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Introduction Sunburn is the damaging effect on the skin of the ultraviolet (UV) light contained in sunlight. With too much exposure to UV light, your skin overheats and becomes red and painful, and may later peel or blister. Ultraviolet light causes changes in the surface and in the deeper layers of the skin. It reduces the stretchiness of the skin and can cause premature aging and wrinkling of the skin, as well as the formation of age spots. Deeper in the skin, it causes changes in the structure of cells, and increases the risk of skin cancers. When your skin is exposed to sunlight, it produces a pigment called melanin to help protect itself against ultraviolet light. This is what makes your skin go darker and is what you see as a suntan. It stops you burning so easily but doesnt prevent the other harmful effects of UV such as premature aging and cancer. The less melanin you have, the less protected you are against the effects of UV light. If you have fair skin or red hair, or have not been in the sun much, you have less melanin so are more likely to burn quickly. Sunburn doesnt just happen in hot weather reflection of light off the snow can also cause sunburn. Although a breeze, cloudy sky or swimming may make you feel cooler, the sunlight can still get through to damage your skin.
Symptoms Sunburnt skin is red and sore. It is warm to the touch, even after attempts to cool it with water or by moving into the shade. After a few days, the redness may fade into a tan, or in very fair people with little melanin pigment in the skin, it may just return to white. The skin may also flake or peel after a number of days. Dark skin can also burn and become damaged if exposed to enough UV light, although because it contains more pigment it can tolerate sunlight without burning for longer than paler skin. Severe sunburn can cause blistering, swelling of the skin and fever. At the same time there may also be symptoms of heatstroke, such as dizziness, headaches, and nausea. The symptoms of sunburn are not usually immediately obvious, and the worst pain occurs 6-48 hours after being in the sun.
Treatment If a baby or small child has been sunburnt, or if blisters, a rash, or fever occur, seek medical advice from your GP, NHS Walk-in centre, or by phoning NHS Direct on 0845 4647. Avoid direct sunlight by covering up and staying in the shade, until the sunburn has healed. Cool the skin by sponging it with tepid (lukewarm) water or having a cool shower or bath. Drink plenty of fluids to replace the water lost through sweating in the sun, and to cool down. Dont drink alcohol because it will dehydrate you further. For mild sunburn, apply a moisturising lotion or a special aftersun cream from a pharmacy. Aftersun helps to cool the skin as well as moisturising and relieving the feeling of tightness. Calamine lotion can also be used to relieve itching and soreness. For adults, painkillers such as paracetamol or ibuprofen can help relieve pain and reduce swelling. Rather than tablets you can alternatively use a pain-relieving gel, or mild 1% hydrocortisone cream as long as the skin is not broken or blistered. Severe burns may require special burn cream and burn dressings. Ask your pharmacist for advice; you may need to see your GP and have your burns dressed by a practice nurse. In very severe cases you may need treatment at your local Accident and Emergency Department. Complications Severe blistering from sunburn can cause infection, as bacteria can enter breaks in the skin. People who are very sensitive to light (photosensitive) can be very quick to burn in only small amounts of sunlight. This can make it very hard to carry out every day life. I
ntensive exposure of the eyes to sunlight can cause sensitivity, also known as photokeratitis or snow blindness. This can be avoided by wearing sunglasses or goggles with UV filters. People who have exposed themselves to a lot of UV light are also at higher risk of developing skin cancers. Prevention Avoid strong sunlight whenever possible, and cover up with loose clothing and a hat. Thickly apply sunscreen with a SPF (sun protection factor) of at least 15 before going out in the sun. Babies under 12 months should be kept in the shade and covered up with a high factor sun lotion or sunblock. Encourage young children to play in the shade, and make sure they wear sunhats and a high SPF lotion. Choose a lotion that blocks both UVA and UVB rays, for maximum protection. When buying sunglasses, look for a style with UV filters. Sun lotions should be applied half an hour before going into the sun, so that they sink into the skin. Make sure you use a generous amount research shows many people dont use enough cream to give proper protection and pay particular attention to skin near the edges of clothing such as straps and necklines, which are easily missed. Reapply sun lotion regularly. Remember that it can rub off on towels or sand, or from going in the water. Even water repellent lotion should be reapplied because you can rub it off when you towel dry yourself after swimming. Its a good idea to use a stick application with higher SPF or even total sunblock for exposed areas such as your nose, ears and lips, which tend to get burnt. Stay out of the sun during the hottest part of the day, between 11am and 2pm, and use weather reports to get an idea of the sun index or UV index, which can tell you how strong the sunlight will be. When buying sun lotion abroad, ask the pharmacist for advice on how effective a particular product is. American SPF numbers are different from European numbers; American SPF 8 is equal to European 4, so the same number is only half as effective.
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