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Sunburn

Sunburn is skin damage caused by excessive exposure to ultraviolet (UV) radiation from the sun or artificial sources such as sunbeds. It causes redness.

Overview

Sunburn is skin damage caused by excessive exposure to ultraviolet (UV) radiation from the sun or artificial sources such as sunbeds. It causes redness, pain, peeling, and in severe cases blistering. Repeated sunburns significantly increase the risk of skin cancer, particularly melanoma. There is no safe suntan — any change in skin colour from UV exposure is a sign of damage.

How common is it?

Sunburn is extremely common. Studies suggest that over 30% of UK adults and 50% of adolescents experience at least one sunburn per year.

Causes and risk factors

UV radiation (UVA and UVB) penetrates skin, damages DNA in keratinocytes, and triggers an inflammatory response. Melanin production (tanning) is a protective response but also a marker of damage.

Common risk factors

  • Fair skin, light hair, and blue eyes
  • Sun exposure between 11am and 3pm (peak UV hours)
  • Altitude and proximity to equator
  • Reflective surfaces: snow, sand, water
  • Use of sunbeds
  • Certain medications (photosensitising): doxycycline, thiazides, amiodarone
  • Not using or reapplying sunscreen

Symptoms

  • Redness and tenderness of sun-exposed skin (appears 2 to 6 hours after exposure, peaks at 12 to 24 hours)
  • Pain and warmth
  • Swelling
  • Blistering in severe sunburn
  • Peeling skin as healing occurs (3 to 5 days after burn)
  • Systemic symptoms with severe sunburn: fever, chills, nausea, headache, dehydration (sun poisoning)

When to see a doctor

Seek medical attention for extensive blistering, fever, confusion, or if a young child has significant sunburn. Sun poisoning (systemic symptoms with sunburn) may require intravenous fluids. See a dermatologist if a blistering sunburn occurs as this significantly elevates melanoma risk.

Diagnosis

Clinical diagnosis. Sunburn severity graded by extent and depth (first-degree: redness; second-degree: blistering). Systemic assessment for sun poisoning.

Treatments

Cool the skin

Cool (not cold) water baths or damp cloths for 15 to 20 minutes. Avoid ice directly on the skin. Cooling is most effective within the first hour of exposure.

NSAIDs and paracetamol

Ibuprofen taken within the first 6 to 8 hours significantly reduces inflammation, pain, and redness. Continue for 48 hours. Paracetamol for pain if NSAIDs are contraindicated.

Hydration and moisturiser

Drink extra fluids to prevent dehydration. Apply fragrance-free moisturiser or aloe vera gel to reduce discomfort and peeling. Avoid petroleum jelly or butter which trap heat.

Blister management

Do not burst blisters — they protect against infection. If blisters break naturally, apply antibiotic ointment and non-stick dressing.

Self-care and lifestyle

  • Apply SPF 30+ broad-spectrum sunscreen 15 to 30 minutes before sun exposure, reapplying every 2 hours and after swimming
  • Seek shade between 11am and 3pm
  • Wear protective clothing, wide-brimmed hats, and UV-blocking sunglasses
  • Never use sunbeds

Prevention

Consistent use of high-factor sunscreen, sun-protective clothing, seeking shade during peak hours, and avoiding sunbeds are the cornerstones of prevention. Start sun protection in children — most lifetime UV exposure occurs before age 18.