Sunburn
 Sunburn - Face
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Definition
- Red, painful skin following sun exposure
General Information
- Sunburn may cause a first-degree (redness and pain) or a second-degree (blistering) burn to the sun-exposed areas of the body.
- Long-term sun exposure increases the risk for skin cancer and causes aging of the skin.
Degrees of Sunburn
- First Degree: Most sunburn is a first-degree burn which turns the skin pink or red. The pain and swelling starts at 4 hours, peaks at 24 hours, and improves after 48 hours.
- Second Degree: Prolonged sun exposure can cause blistering and a second-degree burn.
- Third Degree: Sunburn never causes a third-degree burn or scarring.
Causes of Sunburn
- Broken mercury-vapor lamps (overhead lighting): Damaged mercury-vapor (metal halide) lamps are known to cause outbreaks of UV-radiation "sunburns" and photokeratitis (corneal irritation).
- Tanning lamps
- The Sun
Photokeratitis (Sunburn of Cornea)
- Definition: Photokeratitis can be thought of as a sunburn of the cornea. Exposure to intense light can cause corneal irritation (keratitis), especially if a person uses inadequate eye protection.
- Pain: Usually bilateral eye pain; tearing; light bothers eyes.
- Vision Loss: Usually minimal vision change (haziness) to none. More severe photokeratitis can cause blurred vision; all patients with blurred vision require medical evaluation; in skiers this is referred to as "snow blindness".
- Causes: This is most commonly seen in individuals with inadequate eye protection while outside on a bright sunny day (e.g., water sports, snow skiing). It can also occur in individuals who do not use eye protection while using a tanning booth. This can also occur in welders.
When to call your doctor
Call 911 Now (you may need an ambulance) If
- Passed out (fainted)
- Difficult to awaken or acting confused
- Very weak (unable to stand)
Call Your Doctor Now (night or day) If
- You feel weak or very sick
- Severe eye pain or blurred vision that follows sun exposure (welding or other significant light exposure)
- Looks infected (e.g., draining pus, red streaks, increasing tenderness after day 2)
- Extremely painful sunburn, and not improved after taking pain medication
Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If
- You think you need to be seen
- Many small blisters are present
- Blisters are present on face
- Blister larger than 1 inch (2.5 cm)
Call Your Doctor During Weekday Office Hours If
- You have other questions or concerns
Self Care at Home If
- Mild sunburn and you don't think you need to be seen
- Sunscreen and protection from the sun, questions about
HOME CARE ADVICE
- Ibuprofen for Pain: For pain relief, begin taking ibuprofen (e.g., Advil, Motrin) as soon as possible. Adult dosage is 400 mg every 6 hours. If anti-inflammatory agents such as ibuprofen are begun within 6 hours of sun exposure and continued for 2 days, they can greatly reduce your discomfort. If you can't take ibuprofen, use acetaminophen (e.g., Tylenol) instead.
- Do not take ibuprofen if you have stomach problems, kidney disease, are pregnant, or have been told by your doctor to avoid this type of anti-inflammatory drug. Do not take ibuprofen for more than 7 days without consulting your doctor.
- Do not take acetaminophen if you have liver disease.
- Read the package instructions thoroughly on all medications that you take.
- Hydrocortisone Cream: Apply 1% hydrocortisone cream as soon as possible and then three times a day for 2 days. If begun early, it may reduce swelling and pain. If you don't have any hydrocortisone cream, use a moisturizing cream until you can get some.
- Keep the cream in the refrigerator (Reason: it feels better if applied cold).
- Available over-the-counter in U.S. as 0.5% and 1% cream.
- Available over-the-counter in Canada as 0.5% cream.
- Cool Baths: Apply cool compresses to the burned area several times a day to reduce pain and burning. For larger sunburns, give cool baths for 10 minutes (caution: avoid any chill). Add 2 oz. baking soda per tub. Avoid soap on the sunburn.
- Extra Fluids: Drink extra water on the first day to replace the fluids lost into the sunburn and to prevent dehydration and dizziness.
- Broken Blisters:
- For broken blisters, trim off the dead skin with a fine scissors (Reason: these hidden pockets can become a breeding ground for infection).
- Apply antibiotic ointment (e.g., Bacitracin) to the raw skin under broken blisters. Reapply twice daily for 3 days.
- Caution: leave intact blisters alone (Reason: the intact blister protects the skin and allows it to heal).
- Expected Course: Pain usually stops after 2 or 3 days. Skin flaking and peeling usually occur 5-7 days after the sunburn.
- Call Your Doctor If:
- Pain becomes severe and not improved after taking pain medication
- Pain does not improve after 3 days
- Sunburn looks infected
- You become worse
- Photokeratitis (sunburn of cornea):
- Definition: Photokeratitis can be thought of as a sunburn of the cornea. Exposure to intense light can cause corneal irritation (keratitis), especially if a person uses inadequate eye protection.
- Causes: This is most commonly seen in individuals with inadequate eye protection while outside on a bright sunny day (e.g., water sports, snow skiing). It can also occur in individuals who do not use eye protection while using a tanning booth. This can also occur in welders.
- Eye Treatment:
- Apply cool wet compresses to the eyes.
- Try to rest with your eyes closed.
- Do not wear contacts until your eyes are completely better.
- Avoid rubbing your eyes.
- Expected Course:
- Symptoms should disappear completely over the next 24 hours. There should be no permanent damage to the cornea.
- You can prevent future eye symptoms from sun exposure by wearing sunglasses.
- Call Your Doctor If:
- Severe pain occurs
- Pain lasts more than 24 hours
- Pus or yellow/green discharge occurs
- Blurred vision occurs
- You become worse.
- Prevention - Reduce Sun Exposure:
- Try to avoid all sun exposure between 10 am and 3 pm.
- You can get a sunburn while swimming. Water only blocks the ultraviolet radiation a little.
- Prevention - Clothing:
- Wear a wide-brim hat; it protects your face and neck from the sun.
- Wear shirts with long sleeves when outdoors and pants that go down to at least your knees.
- Prevention - Use Sunscreen:
- Apply sunscreen to areas that can't be protected by clothing. Generally, an adult needs about 1 oz of sunscreen lotion to cover the entire body.
- You should reapply the sunscreen every 2-4 hours. You should also reapply after swimming, exercising, or sweating.
- A sunscreen with a rating of SPF 15 to 30 should be used. Sunscreens with ratings higher than 30 provide minimal additional protection.
- Sunscreens help prevent sunburn, but do not completely prevent skin damage. Thus, sun exposure can still increase your risk of skin aging and skin cancer.
- Vitamins C and E: Vitamins C and E have anti-oxidant properties, which means they help prevent sun damage to cells in your skin. Taking vitamins C and E by mouth may partially reduce the sunburn reaction.
- The adult dosage of vitamin C (ascorbic acid): 2 grams by mouth once a day.
- Adult dosage of vitamin E (d-alpha-tocopherol): 1000 IU by mouth once a day.
- Caution: Prevention is the key. Remember to reduce sun exposure and use sunscreens.
- Read the package instructions thoroughly on all medications that you take.
Author: David A. Thompson, M.D.
Last reviewed: 9/15/2011
Last revised: 8/1/2010 3:42:21 PM
