Ultraviolet B radiation from the sun damages and kills healthy cells, stimulating a local inflammatory response. The resulting vasodilation and increased vascular permeability are responsible for the familiar pain, redness, heat and swelling associated with sunburn.
- Altitude and reflection from water or snow increase UVB exposure and the potential for sunburn.
- Redness, pain and swelling develop within 3-4 hours and peak in 12-24 hours.
- Blistering is possible.
- Fever, chills, malaise, nausea, and vomiting are possible in severe cases.
- Most signs and symptoms resolve within 4-7 days, usually with skin scaling and peeling.
- Replace water and electrolytes to prevent/treat dehydration.
- Monitor urine color and output, and adjust water and electrolyte intake as necessary. You are giving enough fluid if the patient’s urine color and output are normal. You MUST replace electrolytes with the fluid to avoid treatment-induced hyponatremia.
- Treat 1st degree burns with topical aloe vera.
- NSAIDs for pain: aspirin, ibuprofen, naproxen sodium or acetaminophen.
- Flush 2nd degree burns with clean water. Open large closed blisters and remove dead skin prior to cleansing. Pat or air dry. Keep moist. Use white/light petroleum jelly, silver sulfadiazine (Rx), Second Skin™, or cover with a micro-thin dressing. Re-clean twice a day. Leave micro-thin dressings in place unless an infection develops; lance the dressing if leaking fluid creates a “blister” under it. Caution: In rare cases, silver sulfadiazine may cause an allergic reaction.
- NOTE: Sunburn predisposes people to dehydration, all heat illnesses, hypothermia and altitude sickness.
- Seek shade during the peak exposure hours.
- Clothing offers safer and more effective sun protection than sun screen. Dark clothing provides more than light, dry more than wet, and a tighter weave gives more protection than a loose weave. Light colored sun-block clothing is commercially available and works extremely well.
- Use waterproof sunscreens with SPF 30 as adjunct protection to augment clothing; it will state on the label 40 or 80 minutes of protection while swimming or sweating. Most sun screens do NOT offer significant protections against UVA; look for sunscreens labeled "broad spectrum" to ensure UVA protection. Opaque zinc oxide offers the most complete and safest skin protection with titanium dioxide coming in a close second.
- Apply on cool, dry skin 30-40 minutes before sun exposure. Use enough to provide for adequate coverage (usually a minimum of 1 oz. per total body application).
- Protective eye wear is mandatory in mountain, river, ocean and desert environments where sunlight and glare are unavoidable. All types—including prescription glasses, contact lenses and intraocular lens implants—should absorb the entire UVR spectrum (280-400 nm).
- Consider goggles, wraparound glasses or glasses with side protection.
- A wide-brimmed hat blocks about 50% of UVR and significantly reduce the amount of light entering above or around glasses.
- Polarization or photosensitive darkening are additional sunglass features that are useful under specific circumstances, but do not, by themselves, provide UVR protection.