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First Aid: Sunburn

Sunburn can be painful and disabling. Understanding how to protect your skin and eyes from the sun is essential outdoor medical information.What causes a sunburn?

Sunburn is a reaction caused by exposure of the skin to ultraviolet radiation (UVR) from the sun.

  • UVA (a wavelength 320 to 400 nanometers (nm)): Less immediate sunburn danger but a serious cause of skin aging, drug-related photosensitivity, and skin cancer.
  • UVB (290 to 320 nm): The culprit in the creation of sunburn.
  • UVC (100 to 290 nm): Filtered out by the ozone layer of the atmosphere.
How do I treat a sunburn?
  1. For a mild sunburn where no blistering is present, treat with cool liquid compresses, cool showers, a nonsensitizing skin moisturizer (such as Vaseline Intensive Care), and aspirin to decrease the pain and inflammation.
    • Avoid topical anesthetic sprays, many of which contain benzocaine, as they can (rarely) cause sensitization and an allergic reaction. Menthol-containing lotions may be helpful.
  2. If the victim is deep red ("lobster") without blisters, then a stronger anti-inflammatory drug, such as ibuprofen, may be given.
  3. For an extensive non-blistering first degree sunburn, the victim may be nauseated and weak, with low grade fever and chills. Encourage her to drink enough balanced electrolyte liquids to avoid dehydration.
  4. If blisters are not present, topical steroid creams, such as pramoxine with hydrocortisone (Pramosone cream or lotion) may be used if blisters are not present. Pramoxine alone (Prax) is a non-sensitizing topical anesthetic.
  5. To blistering skin, do not apply topical steroid preparations because wound healing may be delayed and infection potentiated. Aloe vera lotion or gel may be soothing and promote healing.
    • Vitamin E is an antioxidant that, when mixed with aloe vera, may soothe the skin. However, this hasn't been proven to promote healing any better than aloe vera alone.
  6. If blistering is present, the victim has suffered second degree burns. Gently clean the burned areas and cover with an antiseptic ointment or cream under sterile dressings. Seek medical attention.
How to prevent a sunburn.
  1. Avoid sun exposure, particularly near the equator and when the sun's rays are most perpendicular to the earth.
  2. Cover yourself with clothing and wear a wide-brimmed hat.
  3. Wear an adequate sunscreen or sunblock. Choose a sunscreen based on the estimated exposure and on your propensity to tan or burn and overestimate the protection necessary.
    • These either absorb light of a particular wavelength, act as barriers, or reflect light.
    • Substances that are ineffective as sunscreens and that may increase the propensity to burn include baby oil, cocoa butter, and mineral oil.
  4. Sunscreen application: Moisturize the skin (shower or bathe) and then apply the sunscreen at least 15 to 30 minutes prior to exposure.
    • Keep the skin dry for at least 2 hours after sunscreen application.
    • Substantivity refers to the ability of a sunscreen to resist water wash-off. Layering sunscreens doesn't work well, as the last layer applied usually washes off.
  5. Sun protection factor (SPF): A higher number (range 2 to 50) indicates a greater degree of protection against UVB. The SPF number assumes a liberal application of the sunscreen.
    • For sensitive or unconditioned skin, use SPF 10 or greater.
    • For fair-skinned persons who never tan or who tan poorly or mountain climbers, use SPF 15 or greater.
    • Some authorities recommend using a sunscreen of at least SPF 29, with the rationale that most persons underapply or improperly apply them
  6. Situations in which any sunscreen should be reapplied at 3 to 4 hour intervals:
    • Continuous sun exposure, particularly between 10 AM and 3 PM.
    • Exposure at altitude of 7,000 feet or higher.
    • Exposure within 20 degrees latitude of the equator.
    • Exposure during May - July in the northern hemisphere and December - February in the southern hemisphere.
    • Frequent water immersion, particularly with toweling off.
    • Pre-existing sunburn or skin irritation.


Brought to you by Paul S. Auerbach, MD, author of Medicine for the Outdoors.
- Paul S. Auerbach


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