Recently I’ve been noticing patients are coming in with sunburns even though the weather has been cloudy. They are often unaware that the sun is causing damage to their skin at the time, and come in later with severe sunburns. Even on cloudy days, it is important to protect your skin because UV radiation can pass through the clouds and cause sunburns. In addition, UV rays can be reflected off surfaces like sand, snow, cement and water.
Prevention: Here are several ways to help prevent sunburn:
1) Avoid sun exposure: If you plan to be out in the sun during the day, keep in mind that the suns rays are strongest between 10:00am and 4:00pm in the continental U.S. and avoiding exposure during these hours decrease your risk of burning. Wearing a topical sunscreen as well as clothing that blocks the suns rays are helpful in reducing your chance of sunburns.
2) Find Shade: Areas that don’t have direct sunlight reduce your chances of sunburn. These areas include under trees, an umbrella or structures such as porches, or tents. A topical sunscreen is still recommended while sitting in the shade because your skin is still exposed to some UV radiation.
3) UV Index: One way to predict your risk of sunburn on a given day is a numerical value called the UV index. It is a number between 0 and 11+, in which 0 indicates a lower risk of sun exposure and 10 indicates high risk with 11+ an extreme risk. You can find the UV Index online.
4) Sunscreen: There are many sunscreen products on the market, and most of them work by protecting the skin via absorbing the radiation or reflecting it. SPF or Sun Protection Factor is a numerical indicator that gives us some idea of how much protection the sunscreen offers against UVB (Ultraviolet B) burns. It’s important to look for a sunscreen that protects against both UVA (Ultraviolet A) and UVB rays – sometimes they label these products broad-spectrum. Here are some additional tips.
A) I often get asked what SPF rating is best. My first response is usually “the maximum you can get,” because I realize that even low levels of ultraviolet radiation increase your risk for sun damaged skin, skin cancers and a poor cosmetic outcome with increasing age. The American Academy of Dermatology recommends an SPF of 30 or greater on sun exposed skin with protection of UVA and UVB and recommends a higher SPF in your are fair-skinned or will be out in the sun for longer periods of time or anticipate intense exposure (such as on a beach or skiing trip).
B) Use enough: I find that most people don’t use enough sunscreen, and they don’t put it on soon enough. Your really need about 2 tablespoons of lotion to cover an adults arms, legs, neck and face. If you want to cover your back and chest, you will need more than that. You should also apply it at least 15-30 minutes before going out in the sun for it to become active.
C) Reapply: Even if the sunscreen bottle says that it’s sweat-proof, or water-proof, I recommend reapplying every 2-3 hours or after drying off with a towel or swimming. There is some evidence that suggests that after being out in the sunlight for 20 minutes, you should reapply the sunscreen even if you’re not in the water or haven’t been sweating profusely.
D) Protect your lips: Make sure your remember to protect your lips with lip balm that has an SPF of 30 or higher and reapply frequently.
E) Buy new sunscreen each year: Chemical sunscreens become less effective with time. Leaving them in the sun or where it is hot, such as in the car may speed this degradation process. Expired sunscreen is likely less effective and reduces the SPF rating.
Definition: Sunburns occur when the skin is burned by UV radiation. Often sunburns are not severe, but it’s the exposure over years that increase your risk of skin cancer, wrinkles and other cosmetic concerns. In todays society, we often think about the immediate gratification which might include a suntan, however often the harmful consequences come years later often after we are no longer spending as much time in the sun. I show my younger patients who have sunburned skin several photos of older patients who’ve spent years in the sun or had sunburns over years. Hopefully that helps them understand the consequences that come with repeated exposure so they can make more informed decisions about protecting their skin from harmful radiation.
Symptoms: Sunburns are often not immediately apparent because the redness and pain develop 3-5 hours after being out in the sunshine. Redness of the skin that is hot and painful to touch is common. There may also be blistering and swelling over the affected areas. The redness is usually at it’s worst by 12-24 hours after sun exposure and this fades over 72 hours.
Causes: Melanin is a pigment in the skin that causes your skin to appear dark or light colored. Your skin can temporarily increase the amount of melanin to help protect from burns (suntan). The amount of ultraviolet radiation that is needed to burn your skin depends on several factors:
1) Melanin: The amount of melanin in your skin affects how quickly you can get burned. People with light colored skin and light hair generally have a higher risk of sunburn compared with patients with dark colored skin. Some individuals with a low amount of melanin can burn in less than 15 minutes.
2) Location: There is increased UV radiation due to more direct sunlight near the equator so individuals who are in these locations are at more risk of sunburn (Hawaii for example).
3) Medications: Certain medications can increase the risk of sunburn including ibuprofen, some blood pressure medications such as hydrochlorothiazide (HCTZ), and some antibiotics such as tetracycline.
Complications: Premature skin aging, permanent discoloration of the skin, wrinkles, skin cancers such as malignant melanoma, basal cell and squamous cell carcinomas, cataracts (the lens of the eye becomes cloudy).
1) Stay out of the sun until the redness and pain go away. Repeated sun damage after a recent burn is even more harmful.
2) After noticing a sunburn, I often recommend immediately taking ibuprofen or Aleve to help with the pain
3) Cool compresses, and aloe-based lotions and sprays
4) Sprays with a local anesthetic that numbs the skin such as Solarcaine may help decrease the pain but they do not decrease the long-term risks of skin cancer and sun damaged skin.
If you have had repeated sunburns, a history of skin cancer, or strong family history of skin cancers, I recommend that you see a dermatologist at least every year for a head to toe skin examination.
To find a Dermatologist in your area, the American Academy of Dermatology’s Website has a very useful locator: http://www.aad.org/find-a-derm
This document is for informational purposes only, and should not be considered medical advice for any individual patient. If you have questions please contact your medical provider.
I hope that you have found this information useful. Wishing you the best of health,
Scott Rennie, DO