Sunburn

The symptoms of sunburn usually start developing within a few hours after exposure and may vary in severity. The full impact of a sunburn may take up to 24 hours or more to become apparent.

Common symptoms of sunburn:

• Skin color changes, ranging from pink to red and even purple
• Redness
• Warmth
• Tenderness
• Pain and/or itching
• Swelling
• Peeling and flaking
• Blistering

Symptoms of severe sunburn:

• Nausea
• Fevers
• Chills

Sunburn occurs when the skin is exposed to an excessive amount of UV rays (in the form of UV-A and UV-B rays) emitted by the sun, leading to a radiation burn. This exposure triggers the production of melanin in the outer layer of the skin, causing the skin to tan as a protective response against harmful UV radiation.

UV radiation is classified into three categories based on its wavelength, each having distinct effects on the skin:

• UV-A rays: These rays can break down collagen in the skin and damage the cells responsible for generating new skin cells. They contribute to roughness, dryness, blotchiness, wrinkles, and sagging. Additionally, high doses of UV-A radiation can lead to sunburn, harm the genes within skin cells, and increase the risk of developing skin cancer.
• UV-B rays: This type of radiation is even more hazardous than UV-A. It causes tanning, burning, premature aging, and significant damage to the skin, thereby greatly increasing the likelihood of developing skin cancer.
• UV-C rays: Fortunately, the Earth's atmosphere absorbs nearly all UV-C radiation, which is the most dangerous type, before it reaches the ground.

The primary factors that contribute to the risk of sunburn include the duration of skin exposure to UV rays and the level of intensity.

Here are some other common risk factors:

• Skin tone: Individuals with light skin are more prone to sunburn compared to those with deeper skin tones. Lighter skin has less melanin, which provides some natural protection against UV radiation. Having blue or green eyes and blond or red hair also increases susceptibility to sunburn.
• Outdoor activities: Engaging in outdoor activities for prolonged periods, especially between 10 am and 4 pm when the sun's rays are at their strongest, without sun protection increases the risk of sunburn. This includes activities like sunbathing, working outside, socializing, vacationing, transportation, hiking, swimming, and sports.
• Environmental factors: Factors such as ozone depletion, high altitude, and clear skies with decreased cloud coverage can intensify UV radiation, thereby increasing the risk of sunburn.
• Certain medications: Medications such as some antibiotics, diuretics, acne medications, and exfoliating agents can heighten skin sensitivity to the sun, making individuals more prone to sunburn. It is essential to be aware of any potential side effects and consult a doctor for guidance.
• Sunscreen effectiveness: If enough sunscreen is not applied regularly, it may not provide adequate protection from UV radiation, increasing the risk of sunburn.

Are you making these common sunscreen mistakes?

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Minor cases of sunburn typically do not necessitate a visit to the doctor. Nevertheless, if the sunburn is severe and accompanied by other symptoms, it is crucial to promptly seek medical assistance.

Your doctor will:

• Assess the affected area
• Inquire about your symptoms
• Review your medications
• Discuss your exposure to UV rays
• Consider your past experiences with sunburn

In certain situations, they may advise you to consult a specialist in skin disorders or a dermatologist for comprehensive recovery.

To prevent sunburn, you can take the following preventive measures:

1. Use sunscreens generously and regularly

Using the right sunscreen product is your first step in lowering the chances of sunburn. The information regarding sunscreens with various scientific terms can be overwhelming. The following points can help you decipher these terms as well as help you choose the right sunscreen.

A. Types of sunscreen

1. Chemical (organic) sunscreens: These sunscreens contain ingredients that absorb UV radiation and convert it to a very low level of heat.

UV-A filters:

• Benzophenones (UVB and UVA2 absorbers) - Oxybenzone, Sulisobenzone, Dioxybenzone
• Avobenzone or Parsol 1789 (UVA1 absorber)
• Meradimate (UVA2 absorber)

UV-B filters:

• PABA derivatives – Padimate O
• Cinnamates – Octinoxate, Cinoxate
• Salicylates – Octisalate, Homosalate, Trolamine salicylate
• Octocrylene
• Ensulizole

Newer generation broad spectrum (UVA + UVB) filters:

• Ecamsule (Mexoryl SX)
• Sila Triazole (Mexoryl XL)
• Bemotrizinol (Tinosorb S)
• Bisoctrizole (Tinosorb M)

2. Physical (inorganic) sunscreens: These sunscreens function by reflecting, scattering, or absorbing UV radiation. Their opaque nature gives a “whitening effect,” which is an inherent disadvantage. However, this demerit can be minimized by the use of microfine particles. Examples include:

• Zinc oxide
• Titanium oxide
• Iron oxide
• Calamine
• Talc
• Kaolin

B. Sun protection factor (SPF)

Sunscreens are assigned a sun protection factor (SPF), which is a number that rates how well they filter out UV-B rays. Higher numbers indicate more protection. A broad-spectrum sunscreen that blocks both UV-A and UV-B rays should be used with an SPF of 30 or more.

C. Protection factor (PA+)

PA stands for the protection grade of UV-A. It measures the ability of sunscreen to block UVA rays. This is an important distinction because SPF (sun protection factor) measures only UVB protection, while the PA rating measures only UVA protection.

This is what each PA rating means:

• PA+ = Some UVA protection.
• PA++ = Moderate UVA protection.
• PA+++ = High UVA protection.
• PA++++ = Extremely high UVA protection.

Different skin types need different sunscreens. How to find the right sunscreen that suits your skin type?

Tips to choose wisely:

• How much to use: An FTU or Fingertip Unit is used to measure the amount of cream that covers the end of the finger to the first crease of a finger. For the face and neck, use 2.5 FTU. To cover the other exposed parts of the body, you need an ounce of sunscreen, which is sufficient to fill a shot glass.
• When to apply: Always apply sunscreen around half an hour before going out because it takes at least 30 minutes for the chemicals in sunscreen to get absorbed and start working.
• When to reapply: If you are going out, playing sports, or exercising outdoors, it is advised to reapply the sunscreen every 2 hours. The same rule applies when you go swimming.
• How to store: It is recommended to store sunscreen in a cool, dry place, away from sunlight. Also, remember to close it properly after every use.
• When to discard: Do not use sunscreen that has passed its expiry date or if there are any visible changes in the sunscreen such as a change in color, smell, or consistency. It is advised to buy a new one every year.

Still looking for the right sunscreen? Watch our doctor discuss how to choose the best sunscreen for yourself.

2. Seek shade

Minimize your exposure to direct sunlight, particularly between 10 a.m. and 4 p.m., as these are the hours when the sun's rays are most powerful. Follow the shadow rule as a guide: if your shadow is shorter than your height, it indicates that the sun's rays are at their strongest, and you should seek shelter in the shade under an umbrella, tree, or any available form of protection.

3. Wear protective clothing

The following measures should be kept in mind while wearing clothes for the best sun protection:

• Wear lightweight clothing
• Use wide-brimmed hats
• Wear long-sleeved shirts and long pants
• Use clothes made from tightly woven fabric
• Use thoroughly dry clothes
• Prefer darker-colored clothes. They prevent more rays overall from reaching your skin. Within the same color, more saturated hues outperform paler ones.

To assess sun protection provided by clothing, the ultraviolet protection factor (UPF) is used, similar to the SPF rating for sunscreens. UPF measures a fabric's ability to filter both UVA and UVB rays. For good sun protection, seek clothing with a UPF rating above 15.

Interesting hat facts!

What level of sun protection do hats offer? It's worth noting that the level of protection provided by hats depends on the width of their brims.

• A brim width exceeding 7.5 cm provides an SPF of 7 for the nose, 5 for the neck, 3 for the cheeks, and 2 for the chin.
• A brim width ranging from 2.5 to 7.5 cm offers an SPF of 3 for the nose, 2 for the neck and cheeks, and 0 for the chin.
• A brim width less than 2.5 cm provides an SPF of 1.5 for the nose, with minimal protection for the chin and neck.

4. Wear sunglasses

Sunglasses not only protect the eyes but also the soft skin around the eyes. They should be used while moving out under the sun.

5. Be cautious of reflective surfaces

The presence of water, sand, snow, and similar reflective surfaces can amplify the impact of UV radiation. Such surfaces can reflect the harmful rays emitted by the sun, thus elevating the risk of sunburns.

6. Be mindful of the UV index

Check the UV index for your location before heading outside. The UV index provides information on the intensity of UV radiation and can help you plan outdoor activities accordingly. When the UV index is above 8, avoid stepping out. If the UV index is between 3 and 7, follow all sun protection steps before stepping out.

7. Avoid tanning beds and lamps

A tanning bed is a device that emits ultraviolet radiation to give people a tan. These beds produce stronger UV rays than sunlight. Steer clear of tanning beds, which can increase skin cancer risk and accelerate wrinkling. If you desire a tan appearance, consider using a self-tanning product in conjunction with sunscreen.

8. Stay hydrated

Drink plenty of water to stay hydrated, especially when spending time outdoors in the sun. Sunburn can dehydrate your body and increase the risk of heat-related illnesses.

9. Be mindful of certain medications

Certain medications such as specific types of antibiotics, anti-inflammatories, antifungals, blood pressure medications, chemotherapies, acne treatments, and some herbal remedies can increase your skin's sensitivity to sunlight. Check with your doctor or read the medication labels for any warnings about sun exposure.

Prevention of sunburn in children

The best way to prevent sunburn in children over 6 months of age is to follow these A, B, C’s of sun safety rules:

• Avoid: Avoid being in direct sunlight during the peak hours of the day when the sun is the strongest and can harm the skin the most.
• Block: Ensure the safeguarding of the skin by using sunscreen that has a sun protection factor (SPF) of 30 or above. Apply it half an hour prior to stepping outside and consistently reapply it throughout the day. Note: Keep in mind that sunscreen should not be used on infants younger than 6 months.
• Cover up: Keep your kids safe by wearing protective clothing like long-sleeved shirts and wide-brimmed hats when you're out in the sun. Choose clothes with a tight weave to block out as much sunlight as possible. Also, make sure to keep babies under 6 months old away from direct sunlight at all times.

Although sunburn is often a temporary condition, it is important to take appropriate measures to alleviate the symptoms and promote healing. Here are some steps you can take to treat sunburn:

1. Cooling relief: To ease minor sunburn, cooling baths and the gentle application of cool wet cloths on the burned area are the first line of action. Here are some tips for soothing sunburn:
   • Use cold, wet compresses on the affected area. Avoid direct ice application as it can harm the skin.
   • Take a cool bath or a very gentle shower. Set the water to a cool temperature that is just below lukewarm (not extremely cold).
   • If blisters are forming, opt for a bath instead of a shower to prevent popping them.
   • Avoid using soap, bath oils, or detergents while bathing.
   • After bathing, let your skin air dry or pat it gently with a towel. Avoid rubbing.
   • Repeat the cool baths/showers as needed for relief.
2. Moisturize skin while it is damp: Use a gentle, fragrance-free moisturizer or aloe vera gel to soothe the sunburned skin. Avoid using heavy creams or oil-based products, as they can trap heat and irritate the skin further.
3. Topical applications for relief: Apply a suitable anti-inflammatory paste like aloe vera or low-dose (0.5%-1%) hydrocortisone cream to soothe irritated and sunburned skin, reduce the burning sensation and swelling, and speed up healing. Tips for application:
   • You can use gels or lotions that contain aloe vera, or you can cut a chunk off the aloe vera plant itself.
   • Using the pads of your fingers, gently apply aloe to the sunburned area. Do not "rub it in."
   • Leave it a bit gooey and moist on top of the burn, as this helps prevent drying out of skin and becoming more irritated.
   • Reapply as often as required.
   Note: Do not use hydrocortisone cream on young children. Ask your healthcare provider for advice if you have any doubts or concerns about using this cream.
4. Take over-the-counter pain relievers: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen sodium can help reduce pain, swelling, and inflammation associated with sunburn.
5. Blister management: If blisters develop, avoid popping them unless necessary. They act as a natural barrier against infection and help the skin heal. If a blister does break on its own, clean the area gently and apply an antibiotic ointment to prevent infection. Here are some guidelines to follow when dealing with blisters:
   • Apply aloe vera or low-dose (0.5%-1%) hydrocortisone ointment on blisters.
   • Cover blisters with a loosely-wrapped gauze bandage.
   • Change the bandage daily or when it gets wet or dirty.
   • Wear loose cotton clothing over blisters.
   • Wash your hands with soap and water before touching blisters.
6. Replenish fluids: Sunburn can cause dehydration, so drink plenty of water. Aim for at least 8 glasses (8 ounces/236ml each) per day, or even more.
7. Protect sunburned skin: Protect the sunburned area from further sun exposure until it has fully healed. Further exposure to UV rays will only worsen the condition. If you need to go outside, wear loose-fitting clothing that covers the affected area, use a wide-brimmed hat, and apply a broad-spectrum sunscreen with a high SPF to other exposed areas.

For mild sunburns, the following herbal remedies can help soothe the skin. However, it is always advisable to take consent from your healthcare provider before initiating any of these home remedies:

• Aloe vera: Apply pure aloe vera gel to the sunburned area. Aloe vera possesses hydrating and anti-inflammatory qualities, making it effective in soothing and healing the skin.
• Moisturizers: Apply a gentle, fragrance-free moisturizer or lotion to keep the skin hydrated. Opt for products that contain beneficial components such as aloe vera, chamomile, or cucumber.
• Cold milk compress: Soak a cloth in cold milk and gently apply it to the sunburned skin. The proteins in milk can help soothe the burn.
• Essential oils: Essential oils such as peppermint, lavender, chamomile, and tea tree oil can reduce inflammation and cool your skin. Mix a few drops of essential oil with a carrier oil, such as coconut oil, and gently apply it to the sunburned skin.
• Oatmeal: Oatmeal can help alleviate itching and inflammation associated with sunburn. Grind oats into a fine powder and mix it with cool water to create a paste. Apply the paste to the affected areas for 15-20 minutes and then rinse off with cool water.
• Witch Hazel: Witch hazel has a cooling effect and can help reduce inflammation. Apply pure witch hazel extract to a cotton ball and gently dab it on the sunburned skin.
• Baking Soda: Baking soda has antibacterial properties that prevent infections and also help to smoothen the burnt area. Mix half a spoon of baking soda with water. Using a soft cloth, dip it in the solution and gently rub it over the affected areas. Rinse off after a couple of minutes.
• Gram Flour (Besan): Gram flour or besan can soothe the sunburned skin. You can prepare a thick paste of gram flour and water or rose water. Apply the paste on the affected area or rashes and keep it on for 10-15 minutes. Wash away with cold water.
• Raw Potato: A raw potato is a rich source of starchy compounds and helps to reduce the burning sensation of sunburn. Slice a raw potato and place it on the affected area. Leave the potato slice on for 15 minutes and then rinse the face with cold water.
• Papaya: Papaya is a rich source of antioxidants and enzymes that have healing abilities and help to treat sunburns and rashes. Slice the papaya and mash it. Apply the paste on the affected area for a few minutes and let it dry. Wash it with cold water.
• Coconut Oil: Renowned for its moisturizing qualities, coconut oil can be applied to sunburned areas for skin soothing and relief. Opt for organic and unrefined coconut oil for best results.

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Sunburn can lead to several complications, especially if it is severe. Here are some of the potential complications of sunburn:

• Sun stroke: Severe sunburn can cause a condition called sun poisoning or sunstroke. Symptoms may include fever, chills, nausea, vomiting, headache, dizziness, and dehydration. Sun poisoning requires medical attention.
• Infections: When the skin is damaged due to sunburn, it becomes more susceptible to bacterial or fungal infections. Scratching the affected area or popping blisters can also introduce bacteria and increase the risk of infection.
• Premature skin ageing: Repeated sunburns can cause long-term damage to the skin, including premature aging, wrinkles, dark spots, and a rough or leathery texture. Even tanning without experiencing a sunburn can result in skin damage and premature aging.
• Skin cancer: Sunburn damages the DNA in skin cells, which can increase the risk of skin cancer, including both melanoma and non-melanoma types. Melanoma is the most dangerous form of skin cancer and can be life-threatening if not detected and treated early.
• Eye complications: Prolonged exposure to the sun's ultraviolet (UV) rays can lead to various eye problems such as:
  • Photokeratitis: Commonly known as snow blindness, this is a temporary condition characterized by the inflammation of the cornea due to intense exposure to UV rays.
  • Cataracts: A condition where the lens of the eye becomes cloudy, which can also be caused or exacerbated by UV exposure.

The scorching sun can cause sunburns and its associated complications. Right sun protection is key!

Tips to protect your skin this summer!

Living with sunburn can significantly impact one's quality of life in several ways, such as:

• Physical discomfort: Sunburns can make daily activities difficult due to pain, itching, and inflammation, affecting tasks like dressing, bathing, and sleeping.
• Limited mobility: Severe sunburns can restrict mobility and hinder daily activities, exercise, and work.
• Impact on appearance and emotional and psychological effects: Sunburns can negatively affect appearance, leading to self-consciousness, lower self-esteem, and reduced confidence, which impacts social interactions and overall well-being.
• Sleep disturbances: Sunburns can disrupt sleep, leading to fatigue, irritability, and poor concentration.
• Increased sensitivity: Sunburned skin becomes more sensitive to touch, heat, and clothing, which can limit daily activities and social interactions.

To mitigate the impact on quality of life, it is crucial to practice proper sun protection measures, including using sunscreen, wearing protective clothing, seeking shade, and avoiding excessive sun exposure.

Additionally, managing pain and discomfort with appropriate over-the-counter remedies, staying hydrated, and applying soothing creams or aloe vera can help alleviate some of the symptoms. Seeking medical attention for severe sunburns or complications is also advisable.

Burns cause pain and anxiety, even during recovery. Complementary therapies that may help alleviate such pain and anxiety include:

1. Massage Therapy: Involves the manipulation of soft tissues in the body, such as muscles and skin, using various techniques. When applied to burn patients, it can help improve blood circulation, reduce muscle tension, and promote relaxation, leading to pain relief and decreased anxiety levels.
2. Hypnosis: A state of focused attention and increased suggestibility that allows individuals to access their subconscious mind. In the context of burn pain, hypnosis can help manage pain perception by redirecting attention, promoting relaxation, and reducing anxiety and distress. It can also assist individuals in developing coping mechanisms and enhancing their overall well-being.
3. Therapeutic Touch: A gentle touch therapy promoting relaxation and a sense of calm. This therapy aims to rebalance and harmonize the body's energy, which can help reduce pain and promote relaxation and healing. It may also enhance the overall sense of well-being and emotional stability in burn patients.
4. Transcutaneous Electrical Nerve Stimulation (TENS): A non-invasive treatment that involves controlled, low-voltage electrical stimulation of the skin to relieve pain at specific points on the body. By stimulating these points, it can help release endorphins (natural pain-relieving chemicals), improve blood circulation, and modulate the nervous system, resulting in pain relief and a reduction in inflammation and swelling associated with burns.