Sunburn
What is sunburn?
Sunburn is damage done to your skin as a result of too much exposure to ultraviolet (UV) radiation, usually from the sun. You can’t see or feel UV radiation which means you can be sunburnt without realising it. Sunburn is a radiation burn to the skin, although it happens a lot slower than other kinds of burns and therefore, you may not feel it happening.
In Australia, around 25% of adolescents and almost 17% of adults get sunburned on summer weekends, with around half of them occurring during day-to-day activities.
While sunburn heals, the damage done to your skin increases your risk of developing skin cancer. One study showed that Caucasian women who had at least five blistering sunburns between the ages of 15 and 20 years old had a 68% increased risk for basal cell carcinoma and squamous cell carcinoma of the skin, and an 80% increased risk for melanoma.
Won’t a tan protect me from sunburn?
The short answer is, no.
When you’re exposed to UV radiation, your body tries to protect itself by producing more melanin (the dark pigment in your skin’s outer layer that gives skin its colour). This extra melanin is what produces a tan, and it’s your body’s natural way of trying to block UV rays. However, a tan provides very little protection from UV radiation which is why you can be burnt even if you have a tan.
A tan is a sign that your skin has been damaged by UV radiation and is not a sign of being healthy.
Signs of sunburn
Sunburn is an acute skin inflammation that occurs after overexposure to UV radiation. In summer, typical signs of sunburn can appear in as little as 11 minutes, and may include:
changes in skin colour ranging from pink, to red and even purple — skin usually changes colour within two to six hours of being burnt and may continue to change for up to 72 hours
skin that feels warm or hot to the touch
painful or itching skin
swelling and tenderness
blistering including blisters that break
peeling skin
Severe sunburn may also result in fevers, chills, headaches, nausea, vomiting and dehydration .
What about heatstroke?
Heatstroke is a serious condition that occurs when your body overheats, usually as a result of prolonged exposure to high temperatures, or physical exertion in the heat. Heatstroke is a medical emergency so if you notice any of the following symptoms, you should call an ambulance (000):
fast, shallow breathing and rapid pulse
headache, nausea or vomiting
sudden rise in body temperature to above 40.5⁰C
hot and dry skin with no sweat
dizziness, confusion, seizures or loss of consciousness
coordination problems
difficulty speaking
aggressive or out-of-character behaviour
dry, swollen tongue
What causes sunburn?
Sunburn is caused by UV radiation which mostly comes from the sun. UV radiation can pass through clouds and may also be reflected off surfaces such as water, sand, snow and even concrete and buildings. Australia has some of the highest levels of UV radiation in the world.
There are three types of UV radiation — UVA, UVB and UVC. Almost all of the UVC radiation (the most dangerous type) is absorbed by the earth’s atmosphere but UVA and UVB are not.
UVA — these rays can penetrate the deeper skin layers and damage areas where new skin cells grow. High doses of UVA are mainly responsible for aging but they can also cause sunburn along with, skin damage, changes to the genes in skin cells and skin cancer.
UVB — these are predominantly responsible for sunburn, but they are more dangerous than UVA rays as it significantly promotes the development of skin cancer.11It is also responsible for tanning, burning, aging and skin damage
You can also get sunburnt by using a solarium (tanning bed) as these emit intense and damaging levels of UV radiation which can be up to six times as strong as the midday sun.12Due to solariums significantly increasing the risk of skin cancer, commercial solariums are illegal in Australia.
The UV index
The UV index is a measure of the amount of UV radiation at a particular place and time. Levels of UV radiation vary according to geographic location, altitude, time of day, time of year and cloud cover.
The Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) measures the UV index in each of Australia’s capital cities and publishes this real-time data daily. The UV index divides UV radiation levels into:
low (1-2)
moderate (3-5)
high (6-7)
very high (8-10)
extreme (11+)
You can use the UV index to determine what level of sun protection you should use. The index is reported in the weather section of all Australian daily newspapers, and on the Bureau of Meteorology website. You can also download the free SunSmart app and check it each day.
For low UV, sun protection isn’t recommended unless you are outdoors for extended periods, or near reflective surfaces such as snow or water. For a UV index of 3 and above, you should use sun protection.
Who is at risk of sunburn?
Everyone is at risk of sunburn, but your risk of sunburn is increased if you:
have light skin, blue eyes or red or blond hair
live in a warm climate or at high altitudes
spend a lot of time outdoors, particularly if you work outside
expose unprotected skin to UV radiation (e.g. sunlight or tanning beds), particularly when the UV index is high
mix alcohol and outdoor activities
take photosensitising medications (these make your skin more likely to burn)
What are the complications of sunburn?
The main complication of sunburn is the increased risk you have of developing skin cancers. Australia has one of the highest rates of skin cancer in the world with at least two-thirds of Australians being diagnosed before the age of 70.16In Australia, sun exposure causes around 99% of non-melanoma skin cancers and 95% of melanoma skin cancers.
Sunburn also damages your skin and contributes to premature ageing. Signs may include:
deep wrinkles
rough, dry skin
reduced strength and elasticity of the skin
the appearance of fine red veins on your cheeks, nose and ears
freckles
age spots
How to treat sunburn
There is no cure for sunburn. Treatment aims to reduce and manage symptoms until it heals. Mild cases of sunburn can easily be managed at home using the following suggestions:
take cool or lukewarm showers, or use cold compresses to the skin
avoid using soap as this may irritate the skin
apply moisturiser if the skin is not too painful, which will help boost the moisture content of your skin
use spray-on products to soothe sunburn if it’s too sore to rub — your Pharmacist will be able to advise you
drink plenty of water to combat possible dehydration
use over-the-counter (OTC) pain medications if necessary
avoid popping any blisters
stay out of the sun until your skin is completely healed
wear loose, soft clothing to avoid irritating your skin further
When your skin is peeling, you should avoid picking at it and let it naturally detach on its own.
When should you see your doctor about your sunburn?
Sometimes it may be necessary to seek medical attention for your sunburn. You should see your doctor if:
sunburn is severe with extensive blistering and pain
sunburn is widespread
you have headache, nausea or vomiting
you have fever, dizziness or altered states of consciousness
sunburn affects an infant under 18 months
your eyes are painful — this may indicate sun damage to your eyes
the amount of sunburn for the amount of exposure seems extreme and you take prescribed medication
What’s the best way to prevent sunburn?
Fortunately, sunburn can be prevented by using a combination of five sun protection measures. These include:
Slip — slip on protective clothing that covers as much skin as possible
Slop — slop on SPF30 (or higher) water-resistant sunscreen that protects from UVA and UVB rays, around 20 minutes before going outdoors, and reapply every two hours
Slap — slap on a wide-brimmed hat that protects your face, neck, ears and head
Seek — seek shade
Slide — slide on wrap-around sunglasses (ensure they meet Australian Standard AS/NZS 1067)
It’s important to note that the widespread use of sunscreen in babies under six months old is not recommended, so keeping them out of the direct sun is very important.
Your local MediADVICE Pharmacist is available to help you manage your health, including identifying if you are taking photosensitising medications. Speak to your MediADVICE Pharmacist about sun protection products that may be suitable for you. We can also provide advice on products to ease the symptoms associated with sunburn or refer you to a doctor if necessary, if you are exhibiting symptoms of heatstroke.
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General advice only – this information should not replace the information provided to you by your health care professional. If symptoms are severe or persist, please speak to your health care professional. Information current as of date of publishing.
[1] Cancer Council Australia.Half a million Australian teenagers sunburnt on summer weekends. Media release.Sydney, Australia; 2019 Nov 17 Available from: https://www.cancer.org.au/news/media-releases/half-a-million-australian-teenagers-sunburnt-on-summer-weekends.html.
[2] Cancer Council Australia. We’re still a sunburnt country. Media release.Sydney, Australia; 2017 Nov 19 Available from: https://www.cancer.org.au/content/pdf/News/MediaReleases/2017/191117%20National%20Skin%20Cancer%20Action%20Week%20FINAL%20for%20website.pdf.
[3] Cancer Council WA, One in two Aussie sunburns occur during everyday activity. Media realse. Perth, Australia; 2015 Nov 15, https://www.cancerwa.asn.au/articles/news-2015-media-releases/one-in-two-aussie-sunburns-occur-during-everyday-a/
[4] Shaowei Wu, Jiali Han, Francine Laden and Abrar A.Qureshi, Long-term Ultraviolet Flux, Other Potential Risk Factors, and Skin Cancer Risk: A Cohort Study, Cancer Epidemiol Biomarkers Prev June 1 2014 (23) (6) 1080-1089; DOI: 10.1158/1055-9965.EPI-13-0821, https://cebp.aacrjournals.org/content/23/6/1080.abstract
[5] Mayo Clinic, Sunburn, https://www.mayoclinic.org/diseases-conditions/sunburn/symptoms-causes/syc-20355922
[6] Better Health Channel, Sunburn, https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/sunburn
[7] MyDr, Sunburn, https://www.mydr.com.au/sunburn/
Cancer Council Australia, Skin Cancer Statistics and Issues, https://wiki.cancer.org.au/skincancerstats/Sunburn#cite_note-Citation:H.C3.B6nigsmann_H_2002-7