What is Sunburn?
Sunburn is an intense skin reaction that happens when your skin is exposed for too long to ultraviolet (UV) rays. These UV rays can come from the sun or from artificial sources, such as tanning beds. A number of factors can increase the risk of getting a sunburn, including the strength and length of time you’re exposed to UV rays and things like taking certain medications, the time of day, high altitudes, clear skies, and even the type of skin you have. It’s important for you to understand how sunburns happen, how to treat them when they do occur, and most importantly, how to prevent them. Repeated sunburn puts you at risk of skin cancer and can also lead to visible aging of your skin, which can affect your appearance. This review covers what happens to your skin when it’s sunburned, how to deal with sunburn when it happens, and how to avoid getting sunburned, all with the goal of reducing your risk of skin cancer and enhancing your quality of life.
What Causes Sunburn?
Sunburn happens when your skin is exposed to the sun or other sources of UV radiation for too long. How severe a sunburn can be depends on a number of factors.
Some medicines might increase your chance of getting sunburned. These include certain kinds of diuretics (pills that help get rid of water from the body), antibiotics like doxycycline, certain pain relievers, retinoids (medicines often used for skin conditions), and even some herbal remedies like St John’s wort.
The risk of sunburn can also be higher because of things in your environment. Here are some things to keep in mind:
– The sun’s rays are strongest between 10 AM and 4 PM.
– A clear sky means more intense UV rays coming down to earth.
– At high altitudes, there’s less of the Earth’s atmosphere to shield you from the sun’s rays, which increases the risk of sunburn.
– The closer you are to the Equator, the more direct the UV rays will be.
In some places, there’s less ozone in the atmosphere, meaning more of the sun’s UV rays can reach us.
Your skin type can also play a role in how easily you can get sunburned. In 1975, a doctor named Thomas Fitzpatrick came up with a system to categorize different skin types and how they react to UV light:
– Type I: Very light skin that burns easily and doesn’t tan.
– Type II: Light skin that burns easily and has trouble tanning.
– Type III: Light skin that might burn but usually tans.
– Type IV: Light brown or olive skin that hardly burns and tans easily.
– Type V: Brown skin that doesn’t usually burn and tans easily.
– Type VI: Black skin that hardly ever burns and darkens with sun exposure.
People with skin types I, II, and III have less melanin (the pigment that gives skin its color) and are more likely to get sunburned. These skin types also need less UV radiation to start seeing redness, which is a sign of sunburn.
However, skin type can be hard to determine, especially when people categorize their own skin. Even though this system was created for people with light skin, it’s still being researched to see how it can better include those with darker skin tones.
Sun-tanning has been a popular habit for a long time, but spending too long in the sun can increase the chances of getting skin cancer and make your skin age faster. Too much sun can also cause a painful sunburn.
Not using enough sun protection can also become a problem. This can happen if you don’t use enough sunscreen, don’t reapply often, use a sunscreen with low sun protection factor (SPF), or don’t cover up with hats or clothes when you’re out in the sun.
Risk Factors and Frequency for Sunburn
A study from the 2015 National Health Interview Survey, which included over 31,000 adults, found that in that year, 34% of people experienced at least one sunburn. Certain groups were more prone to getting sunburned. These include people with lighter skin tones (Fitzpatrick skin types I to III), people between 18 and 29 years old, and non-Hispanic White individuals.
Lifestyle factors such as using tanning lotions, doing physical activity outside, binge drinking, and being overweight can increase the chances of getting sunburned. Taking vacations where a lot of time is spent outdoors can also up the annual UV radiation exposure by 30% to 50%.
Sunburn can affect people with all skin types and from all regions. However, people in Australia and New Zealand report the highest number of melanoma cases each year, which are often linked to preventable sunburns. In studies of individuals of Black African or Black Caribbean heritage in the UK, half reported having been sunburned at some point. The rates of sunburn within a year were 13% for Black Americans and 30% for Hispanic Americans.
Signs and Symptoms of Sunburn
Sunburn is usually caused by too much sun exposure without enough sun protection. A lot of the time, people forget to use sunscreen, don’t apply it often enough, stay in the sun longer than they thought they would, or don’t wear protective clothing. When doctors look at your skin, they might see different levels of redness and swelling, depending on how bad the sunburn is.
If the sun’s rays didn’t hit certain spots on your skin because they were covered by clothing, those areas might not be sunburned. But if you see blisters, that could mean the sunburn is severe and you might need extra care. Sunburn can make your skin feel hot and painful. In really bad cases, sunburn can cause other symptoms like feeling sick to your stomach, fever, and feeling cold.
Redness from sunburn usually shows up about 3 to 5 hours after you’ve been in the sun and is worst between 12 to 24 hours later. Redness typically goes away within 3 to 7 days. Any blisters should heal within 7 to 10 days. Your skin might continue to peel for 7 to 10 days after you’ve been in the sun. People with fair skin may get pale brown spots on their skin that stay even after the sunburn symptoms go away.
Testing for Sunburn
Your doctor can figure out if you have a sunburn just by examining you. There’s no need for any extra lab tests or x-ray type scans.
Treatment Options for Sunburn
Most sunburns are able to heal on their own and usually don’t require medical intervention. There are several things you can do at home to relieve sunburn symptoms:
- Avoid exposing the sunburned skin to more sunlight, which can cause further damage. Remember to always wear sunscreen and sun-protective clothing.
- Consider taking over-the-counter pain relievers, such as NSAIDs, to reduce discomfort.
- Stay hydrated by drinking lots of water.
- Apply cool compresses, aloe vera gel, or lotion to soothe and moisturize the skin. Try to stay away from creams with local anesthetic in them.
- To soothe the skin, consider soaking in a cool bath with colloidal oatmeal or apply calamine lotion.
- Avoid using types of medication called topical and oral corticosteroids, which have not been found to be helpful for treating sunburns.
For blisters that have opened, gently wash them with soap and water before covering with a moist piece of gauze. But try not to intentionally pop or peel off skin from intact blisters.
In severe cases of sunburn that result in a lot of blistering, there’s a risk of losing body fluids and salts called electrolytes. This can sometimes require medical intervention to replenish the fluids. This is especially the case when more than 20% of the adult’s total body surface is affected. In situations like this, treatment at a specialized burn center might be the best option.
The most crucial thing in managing sunburn is to avoid getting sunburned in the first place. If you’re genetically more prone to getting sunburned, you’re also at a higher risk of developing skin cancer. To reduce your risk of sunburn, try to stay out the sun, especially between 10 AM and 4 PM, wear sun-protective clothing, and regularly apply a broad-spectrum sunscreen with a sun protection factor (SPF) of 30 or more. Infants younger than six months should not be exposed to direct sunlight and should be protected by clothing and shade. Sunscreen can be applied to small areas like hands, faces, and heads if there’s no other option.
Keep in mind that tanning beds are not a safer option than sunbathing. Even those that only use UVA light can still cause skin damage.
What else can Sunburn be?
When a person presents with what seems like a sunburn, doctors will consider a variety of other conditions that may cause similar symptoms. These might include:
- Autoimmune diseases, like systemic lupus erythematosus and dermatomyositis.
- Infections, such as staphylococcal scalded skin syndrome, cellulitis, and erysipelas.
- Unexplained conditions, such as pityriasis rubra pilaris.
- Certain cancers, like Sézary syndrome, cutaneous lymphomas, or skin signs of an internal cancer.
- Common skin conditions, such as rosacea, acne, stasis dermatitis, and seborrheic dermatitis.
- Reactions to sunlight, like solar urticaria, phytophotodermatitis, photoallergic type IV sensitivity reactions, and phototoxic reactions.
- Inherited conditions, such as xeroderma pigmentosum and erythropoietic protoporphyria.
It’s crucial that a careful examination is done in these cases to ensure the correct diagnosis is made.
What to expect with Sunburn
Sunburn is typically something you can take care of at home with straightforward treatment. As such, the outlook is usually quite positive.
Possible Complications When Diagnosed with Sunburn
Sunburns may seem minor, but it’s crucial to closely monitor them when they first appear. Sunburns initially impact just the top layer of your skin, known as the epidermis. However, if left unattended, they can become more serious, progress to deeper burns, and may require immediate medical attention or the need to visit a certified burn center. There may be a need for hospitalization for some patients to replenish fluids and manage pain using potent painkillers. Exposure to UV light from the sun can speed up skin aging and increase the risk of skin cancer. It’s important to keep in mind that both melanoma and non-melanoma skin cancers are linked to exposure to UV light over a lifetime. However, melanoma cancer is more strongly associated with short, high-intensity exposures to the sun and sunburns than other types of skin cancer.
- Close monitoring of sunburns is necessary
- Sunburns can progress into deeper burns
- Immediate medical attention or visit to a certified burn center might be required
- Some patients may require hospitalization
- UV exposure can speed up skin aging
- UV exposure can increase skin cancer risks
- A link exists between UV exposure and both melanoma and non-melanoma skin cancers
- Melanoma is strongly associated with intense sun exposure and sunburns
Preventing Sunburn
Every year, the number of skin cancer cases, including a serious type called melanoma, increases by 3% to 8%. People who spend a lot of time in the sun for work, or even just for fun, are at higher risk of skin cancer. It’s important to know that even one sunburn, no matter your age, can lead to skin cancer. Campaigns around the world are working to teach people how to protect their skin from the sun, which can prevent sunburn and lower the risk of developing melanoma and other skin cancers.
One of the best ways to protect your skin is to regularly and correctly use sunscreen with a high Sun Protection Factor (SPF), which shows how much the sunscreen shields your skin from the sun’s rays. Also, wear clothing that protects you from the sun and seek out shady areas when you’re outside. Even though a growing number of people in the United States understand the importance of sun protection, areas popular with tourists often have higher rates of sunburn. This tells us we need to do more to educate people about how to prevent sunburn.
The American Academy of Dermatology, a group of skin doctors, recommends using sunscreens that are water-resistant and broad-spectrum, meaning they protect against both types of harmful sun rays: UVA and UVB. These sunscreens should have an SPF of more than 30. Here are some tips for effectively protecting your skin and reducing the chance of getting sunburned:
- Try to stay in shady areas when the sun is strongest between 10 AM and 4 PM.
- Wear clothes that protect you from the sun whenever you’re outside.
- Don’t use tanning beds, which give off artificial UV rays.
- Be especially careful in places where the sun’s rays can reflect, such as on snow, water, and sand.
