SUNBURN

General Information

DEFINITION--Inflammation of the cells of the skin that follows overexposure to the sun, sun lamps or occupational light sources.

BODY PARTS INVOLVED--Exposed skin.

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS

• Red, swollen, painful and sometimes blistered skin; fever (occasionally).
• Nausea and vomiting (severe burns).
• Delirium (severe, extensive burns).

CAUSES--Excess exposure to ultraviolet (UV) light. This is not screened out by thin clouds on overcast days, but it is partially screened by smoke and smog. A great deal of ultraviolet light reflects from snow, water, sand and sidewalks.

> Photosensitivity--some drugs, including sulfa, tetracyclines or oral contraceptives, and the chemicals in some substances applied to the skin (perfumes, after shaves, soaps) heighten sensitivity to the sun's ultraviolet rays.

HOW TO PREVENT

• Avoid sun exposure from 10 a.m. to 3 p.m. Sun exposure is more intense at high altitudes, tropical locations and near snow or water.
• Use a sun-block preparation for outdoor activity. Products with a sun-protective factor (SPF) of 15 or more protect almost totally. Those with lower values offer partial protection and allow minimal tanning. Some of these resist water and perspiration, but reapply them after swimming or after prolonged exposure. Baby oil, mineral oil or cocoa butter offer no protection from the sun.
• For maximum protection, use a physical-barrier agent such as zinc-oxide ointment. Reapply after swimming and at frequent intervals during exposure. Barrier agents are especially helpful on skin areas that are most susceptible to burns, such as the nose, ears, backs of the legs and back of the neck.
• Wear muted colors such as tan. Avoid brilliant colors and whites.
• If you take prescription drugs, ask your doctor or pharmacist if they cause photosensitivity.

What To Expect

DIAGNOSTIC MEASURES----Medical history and physical exam by a doctor (sometimes).

APPROPRIATE HEALTH CARE

• Self-care for minor sunburn.
• Doctor's treatment for severe sunburn.

POSSIBLE COMPLICATIONS

• Skin changes leading to skin cancer, including life-threatening malignant melanoma.
• Keratoses, premalignant skin lesions.
• Premature wrinkling and loss of skin elasticity.
• Temporary delirium in worst cases.

PROBABLE OUTCOME--Spontaneous recovery in 3 days to 3 weeks, depending on the severity of the sunburn.

How To Treat

GENERAL MEASURES--

• To reduce heat and pain, dip gauze or towels in cool water and lay these on the burned areas.
• After skin swelling subsides, apply cold cream or baby lotion.
• For badly blistered skin, apply a light coating of petroleum jelly. This prevents anything from sticking to the blisters.
• Soak in a tub of cool water to which colloidal oatmeal (Aveeno) or baking soda has been added. Pat skin dry, do not rub. Avoid soap.

MEDICATION--

• Use non-prescription drugs, such as aspirin, acetaminophen or ibuprofen, to relieve pain and reduce fever. Non-prescription burn remedies that contain local anesthetics, such as benzocaine or lidocaine, may be useful, but they produce allergic reactions in some. Aerosols are easier to use than creams or ointments (to avoid contact with your eyes, don't spray directly on your face; spray some on a cotton pad and apply to your face).
• Your doctor may prescribe pain relievers or cortisone drugs to use briefly.

ACTIVITY--Rest in any comfortable position until fever and discomfort diminish. Cover yourself with an upside-down "cradle" or tent of cardboard or other material to keep bed linens off the burned skin. If your legs are burned and your feet swollen, raise your legs above heart level while you are resting.

DIET--No special diet. Increase fluid intake.

Call Your Doctor If

The following occurs after sunburn:

• Extensive blistering (if blisters seem to spread, you may have an infection).
• Oral temperature rises to 101F (38.3C).
• Vomiting, diarrhea or delirium.
• Pain and fever that persist longer than 48 hours.