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You have a sunburn? Really? With me going on and on about sun smart behavior you went out there and got burnt? And now you want me to tell you how to treat said sunburn?
Don’t worry. I have got you covered.
Today we will talk about what happens when you get sunburned, the three different stages there are and the five things you should do to treat it.
So hand on heart – when was the last time you got a sunburn? Mine was at the end of last summer, when it was warmer than I had anticipated, so I took off my jacket and burned my shoulders…
What is a sunburn?
When the sun hits our skin, the UV rays, and here especially the UVB rays, get absorbed by the skin cells DNA where they lead to either punctual damage in the DNA or, if the damage is severe, to the cells dying. On top of that it triggers so-called Reactive Oxygen Species or ROS that lead to even more damage.
Just to be clear: Every bit of UV radiation will lead to damage, there is no “safe dose”. But our skin has its own repair mechanisms that can undo some of the damage as long as it isn’t too much. If it gets too much, the damage is there and the skin starts to react: with redness called erythema and, depending on the severity, with swelling, blistering and even systemic reactions. (More info: What is UVA protection and why does it matter?)
The cells damaged or dying send a SOS signal in the form of transmitters like Histamine or NO, which in turn lead to vasodilation and the start of an inflammatory cascade that brings things like prostaglandin and immune cells to the site of the trauma.
Our bodies have a default reaction to any kind of trauma that needs repair, and sunburn is no exception.
The three stages of sunburn
A sunburn comes in different stages of severity, with Stage 1, first-degree burn, being just redness.
Yes, even the light pink tint your skin gets after sun exposure is a sunburn and a sign of cell damage and death.
With growing intensity there is more intense redness and, due to the vasodilation and inflammation, swelling and a feeling of heat. That swelling is caused by fluid leaving the blood vessels, a process called exsudation, and the feeling of heat comes from the dilated blood vessels. It is not heat trapped in the skin, the skin just feels hotter.
If the sunburn leads to blisters, that is the sign of a second degree burn when the damage reaches the epidermis. Depending on the area affected, a second degree burn can make it necessary to seek medical attention, we will get to that in a bit.
Thankfully very rare is a third-degree sunburn, where the damage goes down as deep as the subcutaneous fat. That kind of burn needs intense sun and can lead to destruction of the skin’s structures like nerves or hair follicles. It will always require medical attention!
How long does sunburn last?
The degree also determines how long the sunburn will take to heal. While it will take up to six hours after sun exposure until the full extent of the sunburn is visible, the first degree burns will usually heal within 24 to 72 hours. The time it takes is heavily influenced by your genetics, but also by things that affect your general healing ability like age, smoking or diabetes for example.
A second degree burn can take as long as 7 to 10 days until the skin has healed and has a risk of leaving scarring or hyperpigmentation behind, and a third degree burn not only takes very long, but can also require surgical intervention. It always leaves scars behind. (More info: Everything you need to know about hyperpigmentation)
How to treat a sunburn
Now let’s talk treatment, with one very important message:
You can only ever treat the symptoms of sunburn. The damage is done and you won’t be able to heal or even reduce it!
With that being said, here are the 5 things you need to do:
Get out of the sun and stay out of the sun! The burn will need up to six hours to fully develop and that it appears means your skins defense mechanisms are down. Until it is fully healed, you will need to stay out of the sun – applying sunscreen on top is not enough!
Cool the area with a cold shower or a cold compress. That will lessen the pain and the swelling.
Moisturize with soothing and repairing products. The burn means the skins barrier is damaged with an increase in Transepidermal Water Loss (More info: The difference between dry and dehydrated skin), and you’ll notice your skin getting dry during recovery. Ingredients like colloidal oatmeal, Panthenol, Ceramides and Centella Asiatica are a good option, as are antioxidants to help fight off the ROS. (More info: Everything you need to know about Colloidal Oatmeal in skincare, Everything you need to know about Panthenol in skincare, Everything you need to know about Ceramides in skincare, Everything you need to know about Centella Asiatica in skincare)
Drink enough water. The vasodilation leads to exsudation, to fluids leaving the blood vessels, and if your sunburn covers a larger area like your entire back, that could in combination with the increased loss of water through the damaged skin barrier be enough to lead to systemic dehydration with dizziness or other circulatory symptoms.
Treat your skin gently. Your skin experienced trauma, it needs gentle care, not more trauma through exfoliation, irritating actives like retinoids or, especially when you have blisters or the dead skin starts to peel off, through more physical damage. Leave your skin alone, don’t pick your blisters, don’t peel off your skin and if possible, wear loose clothing to avoid chafing. (More info: The 5 things you need to do to heal your damaged skin barrier)
How about medication to treat sunburn?
If you’re in pain, it might be a good idea to take antiinflammatory pain medication like Ibuprofen, but despite the inflammatory cascade that is part of the sun burn, there is no evidence that it will be beneficial in any other way than pain reduction. It will sadly not reduce the amount of damage and, as a word of caution, could lead to problems with the kidneys when you are at the same time severely hydrated.
Same is true for oral or topical corticosteroids, they lessen the symptoms, but don’t influence outcome.
If oral antioxidants help is unclear, but at least they have little side effects if you don’t overdo it. Just have some fruits or tomato juice or whatever you enjoy.
Does sunburn turn into a tan?
And for all of those that are about to tell me: But if I don’t get a little redness, I won’t tan! That isn’t true.
Sunburn does not turn into tan, it is just that tanning is the attempt of the skin to protect its DNA by producing Melanin to absorb UV radiation. That mechanism will get triggered with or without a sunburn, it is just the more intense the damage is, the more intense the trigger.
The best thing for your skin would be not to tan, as that would be a sign it is well protected.
The second best thing for it would be to tan without a sunburn.
And believe me, I feel you. I am pale, I am blonde, if I don’t put color into my face people assume I am sick. But trying to tan in my youth just gave me hyperpigmentation that I need to deal with now, alongside an increased risk for skin cancer, so now I rely on bronzer or self tan for the face – my personal favorite is the Tan Luxe Super Glow Hyaluronic Acid Face Tan Serum (30 ml for 43 €, full review here).
When do you need to see a doctor about your sunburn?
If you experience a second degree sunburn, the one with blisters, over a large surface area, or if you have accompanying symptoms like nausea, severe headache, dizziness, drowsiness or worse, you should seek medical attention. Again, whatever treatment they can offer will not reduce the damage in your skin, but severe dehydration or the neurological symptoms that can be triggered by intense sun exposure need to be addressed.
Every bit of sunburn, even the slight redness that stays, is a sign of damage in the skin. That damage is not reversible, treatment of sunburn will only ever treat the symptoms, so prevention is your best option. But if you slipped up and burnt yourself, here is what you need to do:
- Get out of the sun immediately and stay out!
- Cool with cold showers or cold compresses
- Moisturize with soothing and repairing ingredients like Panthenol, Colloidal Oatmeal or Ceramides
- Stay hydrated, you will lose fluid through swelling and the damaged skin barrier
- Leave your skin alone: No actives and no picking
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