Sunburn

What is sunburn?

Sunburn is the skin's reaction to too much exposure to ultraviolet (UV) radiation from the sun. You can see sunlight and feel heat (infrared radiation), but you can't see or feel UV radiation. It can be equally high and damaging on cool, cloudy days as it is on warm, sunny days.

UV radiation can pass through light cloud. It can also be scattered by particles in the air and reflected off surfaces such as buildings, concrete, sand and snow. You can’t feel UV do damage.

Sunburn can occur in as little as 11 minutes and you won’t even know the cell and DNA damage is happening. Skin can start to turn red within 3 to 4 hours but reaches peak skin reddening and inflammation between 12 to 24 hours after exposure.

Increased blood flow to the area, increases heat and swelling as the lymphatic system sends fluid to that area to try to repair the damage.
Because the sun also emits infrared energy, heat also effects the cells and cause burn damage showing as first-degree burns. The longer and stronger the duration of exposure the deeper the damage. Some people will even blister with second and third-degree burns.

Most of the cells in the epidermis that suffer from DNA and heat damage begin programmed cell death. Cell death causes outer dead layers to appear as skin peeling. New cells appear underneath but may still have DNA damage within the cells.

Depending on the severity, it can take days or weeks to heal.

Mild sunburn can be treated at home, but severe and blistered sunburn requires prompt medical attention.

Of the 5053 presentations to Victorian emergency departments for principal diagnosis of sunburn from July 2004 to June 2023, half were aged between 10-24 years (49.63%). In the age group 0-14 years, a higher proportion of boys (60.55%) than girls presented to ED with sunburn. Whilst among teenagers and young adults aged 15-24 years, a higher proportion of females (53.25%) than males presented to ED with sunburn.

The long-term effects of repeated bouts of sunburn include premature wrinkling and an increased risk of skin cancer, including melanoma (the most dangerous type of skin cancer). DNA in cells may be damaged, and, if not repaired by the body repeatedly over time, abnormal cells may develop, leading to cancer. This is why prevention is very important.

Symptoms of sunburn

The symptoms of sunburn include:

• changes in skin colour, ranging from pink to red and even purple
• skin that feels hot to the touch
• pain and/or itching
• swelling
• fluid-filled blisters that may itch and eventually pop or break
• broken blisters that peel to reveal even more tender skin beneath.

Reduce the risk of sunburn

To prevent sunburn and skin damage, use a combination of sun protection measures during the sun protection times each day (when the UV levels are forecast to reach 3 or higher). You can find these times on the SunSmart Global UV app or widget, or at the Bureau of Meteorology website.

In Victoria, UV levels are typically 3 and above from mid-August to the end of April. From May to mid-August, UV levels are usually low (below 3), so sun protection is not required, unless in high altitudes or near UV reflective surfaces such as snow or if outdoors for extended periods.

It is recommended that you use sun protection every day if you work outdoors as cumulative UV exposure adds up over time which adds to your risk of skin cancer.

During the daily sun protection times, use a combination of 5 sun protection measures to reduce your risk of skin damage and sunburn.

Slip – on sun-protective clothing (make sure it covers as much skin as possible).

Slop – on SPF (sun protection factor) 50+ broad-spectrum, water-resistant sunscreen. Apply 20 minutes before going outdoors and reapply every 2 hours.

Slap – on a broad-brimmed hat that protects your face, head, neck and ears.

Seek – shade.

Slide – on wrap-around sunglasses (make sure they meet Australian Standard AS/NZS 1067).

Watch a video of top tips for sunscreen use.

Treatment for sunburn

There is no cure for the symptoms of sunburn except time and patience. Treatment aims to help manage the symptoms while the body heals. Suggestions include:

• Drink plenty of water, because spending time in the sun can lead to dehydration as well as sunburn.
• Gently apply cool or cold compresses, or bathe the area in cool water.
• Avoid using soap as this may irritate your skin.
• Speak to a pharmacist about products that help soothe sunburn. Choose spray-on solutions rather than creams which require rubbing in by hand.
• Don't pop blisters. Consider covering itchy blisters with a wound dressing to reduce the risk of infection.
• If your skin is not too painful, apply moisturiser. This won't stop the burnt skin from peeling off, but it will help boost the moisture content of the skin beneath. Do not apply butter to sunburnt skin.
• Take over-the-counter pain-relieving medication, if necessary.
• Keep out of the sun until your skin has completely healed.

Peeling sunburnt skin

There's no cream or lotion that will stop burnt skin from peeling off. This is part of the natural healing process. When skin is peeling:

• Resist the temptation and don't pick at the skin. Allow the dead skin to detach on its own.
• Remove detached skin carefully and slowly. Don't rip skin off or you risk removing more skin than you intended.
• Apply antiseptic cream to the newly revealed skin to reduce the risk of infection.

Treatment for severe sunburn

See a doctor or seek treatment from the nearest hospital emergency department if you experience:

• severe sunburn with extensive blistering and pain
• sunburn over a large area of skin
• headache
• nausea and vomiting
• fever
• dizziness or altered states of consciousness.

Sunburn prevention is best

Suggestions on how to avoid getting sunburnt and UV damage include:

• Don't assume that sun exposure is safe when you can't feel it sting your skin – that sting or bite is heat, not UV radiation. If you're not sure, don't chance it – check the sun protection times for your location.
• UV radiation levels aren't linked to temperature. Don't rely on the temperature to gauge when you need sun protection. Check the sun protection times each day and Slip! Slop! Slap! Seek! and Slide!
• Many Australians get sunburnt around water, at the beach or the pool. Always use a combination of sun protection measures, never rely on just one to protect you.
• You can get sunburnt when you're relaxing and taking it easy, such as watching outdoor sports, picnicking at the park or while playing sports.
• Winter activities, such as snow skiing and snowboarding pose a high risk of sunburn because UV radiation is already higher in alpine regions than at sea level. Snow is also very efficient at reflecting UV radiation.
• What many people assume is 'windburn' is actually sunburn. While wind can dry the skin, it doesn't burn.
• A tan doesn't protect against skin and eye damage, or the risk of skin cancer.
• All babies under 12 months should be kept out of direct sun when UV levels are 3 or higher. Physical protection such as dense shade, cool covering clothing and soft broad-brimmed hats are the best sun protection measures. For those small areas of exposed skin not protected by clothing or hats, apply sensitive or toddler sunscreen to infants 6 months and older. The widespread use of sunscreen on babies under 6 months old is not recommended.

Where to get help

• Your GP (doctor)
• Pharmacist
• NURSE-ON-CALL Tel. 1300 606 024 – for expert health information and advice (24 hours, 7 days)
• Cancer Council Tel. 13 11 20 – for information and support
• Cancer Council – multilingual resources Tel. 13 14 50
• SunSmart Tel. (03) 9514 6419
• Radiation Safety Hotline, Department of Health, Victorian Government Tel. 1300 767 469