What is Sunburn?
Sunburn is damage to the skin caused by overexposure to ultraviolet (UV) radiation, usually from excessive sun exposure.
Sunlight emits an invisible radiation (solar radiation) called ultraviolet (UV) rays. These rays have the ability to penetrate skin and alter composition of skin cells. There are three forms of UV rays, ultraviolet A, B and C (referred to respectively as UVA, UVB and UVC.
Of these, UVC rays are absorbed when entering the earth’s atmosphere and pose little risk to humans. UVA and UVB are both capable of damaging skin. UVA can damage the deep layers of the skin and cause skin aging, as well as contribute to skin cancer.
UVB rays penetrate the upper layers of skin and also contribute to photoaging and skin cancer. They are the main cause of sunburn. (1)
Symptoms
When the sun shines it’s nice to spend time outdoors, however, too much exposure can harm our skin resulting in sunburn. While usually mild and short lived, there are occasions when sunburn can be more serious.
Enjoying time in the sun can make us forget how much we are exposed. This is especially true when jumping in and out of a swimming pool or dipping in the sea frequently. Constantly cooling the body in this way may detract a person from the fact that the skin is getting burnt.
Even when it’s overcast and windy, sun rays can still penetrate and cause sunburn. Without the protection of clothing or sunscreen, symptoms of sunburn can appear.
While the summer months are when sunburn is most likely to happen, it can occur any time of year. Participating in sports or working at a high altitude increases the risk of sunburn. Snow and ice reflect UVB rays meaning they bounce back and hit the skin twice. (2)
You might not realize you have sunburn immediately. Symptoms can appear up to four hours after exposure, and continue to get worse for the next 24 to 36 hours. These might be mild or severe and include: (3)
Redness
Skin appears pink or red in color, and will be warm or hot to the touch. It can also feel tender or painful and be swollen. (4)
Fatigue
Fatigue, a feeling of tiredness above what you consider normal, is another symptom. Sunburn raises your body temperature and can cause dehydration. Your body works harder than usual to try and keep you cool leaving you feeling worn out and weary. (5)
Headache
When exposed to high temperatures the body sweats as it tries to regulate internal temperature. The result could be dehydration which can cause headaches. (6)
Fever
Sunburn is an inflammatory response of the skin to overexposure to sunlight. The body’s immune system responds by trying to protect the body from something it perceives as harmful. Consequently when sunburnt, fever can be a symptom. (7)
Nausea
After sun exposure, as well as sunburn, you might experience nausea and vomiting. (8)
Blisters
Red and sore skin and even blisters as a result of sunburn might be seen. When the skin is damaged in this way, fluid filled sacs appear under the surface of the skin. (9)
Stages
There are six stages of burns, the first three of which include sunburn. While sunburn usually falls into the first two stages, when severe it could progress further. (10, 11)
Stage #1 First Degree Burns
These burns are sometimes referred to as superficial. They damage the first or outer layer of the skin (epidermis). They will feel warm to the touch and might be painful. If you press them a white patch will appear (blanching). There is generally no blistering at this stage.
Stage #2 Second Degree Burns
At this stage the outer layer (epidermis) and second layer (dermis) are damaged. These burns are typically red, blistered and very painful. They will again blanch when pressed.
Stage #3 Third Degree Burns
At this level damage extends beyond the outer layers of skin into the fatty layers immediately beneath the dermis. These burns will generally not be painful and will be white or brown in color. They might feel leathery and firm and will not blanch. It is unlikely, but not impossible for sunburn to reach this level.
Stage #4 Fourth Degree Burns
These burns extend lower into the fatty layers of the body.
Stage #5 Fifth Degree Burns
These burns extend into the muscles.
Stage #6 Sixth Degree Burns
These burns extend as far as the bones.
There are other factors which can determine how quickly you might experience sunburn during UV exposure. One of these is a pigment found in the skin called melanin.
The darker the natural color of the skin, the more melanin the body contains. Melanin helps protect the deep layers of the skin from UV damage. When exposed to sunlight, the skin is damaged by the UV rays. The body produces more melanin to counteract and to try and prevent further damage.
Melanin is what gives our skin a tan; the more melanin, the deeper the color change. Consequently, darker skinned people will tan easily while lighter skinned people are more likely to get sunburn. (12)
Treatment
We have established that too much sun exposure without protection can leave us vulnerable to sunburn. To ease the effects of this condition, early treatment is important.
Home Treatment
As soon as you notice the skin burning, you should move out of the sun. Preferably this should be indoors, but if not possible, certainly into some shade. Even putting on some clothes or protecting exposed skin from the sun with a hat or umbrella will help.
Once out of the sun there are things you can do to relieve the heat and discomfort.
Placing a damp cold towel on your skin will help take out some of the heat. Try and do this a few times a day for about 10 to 15 minutes at a time. Bathing or showering in cool water several times a day will also help relieve the symptoms.
Moisturizing the skin will help relieve dryness and tightness in the skin. If you do this after showering when the skin is already moist it will help trap moisture in the skin.
Moisturizers containing aloe vera or soy help soothe sunburnt skin. However, there are ingredients found in some moisturizers that should be avoided, including petroleum, lidocaine and benzocaine.
Petroleum has the ability to trap heat in the skin, and lidocaine and benzocaine can cause irritation. (13)
A cream containing one percent of the active ingredient hydrocortisone can be used if the sunburn is particularly painful or uncomfortable. This is used to relieve redness, swelling, itching, or other discomfort from many skin conditions. (14)
In the event of fever, headaches or pain, ibuprofen or aspirin can be taken to ease these symptoms.
Too much sun exposure can leave you dehydrated, therefore drinking plenty of water and rehydration salts will replace what is lost. This can also help prevent heat related illnesses like heat exhaustion, or even worse heat stroke.
If sunburn is second degree then blisters might be present. In this case lightly bandage the affected area to protect it and prevent infection. If blisters are in an area which can’t be bandaged, cover them with gauze.
Try not to break the blisters as this will increase the risk of them becoming infected. It can also slow the natural healing process.
If a blister breaks on its own and the skin peels, you can remove dry fragments of skin. Application of an hydrocortisone or antiseptic cream will help prevent infection. (15)
While skin is healing following sunburn, stay out of the sun. If you do go out, wear clothes that will protect your skin from further exposure and damage.
Medical Help
Sunburn that is covering a large area, severe, or causing concern might need medical treatment.
If you experience symptoms including blistering, swelling, nausea, chills, fever, headache or dizziness, see a doctor.
There are burn creams and treatments available by prescription that can help. (16)
Heat exhaustion is also a factor which needs to be considered. This happens when the body’s core temperature is elevated; if not treated this can lead to heat stroke, a life threatening condition.
The symptoms of this include excessive sweating, weakness, headache, fatigue, dizziness, nausea and vomiting, fainting, vertigo and muscle cramps. Skin will feel cold and clammy and appear pale, while breathing will be rapid and pulse weak and fast.
Heat exhaustion is relieved by moving to a cool place and sipping water and rehydration drinks. Reducing body temperature in a cool bath, or by placing cool wet clothes or towels on the body, will also help.
If symptoms worsen, last for more than an hour, or vomiting is present, seek emergency medical help. (17, 18)
FAQ
What is sunburn? Sunburn is damage to the skin caused by overexposure to ultraviolet (UV) radiation, usually from excessive sun exposure.
What are the signs of sunburn? The skin will be red and feel warm or hot to the touch. It can be painful and might be blistered. Fever, headache and tiredness are further symptoms.
How do you develop sunburn? Spending too long in the sun without the protection of sunscreen or clothing can lead to sunburn.
How are you diagnosed for sunburn? The signs and symptoms of sunburn will be apparent and can usually be treated at home.
What is the best treatment for sunburn? Cooling and hydrating the damaged skin will help relieve the symptoms. They usually pass in about three to five days. However if sunburn is very painful and blistered medical help might be needed. (19)
What are the long term complications of sunburn? We have mentioned that sunburn can lead to heat exhaustion and eventually heat stroke. A further complication is the increased risk of developing skin cancer. (20)
Is sunburn considered a disability? Sunburn is not considered a disability.
Is there a cure for sunburn? Sunburn can be treated easily and successfully. However care should be taken to ensure that heat stroke does not develop and risk of skin cancer is reduced.
Is sunburn life threatening? Sunburn is not life threatening, yet heat stroke and skin cancer are.
Summary
Sunburn is damage to the skin caused by overexposure to ultraviolet (UV) radiation, usually from excessive sun exposure.
There are occasions when we might forget to apply sunscreen or spend too long in the sun. Fortunately, when sunburn is the result, there are treatments which you can undertake at home to relieve the symptoms. The other good news is that sunburn heals in about three to five days.
The message to take away is to remember to use sunscreen and limit exposure to the sun when it is at its hottest.