We’ve all done it, haven’t we? Either thought, I’ll only be out for a little while, or “it’s not that sunny; I’ll be fine” – only to have that red, sore, tight feeling later on, and the inevitable sunworshippers’ remorse. Here, in this article, supported by the prestigious Mayo Clinic, we look at what causes sunburn and how we can protect ourselves and our loved ones.
Sunburn is inflamed, painful skin that feels hot to the touch. It often appears within a few hours of being in the sun too long.
You can get sunburn relief with simple self-care measures such as taking pain relief and cooling the skin, but it may take days for the sunburn to fade.
Preventing sunburn year-round by wearing sunscreen or using other skin-protection habits is important for everyone. It is especially important when you’re outdoors, even on cool or cloudy days.
Symptoms
Sunburn symptoms can include:
- Inflamed skin, which looks pink or red on white skin and may be harder to see on brown or Black skin.
- Skin that feels warm or hot to the touch.
- Pain, tenderness and itching.
- Swelling.
- Small, fluid-filled blisters, which may break.
- Headache, fever, nausea and fatigue, if the sunburn is severe.
- Eyes that feel painful or gritty.
Any exposed part of the body — including the earlobes, scalp and lips — can burn. Even covered areas can burn if, for example, clothing has a loose weave that allows ultraviolet (UV) light through. The eyes, which are extremely sensitive to the sun’s UV light, also can burn.
Sunburn symptoms often appear within a few hours after sun exposure.
Within a few days, the body may start to heal itself by peeling the damaged skin’s top layer. A bad sunburn may take several days to heal. Any lingering changes in skin colour sually go away with time.
When to see a doctor
See your health care provider if you:
- Develop large blisters.
- Develop blisters on the face, hands or genitals.
- Experience severe swelling of the affected area.
- Show signs of infection, such as blisters with pus or streaks.
- Experience worsening pain, headache, confusion, nausea, fever or chills.
- Get worse despite at-home care.
- Have eye pain or vision changes.
Seek immediate medical care if you are sunburned and experience:
- A fever over 103 F (39.4 C) with vomiting.
- Confusion.
- An infection.
- Dehydration.
- Cold skin, dizziness or faintness.
Causes
Sunburn is caused by too much exposure to ultraviolet (UV) light. UV light may be from the sun or artificial sources, such as sunlamps and tanning beds. UVA is the wavelength of light that can penetrate to the deep layers of skin and lead to skin damage over time. UVB is the wavelength of light that penetrates the skin more superficially and causes sunburn.
The UV light damages skin cells. The immune system reacts by increasing blood flow to the affected areas, which causes the inflamed skin (erythema) known as sunburn.
You can get sunburn on cool or cloudy days. Surfaces such as snow, sand and water can reflect UV rays and burn skin too.
Risk factors
Risk factors for sunburn include:
- Having white skin and red hair.
- Having a history of sunburn.
- Living or going on holiday somewhere sunny, warm or at high altitude.
- Working outdoors.
- Swimming or spraying your skin with water or baby oil, as wet skin tends to burn more than does dry skin.
- Mixing outdoor recreation and drinking alcohol.
- 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 (photosensitising medication).
Complications
Intense, repeated sun exposure that results in sunburn increases your risk of other skin damage and certain diseases. These include premature aging of skin (photoaging), precancerous skin lesions and skin cancer.
Premature aging of your skin
Sun exposure and repeated sunburns speed the skin’s aging process. 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 the cheeks, nose and ears.
- Freckles, mostly on the face and shoulders.
- Dark or discoloured spots (macules) on the face, back of hands, arms, chest and upper back.
Precancerous skin lesions
Precancerous skin lesions are rough, scaly patches in areas that have been damaged by the sun. They’re often found on the sun-exposed areas of the head, face, neck and hands of people whose skin burns easily in the sun. These patches can evolve into skin cancer.
Complications
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 the risk of 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, legs and back.
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 grow.
See your health care provider if you notice:
- A new skin growth.
- A bothersome change in your skin.
- A change in the look or texture of a mole.
- A sore that doesn’t heal.
Eye damage
Too much UV light damages the 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. This type of damage might be caused by the sun, welding, tanning lamps and broken mercury vapor lamps.
Prevention
Use these methods to prevent sunburn, even on cool, cloudy or hazy days. Sun exposure on cloudy days is decreased by about 20%. Be extra careful around water, snow, concrete 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 can’t do that, limit the time you’re in the sun. Seek shade when possible.
- Avoid sun tanning and tanning beds. Getting a base tan doesn’t decrease your risk of sunburn. If you use a self-tanning product to look tan, also apply a sunscreen before going outdoors.
- Use sunscreen often and generously. Use water-resistant, broad-spectrum lip balm and sunscreen with an SPF of at least 30, even on cloudy days. Broad-spectrum products offer protection against ultraviolet A (UVA) and ultraviolet B (UVB) rays. SPF 30 blocks 97% of UVB rays. No sunscreen can block 100% of the sun’s UVB rays.
About 30 minutes before going outdoors, generously apply your sunscreen to clean, dry skin. Use at least 2 tablespoons of sunscreen to cover all surfaces of the exposed skin, except the eyelids. If you’re using spray sunscreen, spray it into your hands and then rub it into the skin. This helps avoid inhaling the product. Don’t use a spray product while smoking or near an open flame.
If you’re using a product that contains physical blockers (titanium oxide, zinc oxide), apply it over any other products you’re wearing — except insect repellent. Insect repellent goes on last. Physical blockers provide the most effective protection for sensitive skin.
Reapply sunscreen every two hours — or more often if you’re swimming or perspiring. If you’re wearing makeup and want to reapply your sunscreen without redoing your whole face, one option is to use an SPF powder over makeup.
Make sure your sunscreen is within date. All skincare products in the UK are required to show how long they are effective for, usually 12 months, so make sure you’re not keeping the bottles too long. To be sure, take a marker pen and write on the bottom of the container the date you opened it.
- Protect babies and toddlers. Protect babies and toddlers from sunburn with brimmed hats and lightweight clothing that covers the arms and legs. Keep them cool, hydrated and out of direct sunlight. If sun-protective clothing and shade aren’t available, sunscreens containing zinc oxide or titanium dioxide are the next best choice.
- Cover up. When outside, other items such as umbrellas or wide-brimmed hats can offer protection in addition to sunscreen. Dark clothing with a tight weave offers more protection. Consider using outdoor gear specially designed to provide sun protection. Check the label for its ultraviolet protection factor (UPF), which tells how well a fabric blocks sunlight. The higher the UPF number, the better.
- Wear sunglasses when outdoors. Choose sunglasses with UVA and UVB protection. Check the UV rating on the label when buying new glasses. Darker lenses don’t always mean better UV protection. It also helps to wear sunglasses that fit close to your face or have wraparound frames.
- Be aware of sun-sensitising medications and cosmetics. Some common prescription and nonprescription drugs can make skin more sensitive to sunlight. Examples include antibiotics, nonsteroidal anti-inflammatory drugs such as ibuprofen and cholesterol-lowering drugs. Some essential oils can also increase photosensitivity, especially the citrus-based ones. Check with your therapist if you are planning an aromatherapy treatment. Talk with your pharmacist or health care provider about the side effects of drugs you take. Cosmetics that contain alpha-hydroxy acids (AHAs) also increase sun sensitivity.