Not-So-Fun in the Sun: Treatment and Prevention of Sunburn

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SPF, or Sun Protection Factor, is a number used to predict the amount of UVB rays deflected from the outer layers of the skin, which is where most burns and skin cancers occur. The SPF number tells you how much UVB protection you will receive from the product.1,2 However, we must remember that no sunscreen will ever prevent 100% of damaging rays.1,2

Click HERE to view image of Sun Protection (Percent UV Blocked v SPF Number)

The American Academy of Dermatology recommends using at least SPF 30, because beyond that, not much more protection is afforded. The SPF number means it would take you that many times longer to burn than if you didn’t wear sunscreen.2 For example, SPF 30 means it would take 30 times longer to burn than if you used no sun protection.2 The words broad spectrum signify that the product will protect you from UVA and UVB rays.1,2 UVA rays cause the damage in the skin that leads to the tan color, along with signs of aging, and wrinkles.2 This is because UVA rays are capable of penetrating to deeper skin layers and are responsible for more serious, albeit rarer, cancers such as melanoma.1 The sunscreen only works however if applied correctly! It is recommended to apply 30 minutes before exposure to the sun, and reapply every 2 hours and directly after swimming or sweating.2

Treatment after a sunburn will not heal the skin or shorten the duration, but can provide relief from the discomfort that comes with the burn. To cool the skin, you can dampen a towel with cool tap water and apply it to the area, take a cool shower, or apply aloe vera gel. Drinking water will help prevent dehydration which can occur with sun exposure. When skin burns some of the moisture is lost, so applying a gentle fragrance-free moisturizer can soothe the skin as well.3

Topical anesthetics may be tempting, but should be avoided because they have the potential to cause further irritation to already damaged skin.4,5 Additionally, corticosteroid creams which are commonly used for various skin conditions have shown little benefit for sunburn, and are not effective in reducing redness and discomfort.5,6 Products which contain menthol provide a  “cooling” sensation and are a better option for pain relief, but could cause irritation to inflamed skin.

Current research suggests redness, tenderness, and slight swelling that are characteristic of a sunburn are caused by prostaglandins which are molecules designed to protect us from injury and infection. Taking an oral NSAID, such as Advil (ibuprofen) or Aleve (naproxen), which act to reduce prostaglandins can help with some of these symptoms.5 They’re best taken at first sign of sunburn because their effects in reducing symptoms are strongest within the first 24 hours of a burn.7 Tylenol (acetaminophen) won’t help inflammation but can be taken to alleviate the pain associated with sunburn, especially if NSAIDs are contraindicated for any reason.6

Some topical NSAIDs are available without a prescription in some countries outside of the US and have shown similar results to their oral counterparts. One European study demonstrated a reduction in redness, pain, and swelling when low dose diclofenac 0.1% Emulgel was used.8 Peak benefit was seen when applied within 30 hours of sun exposure, so just like oral NSAIDs, topical formulations should be used right away for best results.

The best treatment for sunburn is prevention before it happens and lessening the chance of burn by using SPF products before sun exposure each time and being diligent about reapplying. Staying in the shade, wearing wide-brimmed hats, and breathable, protective clothing are also key components to keeping skin healthy.

As usual, comments are welcome and encouraged!

This guest post was reviewed and edited by Dr. Jeffrey Fudin

About the Authors:

Dr. Jenel Clement received her PharmD from Massachusetts College of Pharmacy and Health Sciences in Worcester, MA in 2019. She is a PGY-1 Pharmacy Resident at the Stratton VA Medical Center in Albany, NY. Her interest areas include pain management and cardiology, with plans to complete specialty training as a PGY-2 in one of these specialties following her PGY-1 year.

 

 

 

Denae H. Moyer is a PharmD candidate in the class of 2020 at Albany College of Pharmacy and Health Sciences. She is currently completing an advanced pharmacy practice rotation in Interdisciplinary Pain Management with Dr. Erica Wegrzyn at the Stratton VA in Albany NY. After graduation she plans to complete a PGY-1 residency with a focus in ambulatory care.

 

 

 


References:

  1. Sunscreen FAQs. American Academy of Dermatology. https://www.aad.org/media/stats/prevention-and-care/sunscreen-faqs. Accessed July 17, 2019.
  2. Ask The Experts. Skin cancer foundation. https://www.skincancer.org/skin-cancer-information/ask-the-experts/does-a-higher-spf-sunscreen-always-protect-your-skin-better. Accessed July 18, 2019.
  3. Sunburn Treatment and Diagnosis. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/sunburn/diagnosis-treatment/drc-20355928. Accessed July 18, 2019.
  4. McStay CM. Sunburn Treatment and Management. Medscape. https://emedicine.medscape.com/article/773203-treatment#d2. Accessed July 16, 2019.
  5. Rapaport MJ, Rapaport V. Preventive and Therapeutic Approaches to Short- and Long-Term Sun Damaged Skin. Clin Derm. 1998;16:429–439.
  6. Dowd MD. Treatment and prevention of pediatric sunburn. Pediatr Ann. 2019 June; 48(6):e213-214
  7. Young AR, Tewari A. Sunburn: Beyond the Basics. UpToDate. https://www.uptodate.com/contents/sunburn-beyond-the-basics#H5. Accessed July 16, 2019.
  8. Magnette J, et al. The efficacy and safety of low-dose diclofenac sodium 0.1% gel for the symptomatic relief of pain and erythema associated with superficial natural sunburn. Eur J Dermatol. 2004 Jul-Aug;14(4):238-46.

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