Suppressing the Sizzle of Sunburn! Wayne Emineth, PA-C

Friday, July 6th, 2018

What is sunburn and why doesn’t it hurt right away?

At the beginning: A person gets too much sun while not wearing sunblock and/or not wearing protective clothing nor a hat.

Sunburn is not like a burn from heat. The injury from sunburn builds in the hours after being exposed to an excess of ultraviolet light made up of UVA tanning rays and UVB burning rays. Thankfully UVC-mutation-causing rays are absorbed by the ozone layer in the atmosphere.

The UV light does several things to the living cells of the skin.

Changes in the appearance of the skin and skin cancer

Accumulated sun damage and sunburns will lead to skin discoloration, wrinkles, freckles, moles, possible abnormal changes in existing moles and lead to skin cancer. Prevention is the best practice.

Ultraviolet light that causes sunburn and tanning also damages the lenses of the eyes leading to cataracts later in life. Wear UV blocking sunglasses to reduce your exposure.

Suppression of immune function.

Too much sun can suppress the immune system enough to activate shingles and fever blisters/herpes.

Direct cell damage.

Each sunburn will cause the death of millions of skin cells. It is a lot of work for the body to replace all of these skin cells. The resultant loss of skin cell barrier function can open the door for infection.

DNA damage.

UVA light penetrates deeply into the skin and directly blasts apart DNA. DNA does not have nerve endings and therefore UVA damage does not hurt. Broken DNA has to be repaired. The problem is that the skin did not know the sunburn was coming so the skin did not make extra DNA repair enzymes ahead of time. This means it takes a long time to repair the damage. Each time the DNA is damaged some parts will not be repairable. UVA (tanning) light does the most long term damage to our DNA. 

Free radicals

UVB light has higher energy than UVA but does not penetrate as deeply. UVB is what causes the pain and redness of sunburn. UVB explodes molecules at the surface of the skin creating oxygen free radicals. These free radicals will pull apart one molecule after another until an anti-oxidant stops them. When a person gets a lot of sun there is a specific smell on the skin--that smell is ozone which is a free radical and a sign of injury and damage. Pain and redness appear hours after being in the sun as a result of accumulating damage from oxygen radicals and inflammation. As damage from free radicals accumulates, inflammation, pain and redness will increase.

UVB does one good thing-it turns inactive Vitamin D-2 into active Vitamin D-3. Vitamin D-3 is an anti-oxidant and does help to reduce damage from free radicals. UVA does not activate vitamin D, thus tanning beds which produce only UVA do more damage than natural sun which has both tanning and burning rays. A person does not have to damage their skin to get vitamin D-3, just swallow a D-3 pill and/or eat salmon, tuna, eggs or cheese.

What to do once a person gets a non blistered 1st degree sunburn.

Get out of the sun and stay out of the sun. Don’t layer more damage onto sunburned skin.

Get some Aleve or Advil Liquigels, swallow a couple and poke a hole in a couple more, squeeze the Liquigel onto the skin with a bit of water and rub it in. Yes, you should apply the “anti-inflammatory” Aleve/Advil medication to the skin. It will reduce pain and reduce inflammation in the skin, possibly prevent some blistering. 

Steroid/Cortisone anti-inflammatory creams also suppress immune function and are second choice for sunburn inflammation. 

Anti-inflammatory medications like Aleve/Advil liquigels are best. The concept already exists in an arthritis medication called Voltaren gel which is applied to the skin to reduce joint inflammation. Voltaren is not the best choice for sunburn because it contains alcohol that will cause a different kind of burning to sunburned skin.

Anti-oxidant rich foods like blackberries, raspberries, green tea, mangos are essential. These will help to soak up the oxygen radicals and limit the additional damage the oxygen radicals might cause.

Applying aloe or a hypoallergenic moisturizer helps preserve the skin’s barrier function. Oatmeal baths can sooth the skin and moisturize all over.

What to do if a person gets a blistered 2nd degree sunburn

Do NOT pop the blisters. As long as the skin is intact infection cannot get in. Once the blisters are broken, you and we have to worry about infection, take measures to prevent it, and likely treat it.

Call for an appointment, because when the blisters break, then infection can and probably will get in. A blistered sunburn of a large area can cause a person to actually become dehydrated by the loss of fluid into the blisters and weeping of fluid from ruptured blisters.

As Ben Franklin noted centuries ago, “An ounce of protection (sunscreen) is worth a pound of cure (aloe, steroids, Advil/Aleve).