Sunburn: how to treat the effects of prolonged sun exposure

After spending a weekend away enjoying the sun, you want to bring back happy memories and perhaps a souvenir. What you don't want to return home with is angry-looking and painful skin, prone to blistering or peeling. For millions of people, however, sunburn is a lasting reminder of time spent in the sun.

Caused by exposure to too much ultraviolet radiation, sunburnt skin is red, painful and hot to touch.

When the skin is exposed to too much ultraviolet (UV) light, be it from the sun or artificial sources such as sunlamps, sunburn can occur. 

Although easily done, sunburn can also be avoided with adequate forms of prevention. If not prevented, it can increase the risk of other skin damage occurring, including cancers such as melanoma.

According to a poll carried out by the Skin Cancer Foundation (SCF), 42% of people get a sunburn at least once a year. 

This suggests firstly that a lot of people may not be taking the risk of sunburn seriously and secondly that there are quite a lot of people that require sunburn treatment.

But if the harmful effect of UV rays are not avoided, how best should this condition be dealt with? While the effects of excess sun exposure can be very dangerous, can people compromise their health further by not treating sunburn properly?

In this Spotlight, we have a quick look at what sunburn is before examining ways in which this uncomfortable condition can be treated. We will also attempt to debunk some of the many popular and unhelpful myths about sunburn that are regularly circulated.

What is sunburn?

We briefly looked at sunburn in our summer vacation Spotlight at the start of the month, as around 62% of travelers report getting sunburn while on vacation.

UV light is the cause of sunburn. The body protects itself from this harmful radiation by accelerating the production of melanin, the dark pigment that gives skin its normal color. When melanin production is accelerated, the extra melanin produced gives the skin a darker color, referred to as a tan.

Unfortunately, melanin can only protect the body from a certain amount of UV light. Eventually, if someone is continuously exposed to it, UV radiation will cause their skin to burn.

When skin is exposed to too much UV light, within a few hours it will typically become red, painful and hot to touch. In severe cases, blisters can form on the skin and a burned individual can experience headaches and fever.

Even when the sun is not shining, UV light can cause sunburn. Up to 80% of UV rays can pass through clouds, and surfaces such as snow, sand and water reflect UV, leading to a similar level of exposure as that provided by direct sunlight. As a result, people should wear sunscreen even when in the shade on bright days.

To protect the skin from UV exposure, regularly apply protective lotion or wear clothing made from tightly-woven fabrics.

In addition, some clothes do not offer much protection from this radiation. A plain white t-shirt offers a sun protection factor of around 7, falling to around 3 if it gets wet.

In general, the easiest way to test if a fabric can protect your skin is to hold it up to the light - if you can see through it, then UV radiation can penetrate.

Many people do not seem to take sunburn seriously, with some even believing that it is a mild inconvenience that comes with the eventual acquisition of an attractive suntan. 

Many dermatologists will attest, however, that there is no such thing as a safe tan.

A tan is literally your body's response to being injured by UV exposure.

According to the SCF, a person's risk for melanoma doubles if they have five or more cases of sunburn. Melanoma is one of the more common forms of skin cancer and also one of the most dangerous. Avoiding sunburn is recognized as the best way of preventing melanoma.

It is clear that sunburn is something that should be avoided where possible, but even the most vigilant people can be caught out by UV rays, particularly on cloudy and breezy days when the threat is not obvious. If we find ourselves sunburnt, then, what is the best course of action?

How to treat sunburn

Sunburn cases can vary in their severity dramatically. In severe cases, it is recommended that professional help is sought. Specifically, the Mayo Clinic state that you should see a doctor if the sunburn is blistering and covering a large portion of the body or if it is accompanied by high fever, extreme pain or headaches.

Once the skin is burnt, efforts should be turned toward soothing the pain and aiding the healing process. As soon as it becomes apparent that the skin is sunburnt, the first thing that should be done is getting out of the sun, preferably indoors. Once the risk of further UV exposure is minimized, there are a number of things that can be done to treat the burn.

Cooling and moisturizing

Cooling the skin down is one immediate way to make it feel less uncomfortable. This can be achieved by placing damp towels on the skin or with a cool bath or shower. The American Academy of Dermatology (AAD) recommend keeping towels on affected areas for 10-15 minutes a few times every day.

Leaving a small amount of water on the skin - particularly after a bath or shower - and then applying moisturizer can help trap the water in the skin, easing the dryness. Moisturizing after bathing the skin is especially important as without it the skin can be left feeling drier than before.

Be aware of what ingredients are in moisturizing lotions, however. Some contain petroleum, which can trap heat in the skin, and some contain benzocaine and lidocaine that can irritate the skin.

A few days after becoming sunburnt, damaged skin will begin to peel away.

Peeling skin and blisters

As well as soothing the skin, moisturizing can make peeling and flaking less noticeable, serving as further reason for the image-conscious to apply it. Peeling is a natural consequence of sunburn, merely the body's way of removing damaged skin.

If blisters form, experts recommend they are not broken. Breaking open blisters not only slows the skin's healing process but increase the risk of infection. 

If a blister inadvertently breaks, be sure to clean the area gently with water and mild soap, apply antibacterial cream and protect the area with a wet dressing. If you are worried and want to protect blisters, lightly cover them with gauze.

Pain relief

There are a number of over-the-counter medications that can be taken to relieve pain caused by sunburn. Pain relief medication such as ibuprofen or naproxen should be taken as soon as signs of sunburn emerge.

It cuts back on the swelling and redness that is going to occur. It's not just treating the symptoms, it's treating the severity of the symptoms.

In addition to moisturizer, a low-dose hydrocortisone cream (0.5-1%) can reduce pain and swelling while speeding up the recovery process. This cream is also available for purchase without a prescription.

Keep hydrated

Sunburn not only dries out the skin but the inside of the body as well, drawing water away from the rest of the body and to the surface of the skin. This means that it is important for people with sunburn to drink extra water to prevent dehydration and help the skin heal.

Eating foods with a high concentration of water can also help. One large portion of watermelon, for example, can provide more than 1 cup of water. Remember to stick to a balanced diet, however, as the skin needs a healthy range of nutrients in order to regenerate properly.

Protect healing skin

While the skin is healing, you should take care to keep it protected. Avoid further sun exposure by either staying out of the sun or protecting the skin as much as possible when venturing outside. Cover up with clothing made from tightly-woven fabrics.

Rest is important, but sleeping can be difficult when the body is sunburnt. Sprinkling talcum powder on bedsheets could help reduce friction and chafing and so make attempting to go to sleep a more comfortable experience.

Popular sunburn myths

Part of the reason that so many people report being sunburnt each year is due to the prevalence of myths that make people less likely to adopt efficient sun protection strategies.

One particularly dangerous myth is the idea that 80% of sun damage occurs before the age of 18, suggesting that any UV-related injury has already been done by the time we reach adulthood. In fact, recent studies suggest that people receive less than 25% of their total lifetime sun exposure by this age.

It's cumulative sun exposure that's associated with other skin cancers, not to mention wrinkles, thinning skin, dark spots, and 'broken' capillary veins on the skin.

In fact, exposure to UV is precisely the same as smoking cigarettes, in that no matter how much damage has already been done, "it's always good to stop."

Another dangerous myth is that people with dark skin do not need to worry about sunburn. Although many people with dark skin have a lower skin cancer risk than people with pale skin, the Centers for Disease Control and Prevention (CDC) revealed in a study that up to 30% of darker-skinned ethnic groups reported at least one case of sunburn in the previous year.

Genetics also play an important part in an individual's skin cancer risk. Even people with dark complexions could be at a heightened risk of developing skin cancer due to carrying certain genes that make them more susceptible to the disease.

Finally, some people believe that sunscreen is only needed during the part of the day when the sun is directly overhead - from around 10 am until 2 pm. Although the chances of developing sunburn are highest at this time, one particular type of UV radiation (UVA rays) is constant all day long.

Everyone needs to be wary when it comes to sun exposure, regardless of age, ethnicity, race and what time they are exposed to the sun. Without due caution, anyone can become sunburn.

And if you happen to be out enjoying the sun and, instead of returning home with good memories, you return with a nasty case of sunburn, you will now know how to cope with this uncomfortable condition. 

Be sure to take heed of the warnings, and let this one occasion be the last time you find yourself reaching for the moisturizer and the ibuprofen.

References:

AAD, Treating sunburn, accessed 16 July 2015.
CDC, Sun exposure, accessed 15 July 2015.
CNN, Six common sun myths, exposed, accessed 16 July 2015.
Mayo Clinic, Sunburn - causes, accessed 16 July 2015.
Mayo Clinic, Sunburn - definition, accessed 15 July 2015.
Mayo Clinic, Lifestyle and home remedies, accessed 16 July 2015.
Mayo Clinic, Sunburn - symptoms, accessed 15 July 2015.
Prevention, 12 natural sunburn cures, accessed 16 July 2015.
Reader’s Digest, 10 sunscreen myths you believe that make dermatologists cringe, accessed 16 July 2015.

SCF, Facts about sunburn and skin cancer, accessed 15 July 2015.
SCF, Five ways to treat a sunburn, accessed 16 July 2015.