Sunburn

Synonyms in a broader sense

A sunburn is a burn of the skin caused by artificial or solar (from the sun) UV radiation. The sunburn manifests itself by redness and swelling of the affected skin. In extreme cases, sunburn can also lead to blistering.

The face, especially the nose, ears, shoulders and décolleté are particularly at risk, as these so-called sun terraces receive a lot of UV radiation due to their location. The damage to the skin caused by UV radiation includes not only damage to the skin cells and the connective and supporting tissue but also genetic damage to the affected skin areas, which can only be partially repaired by the body. Frequent sunburn therefore increases the risk of developing skin cancer many times over.

Skin aging is also accelerated, which leads to earlier and increased wrinkling and age spots. According to U.S. studies, more than a third of the population there suffers from sunburn at least once a year. The steady increase in skin cancers caused by sunburn can be traced back to frequent and unprotected sunbathing in nature and in solariums, and will continue to increase in the years to come.

Currently, about 200,000 new cases of skin cancer are diagnosed in Germany every year, including about 150,000 new cases of the so-called basal cell carcinoma as a result of sunburn (a form of “white skin cancer“), which is largely caused by light damage to the skin. Malignant melanoma with about 15,000 cases per year, colloquially called “black skin cancer“, is also caused by sunburn and too frequent sunbathing and the resulting damage to the skin’s genetic makeup. Although melanoma accounts for “only” 10% of annual skin cancer cases, it is on the other hand responsible for over 90% of deaths from skin cancer.

Symptoms

The skin areas exposed to the sun show a flat redness and swelling four to eight hours after sunbathing (see: Red spots on the face after sun exposure), in case of very severe damage also blistering until the skin detaches. Some people notice a strain on the skin already during sunbathing, the skin tightens and the sun feels unpleasant. The sunburn reaches its peak after 12 to 24 hours and can last up to 48 hours.

In the case of extensive burns, the inflammation can cause the development of fever. Circulatory failure and even shock can also occur in severe sunburn. This is caused by the strong water retention of the inflamed tissue, which leads to a relative lack of fluid in the body’s circulation.

The blood pressure drops and weakness, dizziness and even fainting are the result. If headaches, dizziness and nausea or vomiting occur in addition to sunburn, it is very likely to be sunstroke. A sunstroke is an overheating of the head and thus also of the brain, it can lead to serious complications.

In this case and in case of extensive burns, especially in children, medical advice should be sought immediately. After a sunburn and the redness has subsided, the top layer of the skin often flakes off. Sunburn is often noticed too late, as the first symptoms often appear three to six hours after sunbathing.

Therefore, preventive measures should be taken in advance and sufficient and continuous sun protection should be ensured. If you have a particularly light skin type (skin type 1 or 2), you need to protect yourself particularly well from the sun and should adhere to the recommended maximum length of stay at a certain time of day. Anyone who nevertheless suffers from sunburn should get out of the sun immediately and avoid the sun for a few more days.

One should consider that also in the shade the UV radiation reaches the skin and can further strengthen the sunburn. The most effective protection against further sun exposure is therefore provided inside buildings. Who goes nevertheless into the free one, the reddened places should cover well, best with bright clothes and sun hats and for sufficient UV protection at the entire body provide.

In addition to cooling, it is also very important for the treatment of sunburn to drink enough fluids, as the inflammatory reaction disrupts the skin barrier and a lot of fluid is lost.In addition, a balanced water balance (hydration) supports the body’s regeneration processes and gets the circulation going. Even more important is increased drinking after sunstroke. Dizziness, headaches, nausea and possibly also fever occur after sunbathing and one should urgently consult a doctor.

Sunstroke can be accompanied by severe general symptoms and can even be fatal. If the sunburn causes additional blistering, one should go to a doctor and leave the opening of the blisters to him, so that this happens under sterile conditions and thus the development of an infection is prevented. Likewise one should consider a doctor’s visit if the sunburn is very strong or hurts strongly, if it occurs with children and if it is accompanied by further symptoms such as: headache, neck stiffness, nausea or vomiting.

For the pain that occurs, one can take appropriate medication, such as ibuprofen or diclofenac, as these also have an anti-inflammatory effect. Some doctors recommend taking 1000mg of acetylsalicylic acid (e.g. 2 tablets of ASS 500mg) as soon as you notice the first signs of sunburn to immediately inhibit the inflammatory cells. This is supposed to reduce the severity of the sunburn and in addition, acetylsalicylic acid also relieves pain.

It should be noted that acetylsalicylic acid should not be given to children (especially with fever)! It should also not be taken during pregnancy. Anyone who frequently suffers from sunburn should undergo regular skin cancer screening, as the risk of skin cancer is significantly increased by its frequent occurrence.

This is carried out by dermatologists, as well as family doctors with appropriate qualifications. During screening, the entire skin is inspected and suspicious moles can be examined more closely in a magnifying glass (dermatoscope) and, if necessary, removed with minimal surgery. Cooling is the most important therapeutic measure for sunburn.

Cooling counteracts overheating and inflammation and relieves pain. It is best to start cooling as soon as possible, i.e. as soon as you notice the first symptoms. This can be a tightening of the skin, itching or pain in the burned area or the known redness of the skin.

It is recommended to dip towels or sheets in cold water and place them directly on the skin. You can also put light cotton clothes into cold water and put them on afterwards, this is also possible with children. Lotions (Après Sun, After-Sun-Lotion) are also very popular because they have a strong cooling effect.

It is also possible to use lotions that contain hydrocortisone, because this also has an anti-inflammatory effect and soothes the skin. Itching is also reduced by lotions containing hydrocortisone. Also popular are lotions containing aloe vera, as aloe vera also has a moisturizing and anti-inflammatory effect.

The lotions can also be stored in the refrigerator to enhance the cooling effect. The skin should be cooled continuously and the sheets or clothes should be changed at least every hour and dipped into cold water again. Sunburn should be cooled for one to three hours.

Hypothermia can also occur during the cooling process, so you should cool carefully, especially with children, and observe them. It is also important to drink a lot of liquid, preferably water, as the skin loses a lot of liquid through the burning and inflammation, as its barrier is disturbed by this. Nowadays, it is not recommended to use quark or yoghurt envelopes, as these can also allow bacteria to enter the skin and cause an infection.

It is especially not recommended if there is a higher degree of burns with blister formation, because bacteria can penetrate even faster through the open areas when the blisters open. In addition, curd cheese and yogurt dry quickly on the skin and then often stick to it. This can be very unpleasant or cause pain when removed.

You should never put ice directly on the affected area, as this itself can lead to skin damage or frostbite. If you want to use ice or cold/warm compresses/cool packs from the freezer, it is essential to wrap them in a towel and avoid direct skin contact. If the sunburn begins to itch, this can be an indication that healing is beginning.There are also other causes for itchy sunburn.

See also: Causes of sunburnIn general, itching does not occur immediately, but develops over time (after four to six hours). Under no circumstances should you scratch, as this again leads to small wounds and increases the risk of infection. Small children who cannot resist the itching should have their fingernails cut very short and be distracted.

Home remedies that provide relief include moisturizing lotions, aloe vera lotions and hydrocortisone ointments. Here, too, it is important to avoid quark and yoghurt compresses because of the increased risk of infection. However, cortisone ointments should only be used on children (especially on the face) for a short period of time or better only after medical advice.

The most common cause of itchy sunburn is “polymorphic (multiform) light dermatosis”, known as sun allergy, which is usually caused by UV-A light and occurs in about every 5th person. It particularly affects fair-skinned people the first time they sunbathe in the year and is more common in women. The most common areas are the décolleté and neck, and in children often the face.

In principle, all body regions can be affected. Red, occasionally raised nodules form in the itchy area, these can fuse together with other nodules to form a large area. Normally, the polymorphic light dermatosis recedes on its own within a few days, but patients often need medication against itching.

Another possibility is the use of antihistamines. Prophylactically, patients who frequently complain of itching after sunbathing should use sunscreen with UV-A light filters. This often leads to complete freedom from symptoms.

Sunscreens with antioxidants (vitamin E, alpha-glucosylrutin) also have a protective effect. If necessary a UV light habituation therapy can be considered with the physician. Other factors that trigger itching can be allergens, e.g. fragrances (perfume), UV filters in sun creams and others.

Here the itching area is limited to the place where the allergen had skin contact. To test this, the doctor can perform a provocation test by bringing only a certain skin area into contact with the possible allergen and then irradiating the body with UV-A (Photo-Patch-Test). Various medications can also cause skin irritation on contact with the sun, so it is advisable to read the package insert carefully and consult your doctor or pharmacist. If the itching does not subside, a doctor should be consulted urgently to clarify the symptoms.