The burning truth behind what happens when you get a sunburn

Skin Care

by Lindsay Bicknell, MD

Aug 30, 2018

When you’re enjoying some quality time with family at the lake or gathered around the grill in the backyard, everything is all fun and games—until someone gets a sunburn.

Most of us who enjoy spending time outdoors are familiar with the agony of a sunburn. A bright red patch—often in a bizarre pattern—that swells, blisters and peels. Sometimes, it is even accompanied by fever, chills and nausea.

Aside from the immediate misery, a single blistering sunburn can have lasting effects on the health of your skin.

As a dermatologist, I warn my patients that a history of blistering sunburns and excess sun exposure can put you at increased risk of skin cancers. In addition, excess sun exposure can lead to accelerated signs of aging such as wrinkles, skin discoloration and an overall leathery texture to the skin. 

The science of a sunburn

The development of a sunburn starts at the cellular level. Initial exposure to ultraviolet B (UVB) radiation leads to DNA damage and redness. Ultraviolet A (UVA) exposure leads to an immediate darkening of the skin that results from the movement of already-formed melanin pigment to the part of the skin cells most needing protection from damaging UV radiation. In a sense, it is the skin’s first attempt to protect itself from damaging sun rays.

If your skin is unsuccessful at protecting itself, the death of skin cells occurs (apoptosis), which manifests into what we know as a “sunburn.”

So, what about a tan?

A “base tan” is often touted as an effort to protect against sunburn. After initial exposure to the sun and in response to DNA damage, the skin forms new melanin pigment to protect against further injury. This pigment production results in a tan.

While a summer tan is aesthetically pleasing and may offer a small amount of protection against future sunburn, it comes at the expense of DNA damage that, if improperly repaired, may lead to skin cancer in the future.

Preventing sunburn and sun damage

The best treatment for a sunburn is not to get one in the first place. Prevention is key and can be achieved by following these four simple steps:

  1. Avoid midday sun. As a rule of thumb, the risk of sunburn is greatest between 9 a.m. and 4 p.m., or when the height of your shadow is shorter than you are.
  2. Seek shade. Staying out of direct sun is always a safe option!
  3. Wear protective clothing. Many leading clothing retailers have been approved by the U.S. Skin Cancer Foundation as sun protective, and even display a “UPF” rating on their sun-safe products. UPF is similar to the SPF rating on sunscreens. Clothing with a higher UPF includes older, washed items that are loose fitting and made of a dense weave material. Hats should be broad-brimmed with a 3 to 4-inch brim.
  4. Wear sunscreen! Most individuals only apply about half the amount of sunscreen recommended by the manufacturer, and as a result, we only receive about half the protective benefit advertised by the SPF rating. To remedy this, I recommend using a product of at least SPF 30, but preferably SPF 50, and reapplying about every 80 minutes. Additionally, sunscreen should be applied 20 minutes before going out in the sun.

It’s too late. I’m sunburned. What now?

If you do obtain a sunburn, you can expect two to three unpleasant days of redness and pain. Some of this discomfort can be relieved by taking an NSAID or antihistamine, and/or using a mild potency topical steroid or other soothing over-the-counter topical product.

When it comes to your time outdoors throughout the year, plan to be sun smart. Protecting your skin from sunburn now will help prevent the development of skin cancer later and preserve the youthful appearance of your skin. Additionally, it will ensure that you thoroughly enjoy your holiday plans without suffering the blight of blistering sunburn.

Got skin questions? Find a dermatologist today.

About the Author

Lindsay Bicknell, MD, is a dermatologist on the medial staff at Baylor Scott & White Specialty Care Center Dermatology Clinic – Temple.

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