When Sunburn Requires Medical Attention
are longer, the trees are blooming and baseball season is in full swing. These are all signs that summer is just
around the corner. Outside spring and summer activities bring with them risks
of skin damage, from sunburn in the short term to skin cancer in the long term.
emergency physician, I once cared for a patient who was on a rafting trip with
friends and took a break on a large rock. The young man had fallen asleep on
the rock in direct sunlight for several hours and sustained serious sunburn,
complete with blisters over a large portion of his face, chest, arms, and legs.
The sunburn was so severe that he required admission to the hospital for IV
fluids and pain control.
occurs from exposure of the skin to ultraviolet (UVA and UVB) radiation from
the sun, tanning beds/booths, and other UV sources. Sunburn, also called solar
erythema, occurs when blood vessels near the skin dilate and skin cells become
inflamed and die, causing the red appearance of the skin most commonly
associated with sunburn. Redness and painful skin usually develop within a few
hours of sun exposure and peak at approximately one day after exposure. Blisters
can develop in severe cases.
cases of sunburn only require symptomatic care, such as rehydration and pain
control, usually with over the counter medications such as NSAIDs (for example,
ibuprofen) or acetaminophen, using mild soaps when bathing/showering, skin
moisturizes and anti-itch products such as calamine lotion. Topical and oral
steroids are usually not recommended. The best treatment for sunburn is
prevention. Some strategies to reduce the chance of sunburn include avoiding
prolonged periods in the strong, midday sun (from approximately 10AM to 4PM),
covering skin with hats that cover head, neck, and ears, wearing loose clothing
that covers arms and legs, choosing clothing with UV protection, and wearing
appropriate sun protection factor (SPF) rated sunscreen. A higher SPF Sunscreen
that protects against both UVA and UVB types of radiation (and UV protective
lip balm) should be applied liberally to the exposed areas of skin. Sunscreen
should be applied within 30 minutes of sun exposure and reapplied every 2 to 3
hours or after swimming, drying off with a towel, or if sweating.
most sunburns require only symptomatic care, sunburns that cause blistering,
are associated with nausea, vomiting, fevers, chills, or appear to be infected
should be immediately evaluated by a medical professional.
the Author: Chadd Kraus, DO, DrPH, MPH,
is an assistant professor of Clinical Emergency Medicine at The University of
Missouri in Columbia.