What to do for a bad sunburn

It is common knowledge that sunburns damage skin and increase the risk of skin cancer, but did you know that your risk for melanoma doubles if you’ve had five or more sunburns in your lifetime? 

While that information alone is enough to keep many people out of the sun’s harmful rays, plenty continue to leave their skin unprotected (or even just under protected). According to a recent study, about one third of adults in the United States experience at least one sunburn each year. That means that most of us have experienced at least one really bad sunburn in our lives. And if you have, you know how painful it can be. Keep reading to learn what to do for a bad sunburn.

What is a sunburn?

Sunburn is when ultraviolet (UV) rays damage the skin’s outer layers and cause inflammation and redness. Your skin contains a certain degree of melanin, a pigment that helps to protect it from UV light. Melanin works by making areas of skin that are exposed to the sun darker. How much melanin you have depends on your genetics. People with less melanin are more prone to sunburn.

Sunburn is a self-limited condition, usually resolving in three to seven days. Blisters usually resolve within 10 days. Sunburns occur to those with a genetic susceptibility to skin cancer. Sunburns are associated with an increased risk of melanoma at all ages. 

“Sun can damage the skin so severely,” says Dr. Dathann Hamann, a board-certified dermatologist and medical director at the Contact Dermatitis Institute in Phoenix, Arizona. “In addition to having redness and blisters and pain, you can actually have the death of the top layer of skin and the significant inflammation from this can actually affect the whole body. You can get a fever, chills, and almost flu-like symptoms from a severe sunburn.”

How to prevent a sunburn

The obvious solution is prevention, says Dr. Hamann. This, he says, means staying away from the sun during peak danger hours (between 10 a.m. and 2 p.m.), staying in the shade to avoid direct sunlight, covering up with a wide-brimmed hat, sunglasses, and protective clothing—and using sunscreen, repeatedly. 

It’s important to note that even if your skin normally tans rather than burning, UV radiation still damages the skin at a cellular level. And this can result in premature aging of the skin, wrinkles, and long-lasting damage. That’s why it’s so important to wear a broad-spectrum sunscreen to protect your skin any time you’ll be outside and follow the same steps above.

RELATED: Shedding light on medications that increase sun sensitivity 

What to do for a bad sunburn

But what if it is too late? What if you accidentally fall asleep on the beach and wake up with a second degree burn—in pain, blistery, and looking like a lobster? Consider topical corticosteroids or some other cream, to relieve the discomfort and help your skin heal. These are the sunburn treatment options that work.

Hydrocortisone cream

Should you use hydrocortisone for sunburn? If your sunburn is mild to moderate, applying an over-the-counter 1% hydrocortisone cream to the affected areas three times a day for three days can help soothe your skin by reducing swelling and pain. For added relief, put the cream in the refrigerator so it’s nice and cool prior to application. 

Hydrocortisone is also effective if your sunburn causes severe itching referred to as “hell’s itch.” Hell’s itch is a deep, painful and throbbing itch that usually occurs 1–3 days after a sunburn, and is thought to be caused by damage to the nerve endings in your skin resulting in an allergic reaction.

But hydrocortisone cream for sunburn should never be used on blistered skin or skin that has  an open sore. And if you or your child are experiencing serious side effects such as severe blistering, fever or chills, dizziness or confusion, or signs of infections such as red streaks on the skin or pus that’s oozing out of the burned area, seek medical attention immediately. 

Aloe vera

When it comes to sunburn relief, aloe vera is a good tool to have in your arsenal–the plant is even safe enough to use on the face and lips. According to The National Skin Cancer Foundation, aloe is a safe way to soothe mild sunburn. What’s more, it has many healing properties. Research indicates that the gel from the aloe vera plant has both antibacterial and antimicrobial effects. And because it is abundant in antioxidants—containing vitamin E, carotenoids, vitamin C, flavonoids, and tannins—it is a powerful anti-inflammatory that can enhance the healing process. While both hydrocortisone cream and aloe vera gel have soothing effects, the healing properties of aloe make it a superior treatment for sunburn. 

Pain medication

If you’re experiencing pain from your sunburn, try an over-the-counter nonsteroidal anti-inflammatory drug (NSAID) like ibuprofen, naproxen or aspirin. Starting these meds at the first indication of a sunburn and continuing to take them until your pain resolves is the best way to combat inflammation and discomfort. If your sunburn is severe enough to warrant a trip to the doctor, you may be prescribed prednisone to decrease inflammation; if an infection is present, antibiotics may be necessary.

Soothing creams

As long as your sunburn hasn’t blistered, you can use a moisturizing cream to help soothe your discomfort. For best results, apply a gentle cream while your skin is slightly damp. But it’s important to use the right type of lotion–don’t use oil-based creams or ointments like petroleum jelly (Vaseline). That’s because these products can block your pores, potentially worsening your sunburn by trapping heat in the area and increasing your infection risk. OTC creams containing the ingredients vitamins C and E  are a good option, as they may help limit damage to skin cells caused by free radicals.

Cold compress

If you get burned from sun exposure and you’re near cool water such as a pool or lake, a quick dip will help to cool your skin, but get out of the sun as soon as you’re done. If you’re already home, soothe your skin with a cool bath or a cool shower. After that, applying cool compresses made with ice water to your skin is a good way to achieve fast sunburn relief from symptoms of sunburn–just be sure not to place ice directly on your skin.

Hydration

It’s important to drink extra plenty of liquids, such as water and electrolyte-containing beverages, when you have a sunburn. That’s because the skin tends to draw extra fluid from the body in order to heal, increasing your risk of dehydration. Drink plenty of water and sports drinks to stay hydrated while your body repairs the damage from those harmful UV rays.

When to see a doctor

The best way to find out if your sunburn requires something more than the standard protocol of a cold compress, ibuprofen, hydrocortisone, aloe vera, fluids, or a soothing cream? Talk to your doctor! A primary care physician or dermatologist can advise you on the best options to promote recovery.

Dr. Eshragi emphasizes the importance of seeking medical attention if a severe sunburn is accompanied by fever, chills, lethargy, and dehydration. Other signs to watch out for include headache, nausea and vomiting, confusion, fainting, or skin infection. 

“If someone is having significant systemic symptoms … things like that need to be managed by more than one doctor in a hospital setting,” he says. If a sunburn is so severe that prescription pain medication is recommended, the patient would probably be hospitalized. But even then, a sunburn is usually treated in other ways first, like with proper wound care, pain medication (NSAIDS or prescription meds, depending on pain level), and the same types of soothing creams used for less severe burns.

It goes without saying, but the best thing you can do is to take preventive steps anytime you’re in the sun so that it never reaches that critical stage.