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Sunburn: prevention and treatment

by Josephine Andrews
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Sunburn (dermatitis solaris) is an acute inflammation of the skin caused by too much sunlight or UV radiation from other sources. Fair-skinned people are particularly susceptible. A mild sunburn shows up as reddening of the skin, while a severe sunburn causes blisters on the skin and can even leave scars. Repeated sunburn also increases the risk of skin cancer. Read everything you need to know about sunburn here.

ICD codes for this disease:

ICD codes are internationally valid codes for medical diagnoses. They can be found, for example, in doctor’s letters or on certificates of incapacity for work.

L59 L55

Sunburn: description

Sunburn (dermatitis solaris) is an acute inflammation of the superficial layers of the skin, which is accompanied by visible reddening of the skin and even blistering. The cause is an excess of UV radiation (especially UV-B radiation) – regardless of whether it comes from the sun or an artificial radiation source.

Radiation damage primarily affects the epidermis, i.e. the top layer of skin. But inflammation can also occur in the underlying layer, the dermis. Repeated cases of sunburn over several years also cause the skin to age faster and can eventually lead to skin cancer.

Skin types and self-protection time

Different skin types have different susceptibility to sunburn:

Skin type I includes people with very light skin, reddish-blonde hair, blue or green eyes and freckles . Unprotected, they can only stay in the sun for five to ten minutes (self-protection time) before their skin turns red – a sign of sunburn. The skin practically does not tan at all.

Skin type II is characterized by blond to dark blond hair , light skin and blue or green eyes. The self-protection time here is ten to 20 minutes.

Dark-blonde to brown-haired people with darker skin color correspond to skin type III . You can stay unprotected in the sun for 20 to 30 minutes without your skin turning red.

Skin type IV people have dark brown to black hair and tan-toned skin. Their self-protection time is 30 to 40 minutes.

Children: Particularly at risk for sunburn

Children get sunburned particularly easily because their skin is much more sensitive than that of adults. This is especially true for babies and toddlers, because they still have very thin and pigment-poor skin.

In children, the face, arms and legs are most commonly affected by sunburn, as these areas are often exposed to direct sun without protection in summer. Children can also get sunstroke or heat exhaustion more easily.

sun allergy

Sun allergy is to be distinguished from sunburn: Small wheals, itchy spots or blisters form on the skin after exposure to the sun. Acne-like nodules are observed in adolescents.

Sunburn: Symptoms

A sunburn is a burn that occurs, for example, after skin contact with fire. How severe the sunburn is depends on the intensity and duration of sun exposure as well as individual conditions (such as skin type). There are three levels of severity:

Grade 1: Slight sunburn; the affected areas of skin are reddened and overheated, tight and often slightly swollen. The sunburn itches and burns.

Stage 2: Stage 2 sunburn causes blisters to form on the skin. Later the skin begins to peel.

Grade 3: Grade 3 sunburn corresponds to a severe burn. The top layers of skin are destroyed and peeling off. The wounds usually heal with scarring.

In the case of a large second or third degree sunburn, fever and general symptoms can also occur. You must not open the burn blisters yourself, otherwise a bacterial infection may accompany the sunburn.

The skin of the lips is very sensitive to too much UV radiation. Within hours, redness and swelling appear, especially on the lower lip. In addition, sunburned lips can cause blisters, crusts, flaking and burning pain. In general, sunburn on the face is particularly unpleasant.

Sunburn: Duration

Sunburn shows its first symptoms about six to eight hours after exposure to the sun. The symptoms peak after 24 to 36 hours, only to subside after a week or two.

Sunburn: causes and risk factors

Sunlight consists of rays of different wavelengths. Sunburn is caused by ultraviolet (UV) radiation. Depending on the wavelength, it is divided into:

  • UV-A radiation (wavelength: 400 to 315 nm (nanometers)
  • UV-B radiation (315 to 280 nm)
  • UV-C radiation (280 to 100 nm)

The shorter the wavelength, the more energetic and harmful the radiation.

Sunburn is mainly caused by UV-B radiation. It damages cells in the epidermis, whereupon they release inflammatory messengers (inflammatory mediators such as chemokines, prostaglandins). Within a few hours, these trigger an inflammation in the underlying layer of skin (dermis). Sunburn occurs with the typical symptoms such as redness, swelling, itching and pain.

The shorter-wave UV-A radiation can penetrate deeper into the skin and eyes than UV-B radiation. It strengthens the UV-B effect and is also involved in the aging process of the skin.

UV-C radiation is even more dangerous and would cause sunburn even more than UV-B light. However, it is almost completely filtered out in the upper layers of the earth’s atmosphere, so it does not reach the earth’s surface.

Sunburn: influencing factors

Whether you get sunburn and how severe it is depends, among other things, on how long the sun’s rays affect the skin. Skin type also plays an important role: fair-skinned people get sunburned more easily than people with a darker skin tone because they have less pigment in their skin that blocks the sun’s rays.

Certain areas of the body are also more sensitive than others. Parts of the body that are used to the sun, such as arms and hands, are therefore less susceptible to sunburn than parts of the body that normally get less sun (such as soles of the feet, thighs, buttocks, etc.).

Sunburn & Solarium

Tanning in solariums is often considered less harmful to health than sunbathing. However, the artificial UV radiation in solariums has the same acute and long-term effects on the body as the natural UV light of the sun (rapid skin aging, sunburn, increased risk of skin cancer).

Pre-tanning in solariums is often used to prepare the skin for the summer sun. However, many solariums only emit UV-A radiation: You may tan, but the skin’s own UV protection (to prevent sunburn) hardly builds up, because sufficient UV-B radiation is also required for this.

That being said, even tanned skin carries a risk of developing skin cancer.

Sunburn: investigations and diagnosis

Not every sunburn needs to be examined by a doctor. A light sunburn can also be treated independently. However, it is advisable to see a doctor in the following cases of sunburn:

  • redness and severe pain
  • blistering
  • headache
  • nausea and vomiting

If small children or babies get a sunburn, you should definitely go to the pediatrician.

The doctor first records the medical history (anamnesis). For example, he asks about the type and extent of the symptoms, when they occurred and whether and how long the affected areas of skin were exposed to unprotected UV radiation. This is followed by a physical examination, during which the doctor examines the skin areas closely. The diagnosis of sunburn can usually be made on the basis of the anamnesis and the classic symptoms.

Sunburn: Treatment

How sunburn is treated depends largely on its severity.

In the case of a slight sunburn, it is usually sufficient to cool the affected areas of the skin. You can also make a damp/cold compress, for example with cold chamomile or green tea, yoghurt or quark.

You may also apply skin-soothing lotions containing dexpanthenol or calendula , or cooling aloe vera lotions or gels. In the case of children, it is important to ensure that the preparations are suitable for this age group.

If necessary, a doctor can prescribe a corticosteroid (“cortisone”) to reduce inflammation, which is applied locally – for example as a cream or lotion.

In the case of second-degree sunburn, a doctor should definitely be consulted. He can expertly puncture the burn blisters. This allows the liquid to drain out and the blisters to heal faster. You should not open the blisters yourself, because then they can easily become infected.

In addition, if the sunburn is more severe, the doctor can apply a bandage with an antiseptic ointment and fatty gauze. He can also prescribe tablets against the pain and inflammation, for example with the active ingredients ibuprofen or diclofenac.

Third-degree sunburn is usually treated in the hospital because there is a high risk of infection. Often the patient gets infusions with liquid and mineral salts. Medicines are also given, for example antibiotics for bacteria that have penetrated.

Sunburn – that helps against it

You can find more tips and therapy options in the text Sunburn – that helps against it .

Sunburn: course of the disease and prognosis

The prognosis for sunburn depends on the severity of the burns. A light sunburn usually heals within a few days and leaves no permanent damage. In more severe cases of sunburn, it takes longer to heal and scars may remain.

Sunburn & Skin Cancer

Sunburn is often regarded as quite harmless – a fatal misjudgment: Even if the superficial layers of skin regenerate after sunburn, traces of the damage remain in the deeper layers of tissue. And the radiation damage from every sunburn you get throughout your life adds up. Eventually, it can develop into skin cancer, especially if you were badly sunburned as a child.

Other consequences of sunburn

UV rays also cause damage to the skin before a sunburn becomes visible. Regular exposure to the sun makes the skin large-pored and less elastic and promotes the formation of blackheads and wrinkles .

prevent sunburn

The most effective way to prevent sunburn is to avoid being exposed to the blazing sun, if at all, or only for a short time. You should stay in the shade, especially in the midday hours, when the UV radiation is most intense. Long clothing and a sun hat offer some protection against sunburn. The latter is also very important for another reason: too much sun exposure on the head can lead to sunstroke with symptoms such as dizziness, headaches, nausea, vomiting and clouding of consciousness.

If you do sports , you should choose the morning or evening hours in summer when the radiation intensity is lower.

Use a sunscreen with a high SPF to protect your skin from sunburn and other radiation damage. But this only works if you put on a large enough amount at least 30 minutes before you go out in the sun. Repeat the application after sweating profusely and after swimming .

When staying in the water , caution is generally required: At a depth of one meter, 50 percent of the UV-B radiation and 80 percent of the UV-A radiation are still measured compared to the radiation outside of the water. So you can also get a sunburn while swimming and snorkeling (e.g. on the back). You usually notice this too late, because hardly any infrared light hits the skin under water (water absorbs this part of the solar radiation for the most part).

However, the infrared would warm the skin and thus warn of an impending sunburn. So, to protect yourself from sunburn in the water, choose a sunscreen that doesn’t wash off easily. For extra protection against sunburn, wear a t-shirt when diving or snorkeling.

The intensity of UV radiation increases with sea level and with increasing proximity to the equator . Sunburn is more likely to occur in the mountains or on the Mediterranean than in valleys or in Finland.

The reflection of solar radiation should not be underestimated either : surfaces such as water, snow or sand reflect the UV radiation like a mirror, which intensifies it. For example, you can go pedal boating or get sunburned on the ski slopes . 

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