Skin can become blistered following a severe sunburn. This image displays redness and small blisters on the tops of hands and fingers typical of sunburn. This image displays a woman with a mild sunburn on her chest. This image displays a patient with a sunburn. This image displays a sunburn. This image displays a sunburn on a patient who wore shoes but no sunblock.
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Sunburn  Information for adults

Picture of Sunburn: Skin can become blistered following a severe sunburn. Divider line
Skin can become blistered following a severe sunburn.
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Overview
Sunburn is caused by the skin's reaction to ultraviolet light exposure. It appears as reddening and tenderness of the skin and usually occurs between 12 and 24 hours after the exposure. Sunburned skin can develop blisters and shedding of the outer layer of skin. Some oral medications used for other medical conditions, most commonly hydrochlorothiazide (a blood pressure medication), may make the skin more sensitive to sunburning.
Who's At Risk
Sunburn occurs in people of all ages, particularly those with fair skin.
Signs and Symptoms
Sunburn may occur on any sun-exposed area. Sunburn appears as immediate redness within 4 hours following exposure, followed by deep redness and blister formation in severe sunburn. Long-lasting redness may be present for weeks after the actual burn.
Self-Care Guidelines
If you have suffered a sunburn, further direct sun exposure should be avoided for a few days. Cool water or cool milk soaks may help cool and soothe the affected areas. Acetaminophen and ibuprofen can help decrease the redness and pain. Applying a greasy cream or ointment may actually make the pain worse by trapping the heat on the skin. Make sure to drink lots of fluids.

Do not attempt to break any blisters that may form; you can cover these with gauze if necessary. If any break on their own, a topical antibiotic ointment can be applied. A moisturizer can help with skin peeling afterward. Avoid topical products that end in "-caine" as they can sometimes further irritate the skin.

Prevention is very important. To reduce risk of skin cancer later in life, sunburns should be prevented.

  • Avoid direct sun in the middle of the day (10 AM to 3 PM). Remember: snow and water reflect light to the skin, and clouds still let a lot of light through, so you may still be exposed to ultraviolet light even on cloudy days.
  • Use a hat with a wide brim. A baseball hat does not give much protection.
  • Cover up with tightly woven clothing. Some manufacturers make specialty clothing with a high sun protection factor (SPF) rating, or you can purchase a special ingredient to be added to your washer that can "wash" SPF into your clothing.
  • Use sunscreen on all exposed skin areas, including the lips, before going outdoors. A broad spectrum (blocks UVB and UVA light), with an SPF of at least 30, is best. Apply generously 30 minutes before going outdoors, and reapply every 2 hours or after swimming or sweating a lot.
  • Do not use tanning beds!
If you have suffered from a large number of sunburns, you should regularly perform a self-exam to look for signs of skin cancer. It is best to perform the exam in a well-lit area after a shower or bath. Use a full-length mirror with the added assistance of a hand mirror, when necessary. Using a hair dryer can help you examine any areas of skin covered by hair, such as your scalp.

  • In front of a full-length mirror, inspect the front of your body, making sure to look at the front of your neck, chest (including under breasts), legs, and genitals.
  • With your arms raised, inspect both sides of your body, making sure to examine your underarms.
  • With your elbows bent, examine the front and back of your arms as well as your elbows, hands, fingers, areas between your fingers, and fingernails.
  • Inspect the tops and bottoms of your feet, the areas between your toes, and toenails.
  • With your back to the mirror and holding a hand mirror, inspect the back of your body, including the back of your neck, shoulders, legs, and buttocks.
  • Using a hand mirror, examine your scalp and face.
As you perform your monthly self-exam, familiarize yourself with the moles, freckles, and other marks on your body, and look for any changes in them from month to month, including shape, size, color, or other changes, such as bleeding or itching.
When to Seek Medical Care
Usually, sunburn does not require a doctor's care. If you are running a fever, however, see a doctor because that indicates possible heatstroke. Additionally, if you are burned over a large portion of your body and there is severe discomfort and inflammation, seek medical attention. Also seek medical advice if there are signs of infection.
Treatments Your Physician May Prescribe
In addition to medicine (usually non-steroidal anti-inflammatory drugs) for pain relief, for severe burns, a doctor might prescribe prednisone, an oral steroid, to help reduce the inflammation.



References

Bolognia, Jean L., ed. Dermatology, pp.1275, 1277. New York: Mosby, 2003.

Freedberg, Irwin M., ed. Fitzpatrick's Dermatology in General Medicine. 6th ed. pp.1354, 1380. New York: McGraw-Hill, 2003.

Han A, Maibach HI. Management of acute sunburn. Am J Clin Dermatol. 5(1):39-47, 2004.
Last Updated: 22 Dec 2008