SUNBURN

Main Symptoms

  • Red, painful skin following sun exposure

General Information

  • Most sunburn is a first-degree burn that turns the skin pink or red. Prolonged sun exposure can cause blistering (a second-degree burn). Sunburn never causes a third-degree burn or scarring.
  • The pain and swelling starts at 4 hours, peaks at 24 hours, and improves after 48 hours.
  • Long-term sun exposure increases the risk of skin cancer and causes aging of the skin.

See More Appropriate Topic (instead of this one) If

  • Chemical or thermal burn, see BURNS

WHEN TO CALL YOUR DOCTOR FOR SUNBURN

Call 911 Now (you may need an ambulance) If:

  • Passed out
  • Difficult to awaken or acting confused
  • Very weak (unable to stand)

Call Your Doctor Now (night or day) If:

  • You feel weak or very sick
  • Blisters are present on face
  • Large blister is present (more than ½ inch wide)
  • Unable to look at lights because of eye pain
  • Extremely painful sunburn
  • Looks infected (e.g., draining pus, red streaks, increasing tenderness after day 2)

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If:

  • You think you need to be seen
  • Many smallblisters are present

Call Your Doctor During Weekday Office Hours If:

  • You have other questions or concerns

Self Care at Home If:

  • Mild sunburn (all triage questions negative)
  • Sunscreen and protection from the sun, questions about
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HOME CARE ADVICE FOR MILD SUNBURN

  1. Ibuprofen for Pain: For pain relief, begin taking ibuprofen (e.g. Advil, Motrin) as soon as possible. Adult dosage is 400 mg every 6 hours.  If anti-inflammatory agents such as ibuprofen are begun within 6 hours of sun exposure and continued for 2 days, they can greatly reduce your discomfort. If you can't take ibuprofen, use acetaminophen (e.g. Tylenol) instead.
    • Do not take ibuprofen if you have stomach problems, kidney disease, are pregnant, or have been told by your doctor to avoid this type of anti-inflammatory drug. Do not take ibuprofen for more than 7 days without consulting your doctor.
    • Do not take acetaminophen if you have liver disease.
    • Read the package instructions thoroughly on all medications that you take.
  2. Steroid Cream: Apply 1% hydrocortisone cream ASAP and then three times a day. If used early and continued for 2 days, it may reduce swelling and pain.  If you don't have any, use a moisturizing cream until you can get some. Read the package instructions thoroughly on all medications that you use.
  3. Cool Baths: Apply cool compresses to the burned area several times a day to reduce pain and burning. For larger sunburns, give cool baths for 10 minutes (caution: avoid any chill). Add 2 oz. baking soda per tub. Avoid soap on the sunburn.
  4. Extra Fluids: Drink extra water on the first day to replace the fluids lost into the sunburn and to prevent dehydration and dizziness.
  5. Broken Blisters:
    • For broken blisters, trim off the dead skin with a fine scissors. (Reason: these hidden pockets can become a breeding ground for infection.)
    • Apply antibiotic ointment (e.g. Bacitracin) to the raw skin under broken blisters. Reapply twice daily for 3 days.
    • Caution: leave intact blisters alone. (Reason: the intact blister protects the skin and allows it to heal.)
  6. Expected Course: Pain usually stops after 2 or 3 days.  Skin flaking and peeling usually occur 5-7 days after the sunburn.
  7. Prevention - Reduce Sun Exposure: Try to avoid all sun exposure between 10 am and 3 pm. When you are outdoors, use a hat with a wide brim and cotton clothing with long sleeves.
  8. Prevention - Use Sunscreen:
    • Apply sunscreen to areas that can't be protected by clothing. Generally, an adult needs about 1 oz of sunscreen lotion to cover the entire body.
    • You should reapply the sunscreen every 2-4 hours. You should also reapply after swimming, exercising, or sweating.
    • A sunscreen with a rating of SPF 15 to 30 should be used. Sunscreens with ratings higher than 30 provide minimal additional protection.
    • Sunscreens help prevent sunburn, but do not completely prevent skin damage. Thus, sun exposure can still increase your risk of skin aging and skin cancer.
  9. Vitamins C and E: Vitamins C and E have anti-oxidant properties, which means they help prevent sun damage to cells in your skin. Taking vitamins C and E by mouth may partially reduce the sunburn reaction.
    • The adult dosage of vitamin C (ascorbic acid): 2 grams by mouth once a day.
    • Adult dosage of vitamin E (d-alpha-tocopherol): 1000 IU by mouth once a day.
    • Caution: Prevention is the key. Remember to reduce sun exposure and use sunscreens.
    • Read the package instructions thoroughly on all medications that you take.
  10. Call Your Doctor If:
    • Pain becomes severe
    • Pain does not improve after 3 days
    • Sunburn looks infected
    • You become worse or develop any of the "Call Your Doctor" symptoms.
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Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Adult HouseCalls Online. Copyright © 2000-2003 David Thompson, M.D. FACEP

Reviewed 8/2003

Revised 8/2003

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