating a sunburn are to keep the skin cool and moist. So, one great way to do that is with what we call a cool compress. Just take a washcloth. Put some cool water in there and press gently onto the skin. Or you might do a shower - frequent, cool, and lukewarm showers. Either way right afterwards you want to slather on a good moisturizer to try to seal some of that water in, moisture in, preferably a moisturizer that doesn't contain alcohol or any other drying agent. Another time-honored remedy is the Aloe vera plant. And there's some recent studies questioning how effective it really is, but many people swear by it. You cut a little tip off the end of the plant and that gel you rub just directly onto the sunburn itself. And it certainly feels soothing and may help beyond that. Aloe vera Another piece of treating sunburn is to deal with the pain and the inflammation. And for that you might try acetaminophen for the pain or ibuprofen for the pain and inflammation both. Hopefully that will at least take the edge off. But also hopefully that discomfort will help remind you next time to take extra steps to prevent sunburn.

  • Burns

    Burns - illustration

    The depth of a burn determines its severity. First degree burns damage the outer layer of skin (epidermis) and cause pain, redness and swelling (erythema). Second degree burns damage the epidermis and the inner layer, the dermis, causing erythema and blistering. Damage from third degree burns extend into the hypodermis, causing destruction of the full thickness of skin with its nerve supply (numbness). Third degree burns leave scars and may cause loss of function and/or sensation.

    Burns

    illustration

  • Sun protection

    Sun protection - illustration

    Clothing which blocks or screens the harmful rays of the sun (UVA and UVB), in combination with wide-brimmed hats, sunglasses, and sunscreen, are all helpful in preventing damage to the eyes and skin. Any one of these by itself, even the sunscreen, may not be enough to prevent sun damage.

    Sun protection

    illustration

  • Skin cancer, melanoma on the fingernail

    Skin cancer, melanoma on the fingernail - illustration

    Malignant melanoma is the most dangerous type of skin cancer. Melanomas beneath the fingernail appear as a black or bluish black discoloration. This type of malignancy spreads (metastasizes) readily.

    Skin cancer, melanoma on the fingernail

    illustration

  • Skin cancer, close-up of lentigo maligna melanoma

    Skin cancer, close-up of lentigo maligna melanoma - illustration

    Increased risk for skin cancer, especially melanoma, is associated with chronic exposure to sunlight, blistering sunburns, and a family history of skin cancer.

    Skin cancer, close-up of lentigo maligna melanoma

    illustration

  • Skin cancer, close-up of level III melanoma

    Skin cancer, close-up of level III melanoma - illustration

    Malignant melanoma is the most dangerous type of the skin cancers. Typical features of melanomas include irregular borders, multiple colors within the lesion, rapid growth, and susceptibility to easy injury with bleeding. Any mole that exhibits any of these changes should be evaluated immediately by your physician.

    Skin cancer, close-up of level III melanoma

    illustration

  • Skin cancer, close-up of level IV melanoma

    Skin cancer, close-up of level IV melanoma - illustration

    Malignant melanoma is the most dangerous type of the skin cancers. Typical features of melanomas include irregular borders, multiple colors within the lesion, rapid growth, and susceptibility to easy injury with bleeding. Any mole that exhibits any of these changes should be evaluated immediately by your physician.

    Skin cancer, close-up of level IV melanoma

    illustration

  • Skin cancer, melanoma superficial spreading

    Skin cancer, melanoma superficial spreading - illustration

    Malignant melanoma is the most dangerous type of the skin cancers. Typical features of melanomas include irregular borders, multiple colors within the lesion, rapid growth, and susceptibility to easy injury with bleeding. Any mole that exhibits any of these changes should be evaluated immediately by your health care provider.

    Skin cancer, melanoma superficial spreading

    illustration

  • Sunburn

    Sunburn - illustration

    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. A serious sunburn is as serious as a thermal burn, and may have the same systemic effects such as blistering, edema and fever.

    Sunburn

    illustration

  • Sunburn

    Sunburn - illustration

    When the skin is overexposed to the ultraviolet rays of the sun a sunburn can occur. The symptoms of a sunburn can take up to 24 hours to appear. The skin can be red, warm, tender, blistered, and swollen.

    Sunburn

    illustration

Self Care

 

     

    Review Date: 4/14/2015

    Reviewed By: Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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