Clinical Reference Systems: Pediatric Advisor 10.0
Sunburn (for Teenagers)
Sunburn is caused by overexposure of the skin to the
ultraviolet (UV) rays of the sun or a sunlamp. Most people
have been sunburned many times. Vacations can quickly turn
into painful experiences when the power of the sun is
Unfortunately, the symptoms of sunburn do not begin until 2
to 4 hours after the sun's damage has been done. The peak
reaction of redness, pain, and swelling is not seen for 24
hours. Minor sunburn is a first-degree burn which turns the
skin pink or red. Prolonged sun exposure can cause
blistering and a second-degree burn. Sunburn never causes a
third-degree burn or scarring.
Repeated sun exposure and suntans cause premature aging of
the skin (wrinkling, sagging, and brown sunspots). Repeated
sunburns increase the risk of skin cancer in the damaged
area. Each blistering sunburn doubles the risk of
developing malignant melanoma, which is the most serious
type of skin cancer.
- Pain relief
The sensation of pain and heat will probably last
48 hours. Ibuprofen products started early and
continued for 2 days can greatly reduce the discomfort.
Nonprescription 1% hydrocortisone cream or moisturizing
creams applied three times a day may also reduce
swelling and pain but only if the cream is used soon
after you are sunburned. Continue using the cream for
2 days. Do not use petroleum jelly or other ointments
because they keep heat and sweat from escaping.
The symptoms can also be helped by taking cool baths or
putting cold wet cloths on the burned area several times
a day. Showers are usually too painful.
Drink extra water to replace the fluid lost into the
swelling of sunburned skin and to prevent dehydration
Peeling usually occurs in about a week. Put a
moisturizing cream on your skin.
If you have broken blisters, trim off the dead skin with
small scissors. Then apply an antibiotic ointment (for
example, bacitracin). Wash off and reapply the ointment
twice a day for 3 days.
- Common mistakes in treatment and prevention of sunburn
Avoid putting ointments or butter on a sunburn. They
are painful to remove and not helpful.
Don't buy any first aid creams or sprays for burns.
They often contain benzocaine, which can cause an
Don't confuse sunscreens, which block the sun's burning
rays, with suntan lotions or oils, which mainly
lubricate the skin.
PREVENTION OF SUNBURNS
The best way to prevent skin cancer is to prevent sunburn.
Although skin cancer occurs in adults, it is caused by the
sun exposure and sunburns that occurred during childhood and
adolescence. Every time you protect yourself from too much
sun exposure, you are helping prevent skin cancer.
Apply sunscreen any time you are going to be outdoors
for more than 30 minutes per day.
About 15% of white teenagers have skin that never tans
but only burns. These fair-skinned people need to be
extremely careful about sun exposure throughout their
lives. If you have red or blond hair, blue or green
eyes, freckles, or excessive moles you are at increased risk
for sunburn and skin cancer. Use a sunscreen throughout the
summer, even for brief periods, and avoid the sun whenever
Try to keep sun exposure to small amounts early in the
season until a tan builds up. (Caution: While people
with a suntan can tolerate a little more sun, they can
still get a serious sunburn.) Start with 15 or
20 minutes of sun per day and increase by 5 minutes per
day. Decrease daily exposure time if your skin becomes
reddened. Because of the 2- to 4-hour delay before the
symptoms of sunburn appear, don't expect symptoms (such
as redness) to tell you when it's time to get out of the
sun. After 1 hour of sun exposure, always apply a
Avoid exposure to the sun during the hours of 10:00 AM
to 3:00 PM, when the sun's rays are most intense. Don't
let overcast days give you a false sense of security.
Over 70% of the sun's rays still get through the clouds.
Over 30% of the sun's rays can also penetrate loosely
woven fabrics (for example, a T-shirt).
Be especially careful about exposure to the sun at high
altitudes. Sun exposure increases 4% for each 1000 feet
of elevation above sea level. A sunburn can occur
quickly when you are hiking above timberline. Remember
also that water, sand, or snow increases sun exposure.
The shade from a hat or umbrella won't protect you from
Protect your eyes from the sun's rays. Years of
exposure to ultraviolet light increases the risk of
cataracts. Buy sunglasses with UV protection.
To prevent sunburned lips, apply a lip coating that
contains PABA. If your nose or some other area has been
repeatedly burned during the summer, protect it
completely from all the sun's rays with zinc oxide
There are good sunscreens on the market that prevent
sunburn but still permit gradual tanning to occur. Choose
a broad-spectrum sunscreen that screens out both UVA and
The sun protection factor (SPF) or filtering power of a
sunscreen product determines what percentage of the
ultraviolet rays get through to the skin. An SPF of 15
allows only 1/15 (7%) of the sun's rays to get through and
thereby extends safe sun exposure from 20 minutes to 5 hours
without sunburning. An SPF higher than 15 protects against
sunburn for more than 5 hours. However, an SPF higher than
15 is rarely needed in most parts of the U.S. because
protection against sunburn during the 5 hours between 10 AM
and 3 PM is usually sufficient.
Fair-skinned people (with red or blond hair) need a
sunscreen with an SPF of 30. The simplest approach is to
use an SPF of 15 or greater for all other people.
Apply sunscreen 30 minutes before exposure to the sun to
give it time to penetrate the skin. Give special attention
to the areas most likely to become sunburned, such as your
nose, ears, cheeks, and shoulders.
Most products need to be reapplied every 3 to 4 hours, as
well as immediately after swimming or profuse sweating. A
"waterproof" sunscreen stays on for about 30 minutes in
water. Most people apply too little sunscreen (the average
adult requires 1 ounce of sunscreen per application).
CALL YOUR PHYSICIAN DURING OFFICE HOURS IF:
- The sunburn looks infected (red streaks, yellow pus,
- You have other concerns or questions.