Sunburn

Sunlight can help our mental outlook and help us feel healthier. For people with arthritis, the sun's warmth can help relieve some of their physical pain. Many people also think that a suntan makes a person look young and healthy. But sunlight can be harmful to the skin, causing immediate problems as well as problems that may develop years later.

A sunburn is skin damage from the sun's ultraviolet (UV) rays. Most sunburns cause mild pain and redness but affect only the outer layer of skin (first-degree burn). The red skin might hurt when you touch it. These sunburns are mild and can usually be treated at home.

Skin that is red and painful and that swells up and blisters may mean that deep skin layers and nerve endings have been damaged (second-degree burn). This type of sunburn is usually more painful and takes longer to heal.

Other problems that can be present along with sunburn include:

• Heatstroke or other heat-related illnesses from too much sun exposure.
• Allergic reactions to sun exposure or to sunscreen products.
• Vision problems, such as burning pain, decreased vision, or partial or complete vision loss.

Long-term problems include:

• An increased chance of having skin cancer.
• An increase in the number of cold sores.
• An increase in problems related to a health condition, such as lupus.
• Cataracts, from not protecting your eyes from direct or indirect sunlight over many years. Cataracts are one of the leading causes of blindness.
• Skin changes, such as premature wrinkling or brown spots.

Your skin type affects how easily you become sunburned. People with fair or freckled skin, blond or red hair, and blue eyes usually sunburn easily. Your age also affects how your skin reacts to the sun. The skin of children younger than 6 and adults older than 60 is more sensitive to sunlight.

You may get a more severe sunburn depending on:

• The time of day. You are more likely to get a sunburn between 10 in the morning and 4 in the afternoon, when the sun's rays are the strongest. You might think the chance of getting a sunburn on cloudy days is less, but the sun's damaging UV light can pass through clouds.
• Whether you are near reflective surfaces, such as water, white sand, concrete, snow, and ice. All of these reflect the sun's rays and can cause sunburns.
• The season of the year. The position of the sun on summer days can cause a more severe sunburn.
• Altitude. It is easy to get sunburned at higher altitudes, because there is less of the earth's atmosphere to block the sunlight. UV exposure increases about 4% for every 1000 ft (305 m) gain in elevation.
• How close you are to the equator (latitude). The closer you are to the equator, the more direct sunlight passes through the atmosphere. For example, the southern United States gets 1.5 times more sunlight than the northern United States.
• The UV index of the day, which indicates the risk of getting a sunburn that day.

Preventive measures and home treatment are usually all that is needed to prevent or treat a sunburn.

• Protect your skin from the sun.
• Do not stay in the sun too long.
• Use sunscreens, and wear clothing that covers your skin.

If you have any health risks that may increase the seriousness of sun exposure, you should avoid being in the sun from 10 in the morning to 4 in the afternoon.

Review the Emergencies and Check Your Symptoms sections to determine if and when you need to see a doctor.

• Signs of shock occur:
  • In an adult.
  • In a child.
• A severe allergic reaction occurs with difficulty breathing or swelling of the mouth or throat.
• Signs of heatstroke occur, including:
  • Unconsciousness that lasts longer than 1 minute.
  • Convulsions (seizure).
  • Signs of moderate to severe difficulty breathing.
  • An elevated temperature after exposure to a hot environment.
  • Confusion, severe restlessness, or anxiety.
  • Rapid heartbeat.
  • Sweating that may be heavy or may have stopped.
  • Skin that may be red, hot, and dry, even in the armpits.
  • Severe vomiting and diarrhea.
• Signs of severe dehydration occur after being in the sun too long:
  • In an adult.
  • In a child.

Note:

After calling 911 or other emergency services, begin emergency first aid treatment if emergency medical personnel are not going to arrive soon.

If you answer yes to any of the following questions, click on the "Yes" in front of the question for information about how soon to see a health professional.

Review health risks that may increase the seriousness of your symptoms.

Note: If you have any of the following symptoms, evaluate those symptoms first.

• Heat exhaustion: Go to the topic Heat-Related Illnesses.
• Hives or other symptoms of an allergic reaction: Go to the topic Allergic Reaction.

Other Symptoms to Watch For

Do you have the following symptom?

• Skin changes and a history of sunburns: Go to the topic Skin Changes.

If a visit to a health professional is not needed immediately, see the Home Treatment section for self-care information.

Home treatment measures may provide some relief from a mild sunburn.

• Use cool cloths on sunburned areas.
• Take frequent cool showers or baths.
• Apply soothing lotions that contain aloe vera to sunburned areas. Topical steroids (such as 1% hydrocortisone cream) may also help with sunburn pain and swelling. Note: Do not use the cream on children younger than age 2 unless your doctor tells you to. Do not use in the rectal or vaginal area in children younger than age 12 unless your doctor tells you to.

A sunburn can cause a mild fever and a headache. Lie down in a cool, quiet room to relieve the headache. A headache may be caused by dehydration, so drinking fluids may help. For more information, see the topic Dehydration.

There is little you can do to stop skin from peeling after a sunburn—it is part of the healing process. Lotion may help relieve the itching.

Other home treatment measures, such as chamomile, may help relieve your sunburn symptoms.

Care of blisters

Home treatment may help decrease pain, prevent infection, and help the skin heal.

Small, unbroken blisters [less than 1 in. (2.5 cm) across] usually heal on their own.

• Do not try to break the blisters. Just leave them alone.
• Do not cover the blisters unless something such as clothing is rubbing against them. If you do cover them, apply a loose bandage. Secure the bandage so the tape does not touch the blisters. Do not wrap tape completely around a hand, arm, foot, or leg, because it could cut off the blood supply if the limb swells. If the tape is too tight, you may develop symptoms below the level of the tape, such as numbness, tingling, pain, or cool and pale or swollen skin.
• Avoid wearing clothes or shoes or doing activities that rub or irritate the blisters until they have healed.

Large or broken blisters usually heal without problems. Most large blisters will break on their own and then heal.

• Wash your hands with soap and water before touching blisters. Blisters can easily become infected.
• If you have a large blister, you may want to drain it, depending on where it is. If you decide to drain it:
  • Clean a needle with rubbing alcohol or soap and water, then use it to gently puncture the edge of the blister.
  • Press the fluid in the blister toward the hole you made.
  • Wash the blister after you have drained it, and pat it dry with clean gauze.
• Do not remove the flap of skin covering the blister unless it tears or gets dirty or pus forms under it. If the blister has just a small puncture or break, leave the flap of skin on, and gently smooth it flat over the tender skin underneath.
• Apply an antibiotic ointment, such as polymixin B or bacitracin, if you are not allergic to it. The ointment will prevent the bandage from sticking to the blister and may help prevent infection. Do not use alcohol or iodine on the blister, because these may delay healing. Do not use an ointment if you know you are allergic to it.
• Loosely apply a bandage or gauze. Secure the bandage so the tape does not touch the blister. Do not wrap tape completely around a hand, arm, foot, or leg, because it could cut off the blood supply if the limb swells. If the tape is too tight, you may develop numbness, tingling, pain, or cool and pale or swollen skin below the level of the tape.
• If the skin under the bandage begins to itch or develops a rash, stop using the antibiotic ointment.
• Change the bandage every day and anytime it gets wet or dirty. You can soak the bandage in cool water just before removing it to make it less painful to take off.
• Avoid wearing clothes or shoes or doing activities that rub or irritate the blisters until they have healed.

Watch for a skin infection while your blister is healing. Signs of infection include:

• Increased pain, swelling, redness, or warmth around the blister.
• Red streaks extending away from the blister.
• Drainage of pus from the blister.
• Swollen lymph nodes in your neck, armpit, or groin.
• Fever.

Symptoms to Watch For During Home Treatment

Use the Check Your Symptoms section to evaluate your symptoms if any of the following occur during home treatment.

• Vision problems continue after you get out of the sun.
• Fever develops.
• Nausea or vomiting starts or increases, and you are unable to drink enough to replace lost fluids.
• Signs of skin infection in blisters develop.
• Signs of an allergic reaction develop.
• Symptoms become more severe or more frequent.

Avoid sun exposure

The best way to prevent a sunburn is to avoid sun exposure.

Stay out of the midday sun (from 10 in the morning to 4 in the afternoon), which is the strongest sunlight. Find shade if you need to be outdoors. You can also calculate how much ultraviolet (UV) exposure you are getting by using the shadow rule: A shadow that is longer than you are means UV exposure is low; a shadow that is shorter than you are means the UV exposure is high.

Other ways to protect yourself from the sun include wearing protective clothing, such as:

• Hats with wide 4 in. (10 cm) brims that cover your neck, ears, eyes, and scalp.
• Sunglasses with UV protection.
• Loose-fitting, tightly woven clothing that covers your arms and legs. Some outdoor stores may sell clothing treated with sun protection factor.

Do not use tanning booths to get a tan. Artificial tanning devices can cause skin damage and increase the risk of skin cancer.

Preventing sun exposure in children

You should start protecting your child from the sun when he or she is a baby. Because children spend a lot of time outdoors playing, they get most of their lifetime sun exposure in their first 18 years.

• Keep babies younger than 6 months of age out of the sun. If sunscreen is needed, a small amount on the face or the back of the hands is not harmful.
• Teach children the ABCs of how to protect their skin from getting sunburned.
  • A = Away. Stay away from the sun in the middle of the day (from 10 in the morning to 4 in the afternoon).
  • B = Block. Use a sunscreen with a sun protection factor (SPF) of 15 or higher to protect babies' and children's very sensitive skin.
  • C = Cover up. Wear clothing that covers the skin, hats with wide brims, and sunglasses with UV protection. Even children 1 year old should wear sunglasses with UV protection.
  • S = Speak out. Teach others to protect their skin from sun damage.

Sunscreen protection

If you can't avoid being in the sun, use a sunscreen to help protect your skin while you are in the sun.

• Use a sunscreen that has a sun protection factor (SPF) of at least 30 or higher. Sunscreens that say "broad-spectrum" can protect the skin from ultraviolet A and B (UVA and UVB) rays. Sunscreens come in lotions, gels, creams, and ointments.
• Apply the sunscreen at least 30 minutes before going in the sun.
• Apply sunscreen to all the skin that will be exposed to the sun, including the nose, ears, neck, scalp, and lips. Sunscreen needs to be applied evenly over the skin and in the amount recommended on the label. Most sunscreens are not completely effective, because they are not applied correctly. It usually takes about 1 fl oz (30 mL) to cover an adult's body.
• Apply sunscreen every 2 to 3 hours while in the sun and after swimming or sweating a lot. The SPF value decreases if a person sweats heavily or is in water, because water on the skin reduces the amount of protection the sunscreen provides. Sunscreen effectiveness is also affected by the wind, humidity, and altitude.
• Use lip balm or cream that has sun protection factor (SPF) of 30 or higher to protect your lips from getting sunburned or developing cold sores.

Some sunscreens say they are water-resistant or waterproof and can protect for about 40 minutes in the sun if a person is doing a water activity. Apply sunscreen more often if you are in water. Wet skin can burn easily, so it is important to protect your skin even if you do not feel that you are getting sunburned. Wearing a T-shirt while swimming does not protect your skin unless sunscreen has also been applied to your skin under the T-shirt.

The following tips about sunscreen will help you use it more effectively:

• Older adults should always use a sunscreen with an SPF of at least 30 to protect their very sensitive skin.
• If you have sensitive skin that burns easily, use a sunscreen with an SPF of at least 30.
• If you have dry skin, use a cream or lotion sunscreen.
• If you have oily skin or you work in dusty or sandy conditions, use a gel, which dries on the skin without leaving a film.
• If your skin is sensitive to skin products, use a sunscreen that is free of chemicals and alcohol.
• If you have had a skin reaction (allergic reaction) to a sunscreen, look for one that is free of para-aminobenzoic acid (PABA), preservatives, and perfumes. These ingredients may cause skin reactions.
• If you are going to be in very intense sunlight for a long period of time, consider using a physical sunscreen (sunblock), such as zinc oxide, which will stop all sunlight from reaching the skin.
• If you need to use sunscreen and insect repellent with DEET, do not use a product that combines the two. You can apply sunscreen first and then apply the insect repellent with DEET, but the sunscreen needs to be reapplied every 2 hours.

To prepare for your appointment, see the topic Making the Most of Your Appointment

You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:

• What are your main symptoms?
• How long have you had your symptoms?
• Do you have blisters?
• What amount of time did you spend in the sun? Were you at a high altitude?
• Did you use sunscreen or sunblock, and what SPF was used?
• Have you had this problem before? If so, do you know what caused the problem at that time? How was it treated?
• What activities make your symptoms better or worse?
• What prescription or nonprescription medicines do you take?
• What home treatment measures have you tried? Did they help?
• What nonprescription medicines have you tried? Did they help?
• Do you have any health risks?

Online Resource

• Allergic Reaction
• Blisters
• Burns
• Cataracts
• Dehydration
• Eye Problems, Noninjury
• Fever Seizures
• Fever, Age 3 and Younger
• Fever, Age 4 and Older
• Heat-Related Illnesses
• Rash, Age 11 and Younger
• Rash, Age 12 and Older
• Respiratory Problems, Age 11 and Younger
• Respiratory Problems, Age 12 and Older
• Shock
• Skin Changes

When to See a Doctor

See significance of vision problems if you need information to help you answer the questions below.

Review health risks that may increase the seriousness of your symptoms.

	Call your health professional immediately if you answer "Yes" to any of the following questions.
Yes	Do you have severe pain in one or both of your eyes after being in the sun?
Yes	Have you had partial or complete vision loss or blurred vision for more than 30 minutes after getting out of the sun?

	Call your health professional today if you answer "Yes" to any of the following questions.
Yes	Do you have moderate pain in your eye, such as a scratchy, gritty sensation?
Yes	Are your eyes sensitive when you look at light (photophobia)?
Yes	Have you had mild pain in your eyes for 24 hours or longer?

If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

When to See a Doctor

See significance of a fever if you need information to help you answer the questions below.

Review health risks that may increase the seriousness of your symptoms.

Note:

If you have symptoms of heat exhaustion, go to the topic Heat-Related Illnesses to evaluate your symptoms. If you need information on how to take a temperature, see the topic Body Temperature.

	Call your health professional immediately if you answer "Yes" to any of the following questions.
Yes	Do you have signs of moderate dehydration?
Yes	Do you have severe pain?
Yes	Do you have a severe headache?
Yes	Do you have severe fatigue?
Yes	Are you nauseated or vomiting and unable to drink any fluids?
Yes	Do you have a severe skin reaction or blisters?

	Call your health professional today if you answer "Yes" to the following question.
Yes	Do you feel dizzy even after getting out of the sun?

	You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to the following question.
Yes	Do you have a fever that has not come down after 24 hours of home treatment?

If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

When to See a Doctor

See significance of dehydration if you need information to help you answer the questions below.

Review health risks that may increase the seriousness of your symptoms.

	Call your health professional immediately if you answer "Yes" to any of the following questions.
Yes	Do you have symptoms of moderate dehydration and you are unable to drink enough to replace lost fluids?
Yes	Does your child have symptoms of moderate dehydration and he or she is unable to drink enough to replace lost fluids?

	Call your health professional today if you answer "Yes" to any of the following questions.
Yes	Do you have symptoms of moderate dehydration but you are able to drink enough to replace lost fluids?
Yes	Does your child have symptoms of moderate dehydration but he or she is able to drink enough to replace lost fluids?

	You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to any of the following questions.
Yes	Have you had symptoms of mild dehydration for 24 hours or longer?
Yes	Has your child had symptoms of mild dehydration for 24 hours or longer?

If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

When to See a Doctor

See significance of a skin infection if you need information to help you answer the questions below.

Review health risks that may increase the seriousness of your symptoms.

	Call your health professional immediately if you answer "Yes" to any of the following questions.
Yes	Do you have diabetes?
Yes	Do you have a disease or take medicine that may cause problems with your immune system?

	Call your health professional today if you answer "Yes" to any of the following questions.
Yes	Do you have increased pain, swelling, redness, or warmth around the sunburned area?
Yes	Do you have red streaks extending from the sunburned area?
Yes	Do you have any blisters draining pus?
Yes	Do you know or think you have a fever?

If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

When to See a Doctor

See significance of pain if you need information to help you answer the questions below.

Review health risks that may increase the seriousness of your symptoms.

Note:

If you are evaluating your young child's pain from a sunburn, see how to evaluate pain in a child age 3 or younger.

	Call your health professional immediately if you answer "Yes" to the following question.
Yes	Do you have severe pain?

	Call your health professional today if you answer "Yes" to any of the following questions.
Yes	Do you have moderate pain?
Yes	Does your child younger than 6 months of age have a sunburn and appear to be in pain?

	You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to the following question.
Yes	Do you still have mild pain after using home treatment for 24 hours?

If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

When to See a Doctor

See significance of medicine if you need information to help you answer the question below.

Review health risks that may increase the seriousness of your symptoms.

Call your health professional today if you answer "Yes" to the following question.

Yes

Are you taking a medicine that may cause you to sunburn easily? Note: If your answer is Yes: Call the doctor who prescribed the medicine before taking your next dose to determine whether you should stop taking the medicine or take a different one. An appointment may not be necessary. If you are taking a medicine that was not prescribed by a doctor (nonprescription), stop taking the medicine. If you feel that you need to continue taking the medicine, call your doctor to discuss it.

If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

When to See a Doctor

See significance of blisters from a sunburn if you need information to help you answer the question below.

Review health risks that may increase the seriousness of your symptoms.

Note:

See the topic Burns if you have skin blisters and think you may have a second-degree burn.

	Call your health professional today if you answer "Yes" to the following question.
Yes	Are you worried about scarring?

If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.