Sunburn

Introduction

Sunburn is an acute cutaneous inflammatory reaction to ultraviolet radiation (particularly UVB) from natural sunlight or artificial sources (e.g. tanning beds, phototherapy devices).

• Painful erythema starts 2 to 6 hours after exposure, reaching a maximum at 24 hours. In severe cases, blistering is associated with malaise, fever, nausea and vomiting.
• Resolution, with skin peeling, takes 4 to 7 days.
• There is ofen peeling of the sunburnt skin.

Risk Factors

• Having light skin, blue eyes and red or blond hair
• Living or vacationing somewhere sunny, warm or at high altitude
• Working outdoors
• Swimming or spraying your skin with water, as wet skin tends to burn more than does dry skin
• Drinking alcohol
• Taking photosensitizing medications

NOTE: Susceptibility to sunburn is a marker of genetic susceptibility to skin cancer and is associated with an increased risk of melanoma at all ages.

Management

Sunburns are a self-limiting condition that typically resolve within a few days to a week without treatment.

Management involves the symptomatic treatment of skin inflammation and control of pain.

• Cool compresses or soaks, calamine lotion, aloe vera-based gels and emollients may relieve discomfort.
• Oral NSAIDs (e.g. ibuprofen) may be used for the treatment of skin pain and inflammation. Treatment should be initiated as soon as the first symptoms become apparent and continued for 24 to 48 hours.

Although topical corticosteroids are frequently used in clinical practice, there is little evidence that they are beneficial in reducing the symptoms and healing time of sunburn.

• Effect of topical corticosteroids on symptoms of clinical sunburn, 1978
  
• Topical corticosteroids in the treatment of acute sunburn: a randomized, double-blind clinical trial, 2008
  
• Failure of systemically administered corticosteroids to suppress UVB-induced delayed erythema, 1981
  

Prevention

Sunburn is better prevented by practicing sun protection measures.

• Avoid sun exposure, especially between 10 am and 2 pm.
• Wear protective clothing, including wide-brimmed hats.
• Apply and re-apply sunscreen with a SPF of 50+.

Supplement

An oral food supplement containing Polypodium leucotomos may provide additional oral photoprotection and reduce sunburn.

• Topical or oral administration with an extract of Polypodium leucotomos prevents acute sunburn and psoralen-induced phototoxic reactions as well as depletion of Langerhans cells in human skin, 1997
• Safety and Efficacy of Oral Polypodium leucotomos Extract in Healthy Adult Subjects, 2015

External Links

• UpToDate - Sunburn
• DermNet NZ - Sunburn
  
• Mayo Clinic - Sunburn
  
• Reduction of the erythema response to ultraviolet light by nonsteroidal antiinflammatory agents, 1982
  
• Topical or oral administration with an extract of Polypodium leucotomos prevents acute sunburn and psoralen-induced phototoxic reactions as well as depletion of Langerhans cells in human skin, 1997
  
• Diclofenac-Na gel is effective in reducing the pain and inflammation associated with exposure to ultraviolet light - results of two clinical studies, 2005
  
• Sunburns and risk of cutaneous melanoma: does age matter? A comprehensive meta-analysis, 2008
• Safety and Efficacy of Oral Polypodium leucotomos Extract in Healthy Adult Subjects, 2015