Sunburn:  A Treatment Guide

Ben Adkins, MD

            The best treatment for sunburn is prevention, and the second best is time.  But, if you are unlucky enough to get burned this summer, here are some things you can do to ease your pain.

What to do before the burn:

·Apply at least an ounce of sunscreen (SPF 30); most people use only half as much sunscreen as they need.  Don’t forget the back, the ears, and the hands.  Applying sunscreen can be fun; ask a friend to help.  Reapply every 2-3 hours to all sun-exposed areas. 

            ·Shirts, shade, and clouds reduce the risk, but only by about 50%. 

            ·Swimming doubles the risk- reapply sunscreen when you get out of the water. 

What to do after the burn:

·Cool wet compresses are the simplest treatment, and often the only thing needed.  Witch Hazel can be added to compresses to give additional relief

· Start hydrocortisone cream immediately, and use it 3 times daily for 2 days to reduce the severity of the skin reaction. 

·During the first day or two, add oatmeal or baking soda to bath water to reduce pain and itching. 

·Advil (ibuprofen) may be more helpful than Tylenol (acetaminophen) to reduce the inflammation. 

·Use a simple moisturizing cream (such as Eucerin or Lubriderm) to rehydrate the skin when peeling occurs.

What to avoid:

·Do not use petroleum jelly or similar greasy ointments; they keep heat from escaping.  Butter is not helpful for any type of burn. 

·Avoid using first-aid preparations with local anesthetics (benzocaine and lidocaine).  These do not help much more than cool compresses alone, and can cause allergic skin rashes

What to expect:

Mild burns cause only redness, pain, and itching.  More serious sunburns cause blistering and swelling of the skin.  A burn begins 2-6 hours after exposure, reaches its peak in 12-24 hours, and begins healing after 24 hours.  The pain usually lasts about 2 days.

When to see your doctor:

If you (or your family member) have chills, nausea, vomiting, severe blistering, or confusion, you should visit your doctor.  If you suspect a burn will be severe, visit within the first 24 hours.  Occasionally a severe burn will be treated with oral steroids to decrease the inflammation.

Sources:

Rakel: Conn's Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier

Behrman: Nelson Textbook of Pediatrics, 17th ed., Copyright © 2004 Elsevier

Habif: Clinical Dermatology, 3rd ed., Copyright © 1996 Mosby-Year Book, Inc

Painful personal experience