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How to Treat Sunburn

What is a Sunburn

Sunburn is exactly what it sounds like – a burn caused by the sun. It is a real burn – that is, the skin is actually damaged by the heat – so parents should take it seriously. Anyone can get a sunburn, no matter how old they are or what their natural skin color is. In general, though, younger children and those with lighter-colored skin tend to burn more easily. Infants burn very quickly, and always need to be protected from the sun. Sunburns are almost always the equivalent of a “first degree” burn, which means they involve only the top layers of skin, and don’t cause blistering. Children with severe sunburns can get true second-degree burns that blister and develop fluid under them.

What is the biggest concern?

The biggest immediate concerns with sunburn are the pain and the possibility of dehydration. As first or second-degree burns, sunburns hurt a lot, and they often cover large areas of skin. The pain can be severe enough to make anyone miserable, and very young children who can’t talk much yet can become very fussy. Burned skin also can’t retain water in the body as well as healthy skin, so people with sunburns are at higher risk for dehydration and heat exhaustion. Of course, just being in the sun long enough to burn is also a risk for these things. You can read our Aftercare Instructions on Heat Exhaustion and Heat Stroke.

The longer-term risks of sunburn are becoming clearer every year. Sunlight contains ultraviolet light that damages skin cells and their DNA, the material that controls cell growth. Long-term damage to skin cells from sunlight causes several kinds of skin cancer later in life. This makes protection from sunlight a much more important issue than just comfort and convenience.

Sunburn treatment

The best treatment for sunburn is to prevent it. This is practically impossible for active youngsters during the sunny months, without interfering with other very important tasks of childhood like exploring and playing. Some preventive tips might be useful, however:

  • Try to keep kids indoors or in shaded areas during the most brutally hot parts of the day, usually between noon and 2pm.
  • Offer good incentives to come indoors every hour or so, such as cold drinks or snacks.
  • At the beach or other unprotected areas, try to use a sun umbrella, or have your child wear a loose long-sleeved shirt while playing on the sand.
  • Try to have your child wear a ventilated hat or cap with a brim all the time while in the sun.
  • Use a sun-screen with as high a solar protection factor (SPF) as possible, at least SPF 15. Please do NOT use baby oil – it actually intensifies the effect of sunlight.
  • If your child has developed a sunburn, here are some useful things to do (and to avoid):
  • Like with any burn, get him or her away from the source – in this case, it’s time to come in from the sun.
  • Remove as much clothing as possible. Clothes can rub on burned skin and make it intolerable.
  • A gentle bath in cool or lukewarm water without soap (soap dries the skin more) will help ease the pain.
  • After the bath apply a soothing moisturizing cream or lotion like Vaseline® Intensive Care™ or Jergens®.
  • Give your child acetaminophen (Tylenol®) or ibuprofen (Advil® or Motrin®) as directed for the next 24 hours to help relieve the pain.
  • Children with severe sunburns may experience blistering of the skin – a true second-degree burn. These blisters may develop fluid beneath them. It’s best to leave the blisters alone – they will break on their own. Please leave any intact blisters uncovered. Once they break, you can apply an antibiotic ointment such as Neosporin or bacitracin to the area and cover it with a gauze pad.
  • Remember the risk of dehydration – offer your child plenty of water, juice, or sports drinks such as Gatorade®.
  • Try to reduce sun exposure for the next 24-48 hours, to give the skin a chance to recover.
  • Please work together with your child so that s/he can understand how and why s/he got burned, and can think of smart ways to prevent it from happening again.

When should I be worried?

Aside from their very dangerous long-term effects, most sunburns aren’t dangerous in the short run. Some children, however, develop very severe burns that need special attention, and dehydration is always a risk. Here are some things to look out for:

    • Fever, shaking chills, or goose bumps with pale, dry skin can be signs of actual heat stroke – this is a life-threatening emergency.
    • Light-headedness or dizziness with flushed, moist skin are signs of heat exhaustion – also an emergency.
  • Severe headache is a sign of significant dehydration and possibly heat stroke
  • Restlessness or excessive sleepiness after a long day in the sun
  • Signs of dehydration
    • Sunken appearance of the eyes
    • Dry tongue and mouth (dry lips are common and are not a sign of dehydration)
    • A sunken fontanel (soft spot) in an infant
    • Less than normal urination, or dark or strong-smelling urine
    • Being too sleepy (lethargic) or being very irritable or fussy
    • Cold, pale hands and feet even if the room is warm
  • Wheals or hives or other red, itchy rash
  • Cloudy fluid under blisters, or red, swollen, painful skin spreading away from blisters.

If any of these occur, please be sure to call your doctor’s office right away. If your child has any of the items listed above in bold print, please go directly to the emergency room.

Other points of concern

Even mild sunburns often peel after a few days. This can be itchy and unsightly, but it is a natural process. It’s best to discourage your child from picking at the skin, however. If the itching becomes intolerable, you can give your child diphenhydramine (dye-fen-hi-drah-meen; Benadryl® and many others) for itching. The main side effect of diphenhydramine is drowsiness, which is actually often helpful to a child whose itching is making him or her frantic. Diphenhydramine in topical lotions does not help itching more than the lotion itself.

Other Conditions that Might Be Present with a Sunburn

Some people with very sensitive skin develop a “sensitivity” reaction to sun that people often call “sun poisoning.” Doctors don’t understand the causes of sun poisoning, but of course they have a name for it (two names, in this case)! “Polymorphous light eruption,” or PLE, is the term doctors use for a very common condition in which a person breaks out into itchy red bumps, tiny blisters, or flat plaques from sun exposure. PLE is much more common in teen girls and women than it is in boys and men. Like sunburn, the best treatment for PLE is prevention either by avoiding the UV light of the sun or using a high-SPF sunscreen. “Solar urticaria” (urr-tick-area) (SU) is another form of sun poisoning in which a person develops itchy red wheals or hives, or sometimes flat plaques, within 5 – 10 minutes of being in the sun. Unlike sunburn and PLE, visible, not ultraviolet light causes SU. Since sunscreens don’t block visible light, they won’t help protect against SU. Gradually increasing exposure to direct sunlight, starting with just a few minutes, can help reduce the severity of SU.