Sunburn — red, painful skin that feels hot to the touch — usually appears within a few hours after too much exposure to ultraviolet (UV) light from sunshine or artificial sources, such as sunlamps. Sunburn may take several days or longer to fade.

Intense, repeated sun exposure that results in sunburn increases your risk of other skin damage and certain diseases. These include dry or wrinkled skin, dark spots, rough spots, and skin cancers, such as melanoma.

You can prevent sunburn and related conditions by protecting your skin. This is especially important when you're outdoors, even on cool or cloudy days. If you are sunburned, you can try several home remedies and treatments to relieve pain and speed healing.

Sunburn signs and symptoms include:

  • Pinkness or redness
  • Skin that feels warm or hot to the touch
  • Pain, tenderness or itching
  • Swelling
  • Small fluid-filled blisters, which may break
  • Headache, fever, chills 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.

When to see a doctor

See your doctor if the sunburn:

  • Is blistering and covers a large portion of your body
  • Is accompanied by a high fever, extreme pain, headache, confusion, nausea or chills
  • Doesn't respond to at-home care within two days

Also seek medical care if you notice signs or symptoms of an infection. These include:

  • Increasing pain and tenderness
  • Increasing swelling
  • Yellow drainage (pus) from an open blister
  • Red streaks leading away from the open blister

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) and ultraviolet B (UVB) are the two types of solar radiation most responsible for sunburn. 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 color. When you're exposed to UV light, your body protects itself by accelerating the production of melanin. The extra melanin creates the darker color 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, ice, sand, water and other surfaces can reflect UV rays, burning your skin as severely as direct sunlight.

Risk factors for sunburn include:

  • Having fair skin
  • 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)

Intense, repeated sun exposure that results in sunburn increases your risk of other skin damage and certain diseases. These include infection, premature aging of your skin (photoaging) and skin cancer.

Infection

Ruptured blisters make you more susceptible to bacterial infection. See your doctor if you notice signs or symptoms of infection, which include pain, redness, swelling and an oozing blister.

Premature aging of your skin

Sun exposure and repeated sunburns accelerate the skin's aging process, making you look older than you are. Skin changes caused by UV light are called photoaging. The results of photoaging include:

  • Weakening of connective tissues, which reduces the skin's strength and elasticity
  • Deep wrinkles
  • Dry, rough skin
  • Fine red veins on your cheeks, nose and ears
  • Freckles, mostly on your face and shoulders
  • Dark or discolored spots (macules) on your face, back of hands, arms, chest and upper back — also called solar lentigines (len-TIJ-ih-neze)

Precancerous skin lesions

Precancerous skin lesions appear as rough, scaly patches in areas that have been damaged by the sun. They may be whitish, pink, tan or brown. They're usually found on the sun-exposed areas of the head, face, neck and hands of fair-skinned people. These patches can evolve into skin cancer. They're also called actinic keratoses (ak-TIN-ik ker-uh-TOE-seez) and solar keratoses.

Skin cancer

Excessive sun exposure, even without sunburn, increases your risk of skin cancer, such as melanoma. It can damage the DNA of skin cells. Sunburns in childhood and adolescence may increase your risk of developing melanoma later in life.

Skin cancer develops mainly on areas of the body most exposed to sunlight, including the scalp, face, lips, ears, neck, chest, arms, hands and legs. Skin cancer on the leg is more common in women than in men.

Some types of skin cancer appear as a small growth or a sore that bleeds easily, crusts over, heals and then reopens. With melanoma, an existing mole may change or a new, suspicious-looking mole may develop. A type of melanoma called lentigo maligna develops in areas of long-term sun exposure. It starts as a tan flat spot that slowly darkens and enlarges.

See your doctor if you notice a new skin growth, a bothersome change in your skin, a change in the appearance or texture of a mole, or a sore that doesn't heal.

Eye damage

The sun can also burn your eyes. Too much UV light damages the retina, lens or cornea. Sun damage to the lens can lead to clouding of the lens (cataracts). Sunburned eyes may feel painful or gritty. Sunburn of the cornea is also called snow blindness.

Most sunburns heal fine on their own. But you may seek treatment if you have severe or repeated sunburn. You're likely to first see your primary care doctor. Before you go to your appointment, list the medications you're taking — including vitamins, herbs and over-the-counter drugs. Some drugs increase your sensitivity to UV light.

Questions to ask your doctor about sunburn include:

  • Can I use over-the-counter medications to treat the condition, or do I need a prescription?
  • How soon after I begin treatment can I expect improvement?
  • What skin care routines do you recommend while the sunburn heals?
  • What suspicious changes in my skin might I watch for?

If your sunburn is severe or your doctor notices any skin abnormalities, he or she may refer you to a doctor who specializes in skin diseases (dermatologist) for further evaluation.

What you can do in the meantime

While waiting for your appointment, these steps may reduce your pain and discomfort:

  • Protect yourself from further sun exposure.
  • Take an anti-inflammatory medication, such as aspirin or ibuprofen (Advil, Motrin IB, others).
  • Drink extra water.
  • Apply cold compresses to the affected skin or take a cool bath.
  • Apply moisturizer or aloe vera lotion or gel to your skin.
  • Leave unbroken blisters alone. Gently clean popped blisters with mild soap and water. Apply an antibacterial cream to the area and cover it with a wet dressing.

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 phototesting. During phototesting, 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).

Sunburn treatment doesn't heal your skin or prevent damage to your skin, but it can reduce pain, swelling and discomfort. If at-home care doesn't help or your sunburn is very severe, your doctor can prescribe medications. These include:

  • Pain relievers. Over-the-counter and prescription pain relievers may help control the pain and swelling of sunburn, especially if you take them soon after sun exposure. Your doctor may recommend ibuprofen or naproxen. Some types of pain relievers may be applied to your skin as gels.
  • Medications that control itching. Corticosteroids that you apply to your skin may help control itching as your skin heals. These medications are often combined with pain relievers.

Once sunburn occurs, you can't do much to limit damage to your skin. But the following tips may reduce your pain and discomfort:

  • Take a pain reliever. Over-the-counter pain relievers, such as ibuprofen and naproxen, may help control pain until redness and soreness subside.
  • Cool the skin. Apply to the affected skin a cool compress — such as a towel dampened with cool tap water. Or take a cool bath or shower.
  • Apply moisturizer, aloe vera lotion or gel, or hydrocortisone cream to the affected skin. A low-dose (0.5 to 1 percent) hydrocortisone cream may decrease pain and swelling and speed healing.
  • If blisters form, don't break them. They contain your natural body fluid (serum) and are a protective layer. Also, breaking blisters slows the healing process and increases the risk of infection. If needed, lightly cover blisters with gauze. If blisters break, gently clean the area with mild soap and water, apply an antibacterial cream, and cover with a wet dressing.
  • Drink plenty of fluids, especially water. Sun exposure and heat can cause fluid loss through your skin. Drinking helps your body recover.
  • Treat peeling skin gently. Within a few days, the affected area may begin to peel. This is simply your body's way of getting rid of the top layer of damaged skin. While your skin is peeling, continue to use moisturizing cream.
  • Protect your sunburn from further sun exposure. Stay out of the sun or protect yourself from sunlight when you go outside.
  • Avoid applying "-caine" products, such as benzocaine. Such creams may irritate the skin or cause an allergic reaction.

    Benzocaine has been linked to a rare but potentially deadly condition called methemoglobinemia. This condition decreases the amount of oxygen the blood can carry.

    Don't use benzocaine in children younger than age 2 without supervision from a health care professional. If you're an adult, never use more than the recommended dose and consider talking with your doctor before using it.

Use these methods to prevent sunburn, even on cool, cloudy or hazy days. And be extra careful around water, snow, ice 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're unable to do that, limit the length of time you're in the sun. Seek shade when possible.
  • Cover up. Wear tightly woven clothing that covers you, including your arms and legs. Consider wearing clothing or 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. Dark colors offer more protection, as do fabrics treated with UV- absorbing chemicals.

    Also wear a broad-brimmed hat, which protects you better than a baseball cap or golf visor does.

  • Use sunscreen frequently and generously. No matter what your skin type is, use a broad-spectrum sunscreen with an SPF of 15 or greater. The American Academy of Dermatology recommends using a broad-spectrum sunscreen with an SPF of 30 or greater.

    Apply sunscreen generously, and reapply it every two hours — or more often if you're swimming or perspiring. 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.

    You may use sunscreen on toddlers and babies 6 months or older. But for younger babies, the American Academy of Pediatrics recommends using other forms of sun protection, such as shade or clothing.

  • Wear sunglasses when outdoors. You offer your eyes the best protection outdoors by choosing the highest UV protection-rated sunglasses. Darker lenses are not necessarily better at blocking UV rays. Check the UV rating on the label when buying new glasses. It also helps to wear sunglasses that fit close to your face and have wraparound frames that block sunlight from all angles.
  • Don't expect a base tan to protect. Some people think getting a base tan prevents sunburn. The idea is that a few sessions of indoor tanning will protect them from burning in the sun. Research doesn't support this. A base tan is no substitute for good sun protection. Plus, the risks of long-term tanning outweigh the unproven benefits of a base tan.
May 01, 2014