Sunburn: Protection and Treatment
Ultraviolet light is primarily responsible for the sunburn effect. UV radiation has both short-term and long-term effects. Common short-term effects include solar erythema, blister formation, and tanning. All of these occur in response to DNA damage to our skin cells. There are two different types of UV light that affect our skin: UVA and UVB both can cause skin cancer, premature aging, and damage to our skin. UVB is abundant in the summer during the middle of the day. It is primarily responsible for sunburn and tanning. UVA is abundant all year and passes easily through clouds. It provides delayed tanning by inducing DNA damage but does not cause redness in skin as easily and thus it is popular in tanning beds. The tan that develops from UVA exposure will still allow you to burn from UVB exposure.
The surest protection against sunburn is to cover up and find shade. When that is not an option, an SPF 30 to SPF 50 sunscreen is recommend with reapplication every 90 minutes while active or in water and every few hours while doing other activities. Proper application is 1 ounce, the size of a ping pong ball, spread over the body with each application. One average sized bottle of sunscreen should last 2-3 days at the pool, not the entire summer.
Despite knowing the risks of UV exposure, both natural and artificial, we are all going to get burned and then the question is what do we do?
- Cold Damp Towels - If a sunburn is mild then towels damp with cold water are very soothing. These can be done as many times as needed throughout the day.
- Aloe - Pure aloe gels can be used. They are cooling and soothing.
- Lidocaine - Topical lidocaine sprays and gels can be helpful, but a fairly high percentage of people are allergic to these products so their use is generally not recommended. They should be discontinued with any worsening of the sunburn.
- Acetaminophen and Ibuprofen – Orally, these medications can decrease some of the pain and inflammation that severe sunburns produce. They are not recommended topically because the preparations can often result in irritation or allergic reaction on the skin.
- Steroids – Both over the counter hydrocortisone and stronger prescription steroid ointments can be applied up to twice a day to the affected areas.
- Antioxidants – Several newer antioxidant topicals and antioxidant sunscreens are now available. Application of green tea extracts in particular has been shown to speed resolution of the erythema of sunburns and may help lessen the degree to which DNA damage occurs.
- When blisters develop they should be left intact and allowed to dry up or drain naturally. For larger blisters that open, the base should be kept clean and protected with white petrolatum.
These tips should help you get through the next sunburn and maybe even prevent it from occurring in the first place. Remember, it is going to happen to all of us. No one sunburn is responsible for skin cancers that develop later in life. DNA damage accumulates with every tan and sunburn we get. It is a cumulative effect over many decades of sun exposure, so even if you have had many burns, starting to protect yourself now will be beneficial.