Sunburn is still a major health issue that can be prevented.
Every day, the sun pounds the earth with radiation. Thankfully, we have some protection from the ultraviolet (UV) radiation that penetrates Earth’s atmosphere. Sunburn is still a major health issue that can be prevented.
WHAT IS A SUNBURN?
There are 3 types of UV radiation, and each one affects the body differently. UV-C is the most damaging, but it is filtered by the earth’s atmosphere and doesn’t reach us. UV-A accounts for about 95% of the UV radiation reaching the earth’s surface and is what leads to immediate tanning but also signs of aging skin such as spots, wrinkles, and sagging. UV-B, on the other hand, leads to delayed tanning, burning, and some aging and promotes the development of skin cancer.1 When these UV rays, particularly UV-B, hit our skin, they can cause a sunburn,1which is our body’s inflammatory response to UV radiation. This response can range from mild to intense redness, pain, blistering, and peeling. The redness is usually first noticed 3 to 5 hours after sunlight exposure, peaks at 12 to 24 hours, and usually subsides after about 72 hours.2
WHO IS AT GREATER RISK OF GETTING A SUNBURN?
HOW CAN PEOPLE MINIMIZE THEIR RISK OF BURNING?
Time of day:Avoid excessive sun exposure between 10 a.m. and 4 p.m.7Outdoor activities, especially during summer months, should be planned before or after these times as often as possible.
Sunscreen:Wear it every day. UV radiation can penetrate clouds and damage skin. SPF 15 blocks 93% of UV-B radiation, and SPF 30 blocks about 97%.8Apply sunscreen to all sun-exposed areas, such as the face, ears, nose, hands, toes, etc, 30 minutes before exposure, and reapply it every 1.5 hours to 2 hours,7even on cloudy days and after swimming or excessive sweating/moisture.
Recognize broad-spectrum ingredients:These include zinc oxide, avobenzone, titanium dioxide, salicylates, sulisobenzone, ecamsule, cinnamates, benzophenones, oxybenzone, merxoryl SX, and Parsol 1789.7
Clothes:Wear long pants and long-sleeved shirts made of tightly woven fabric. Wear sunglasses that provide 100% UV protection. Wear a wide-brimmed hat, and for maximum protection, consider clothing with a high ultraviolet protection factor.7
Medications:Both topical and oral medications can increase your skin’s susceptibility to burning.7Protect skin from the sun if you are using topical skin care products that contain alpha hydroxy acids.7These include glycolic, malic, tartaric, citric, and mandelic.
WHAT IS THE BEST WAY TO TREAT A SUNBURN?
For a mild to moderate sunburn, the goal is to control skin inflammation and pain. Use cool compresses and soaks, calamine lotion, or aloe vera—based gels.2Gentle emollients, such as liquid paraffin/white soft paraffin 50/50, can be used on intact skin.2Do not poke, pop, or attempt to rupture blister; keep them protected. Absolutely do not attempt to peel skin. Peeling and popping can lead to infection, bleeding, and scarring.
HOW LONG DOES A SUNBURN USUALLY LAST?
The redness usually goes away within 3 to 7 days, but blisters may not heal for 7 to 10 days.2
WHEN SHOULD PROFESSIONAL MEDICAL ATTENTION BE SOUGHT?
If a sunburn is not improving within a few days or if the pain and tenderness is increasing, swelling is forming, or signs of infection begin are forming, seek medical attention.2Signs of infection include an increase in pain, tenderness, swelling, fever, yellow or white drainage from a blister, and streaks leading away from cuts or blisters. Seek medical attention for severe symptoms such as nausea, vomiting, chills, fever, intense pain, confusion, weakness, fatigue, blistering, or burning over a large portion of the body.2
COMMON SUNSCREEN MYTHS
Wearing sunscreen leads to vitamin D deficiency:First, people need only about 10 to 15 minutes of sun exposure 2 to 3 times per week to produce needed vitamin D. Excessive sun exposure without wearing sun protection will not proportionally increase vitamin D absorption. If that were the case, people who get significant sun exposure would reach toxic levels of vitamin D9. There isn’t sufficient evidence to show that wearing sunscreen leads to vitamin D deficiency, but there is a plenty of research demonstrating the negative effects of excessive sun exposure, such as skin cancer and premature aging.9Bottom line: people should get vitamin D through a well-balanced, nutritious diet, and they should wear sunscreen outdoors.
Getting a base tan will protect me:A tan indicates that DNA damage has occurred, and that can lead to cancer. There is no such thing as a safe tan, and getting a base tan may provide protection equivalent to an SPF of only about 1.5 to 3.10Remember, the minimum effective SPF is 15.
Those who tan easily or who have darker skin do not need sun protection:Just as a base tan does not offer protection from the sun, having naturally darker skin does not give you permission not to use sunscreen. People with darker skin or who tan easily are still susceptible to skin cancer and premature aging. Latinos and those of Chinese and Japanese heritage tend to develop basal cell carcinoma, and African Americans and those of Indian heritage tend to develop squamous cell carcinoma.11When the skin is exposed to UV radiation, it produces a pigment called melanin in response to the damage. This is what creates a tan, but it does not provide sufficient protection from damage.
Sara Marlow, MSN, RN, PHN, FNP-C
, is a licensed and board-certified family nurse practitioner, public health nurse, and adjunct assistant professor of health policy. She was the spring 2015 health policy fellow at the American Association of Nurse Practitioners’ government affairs office in Washington, DC, and is the co-chair of the Health Policy and Practice Committee of the California Association for Nurse Practitioners.