Sunburn

Sunburn is the term for red, sometimes swollen, and painful skin caused by overexposure to ultraviolet (UV) rays from the sun. Sunburn can vary from mild to severe.

The extent depends on skin type and amount of exposure to the sun. Sunburn is a serious risk factor for skin cancer.

Because of variations in the intensity of UV radiation passing through the atmosphere, the risk of sunburn increases as you approach the equator. The higher the latitude, the lower the intensity of the UV rays.

On a minute-by-minute basis, the amount of UV radiation is dependent on the angle of the sun. The greatest risk is at solar noon when the sun is directly above you.

Fast facts on sunburn

Here are some key points about sunburn. More detail and supporting information is in the main article.

  • Sunburn is caused by ultraviolet light from the sun.
  • In some cases, sunburn can cause the skin to blister.
  • Sunburn can be soothed by home remedies.
  • Avoiding sunburn in the first place is better than having to treat its effects.

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Sunburns are caused by exposure to too much ultraviolet (UV) light. UV radiation is a wavelength of sunlight in a range too short for the human eye to see. Ultraviolet A (UVA) is the type of solar radiation most associated with skin aging (photoaging). Ultraviolet B (UVB) is associated with sunburn. Exposure to both types of radiation is associated with developing skin cancer. Sunlamps and tanning beds also produce UV light and can cause sunburn.

Melanin is the dark pigment in the outer layer of skin (epidermis) that gives your skin its normal colour. When you're exposed to UV light, your body protects itself by accelerating the production of melanin. The extra melanin creates the darker colour of a tan.

A suntan is your body's way of blocking the UV rays to prevent sunburn and other skin damage. But the protection only goes so far. The amount of melanin you produce is determined genetically. Many people simply don't produce enough melanin to protect the skin well. Eventually, UV light causes the skin to burn, bringing pain, redness and swelling.

You can get sunburn on cool, hazy or cloudy days. As much as 80 percent of UV rays pass through clouds. Snow, sand, water and other surfaces can reflect UV rays, burning your skin as severely as direct sunlight.

Risk factors for sunburn include:

  • Having light skin, blue eyes, and red or blond hair
  • Living or vacationing somewhere sunny, warm or at high altitude
  • Working outdoors
  • Mixing outdoor recreation and drinking alcohol
  • Having a history of sunburn
  • Regularly exposing unprotected skin to UV light from sunlight or artificial sources, such as tanning beds
  • Taking a drug that makes you more likely to burn (photosensitizing medications)

Sunburn signs and symptoms include:

  • Pinkness or redness
  • Skin that feels warm or hot to the touch
  • Pain, tenderness and itching
  • Swelling
  • Small fluid-filled blisters, which may break
  • Headache, fever, nausea and fatigue if the sunburn is severe

Any exposed part of your body — including your earlobes, scalp and lips — can burn. Even covered areas can burn if, for example, your clothing has a loose weave that allows ultraviolet (UV) light through. Your eyes, which are extremely sensitive to the sun's UV light, also can burn. Sunburned eyes may feel painful or gritty.

Signs and symptoms of sunburn usually appear within a few hours after sun exposure. But it may take a day or longer to know the full extent of your sunburn.

Within a few days, your body may start to heal itself by "peeling" the top layer of damaged skin. After peeling, your skin may temporarily have an irregular color and pattern. A bad sunburn may take several days or longer to heal.

Your doctor is likely to conduct a physical exam and ask questions about your symptoms, UV exposure and sunburn history.

If you develop a sunburn or skin reaction after relatively minor exposures to sunlight, your doctor may recommend photo testing. During photo testing, small areas of your skin are exposed to measured amounts of UVA and UVB light to try to reproduce the problem. If your skin reacts to the UV radiation, you're considered sensitive to sunlight (photosensitive).

It is important to start treatment for sunburn as soon as possible. Sunburn can lead to permanent skin damage and increase the risk of skin cancer. The following are some simple ways to ease the discomfort of sunburn; however, it important to bear in mind that the best way to relieve suffering is to avoid being sunburned in the first place:

Pain relief - over-the-counter (OTC) pain relief such as ibuprofen or other nonsteroidal anti-inflammatory medications (NSAIDs) can help relieve the pain and reduce swelling. It is best to take these as soon as possible. Some pain relief can be applied as a topical ointment.

Hydrocortisone cream - may also help reduce inflammation and itching.

Rehydrate - drink water to help rehydrate the skin.

Don't break small blisters - allow them to run their course. If one breaks, clean it with mild soap and water.

Peeling skin - do not pick, and continue to apply moisturizer.

Cool the skin - apply a damp cloth or towel, or take a cool bath.

Do not use butter - this is a false remedy that can prevent healing and damage skin.

Apply moisturizer - for instance, aloevera gel.

Stay out of the sun - avoid making the burn worse by exposing it to more UV.

If the sunburn is severe enough, oral steroid therapy (cortisone-like medications) may be prescribed for several days. However, steroid creams placed on the skin show minimal to no benefit.

If blistering is present, steroids may be withheld to avoid an increased risk of infection. If the patient is dehydrated or suffering from heat stress, IV (intravenous) fluids will be given.

Use these methods to prevent sunburn, even on cool, cloudy or hazy days. And be extra careful around water, snow and sand because they reflect the sun's rays. In addition, UV light is more intense at high altitudes.

  • Avoid sun exposure between 10 a.m. and 4 p.m. The sun's rays are strongest during these hours, so try to schedule outdoor activities for other times. If you can't do that, limit the length of time you're in the sun. Seek shade when possible.
  • Avoid sun tanning and tanning beds. Using tanning beds to obtain a base tan doesn't decrease your risk of sunburn.
  • Cover up. When outside, wear a wide-brimmed hat and clothing that covers you, including your arms and legs. Dark colors offer more protection, as do tightly woven fabrics. Consider using outdoor gear specially designed to provide sun protection. Check the label for its ultraviolet protection factor (UPF), which indicates how effectively a fabric blocks damaging sunlight. The higher the number, the better.
  • Use sunscreen frequently and generously. Apply water-resistant sunscreen and lip balm with an SPF of 30 or greater and broad-spectrum protection against UVA and UVB rays. About 15 to 30 minutes before going outdoors, apply sunscreen generously on skin that won't be protected by clothing.

Put on more sunscreen every 40 to 80 minutes, or sooner if it has washed off from swimming or sweating. If you're also using insect repellent, apply the sunscreen first. The Centers for Disease Control and Prevention does not recommend products that combine an insect repellent with a sunscreen.

The Food and Drug Administration requires all sunscreen to retain its original strength for at least three years. Check the sunscreen labels for directions on storing and expiration dates. Throw sunscreen away if it's expired or more than three years old.

The American Academy of Pediatrics recommends using other forms of sun protection, such as shade or clothing, for babies and toddlers. Keep them cool and hydrated. You may use sunscreen on babies and toddlers when sun protective clothing and shade aren't available. The best products for them are those that contain physical blockers (titanium oxide, zinc oxide), as they may cause less skin irritation.

  • Wear sunglasses when outdoors. Choose sunglasses with UVA and UVB protection. Check the UV rating on the label when buying new glasses. Darker lenses are not necessarily better at blocking UV rays. It also helps to wear sunglasses that fit close to your face and have wraparound frames that block sunlight from all angles.
  • Be aware of medications that increase your sensitivity to the sun. Common drugs that make you more sensitive to sunlight include antihistamines, ibuprofen, certain antibiotics, antidepressants, antipsychotics and some cholesterol-lowering drugs. Talk with your pharmacist about your medication side effects.

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