Sunburn

• Red or blistered skin from too much sun
• The redness, pain and swelling starts at 4 hours after being in the sun
• It peaks at 24 hours, and starts to get better after 48 hours

Severity of Sunburn

• Most sunburn is a first-degree burn that turns the skin pink or red.
• Prolonged sun exposure can cause blistering and a second-degree burn.
• Rarely, severe sunburn can cause a third-degree burn or scarring.

Causes of Sunburn

• Direct sun exposure. Warning: clouds don't help. 70% of UV light still gets through on cloudy days.
• Reflected sun rays. From snow 80% is reflected, from sand 20%, from water only 5%.
• Tanning lamp or sun lamp.
• Tanning bed. A common cause in teens.

Ibuprofen to Reduce Pain and Other Symptoms

• Sunburn is an inflammatory reaction of the skin.
• Ibuprofen is a drug that can block this reaction. It can reduce the redness and swelling. But, it needs to be started early.
• Sunburns are sneaky. Many parents are surprised when their child gets a sunburn. Reason: there are no warning signs while the burn is occurring.
• Redness (sunburn) often is not seen until 4 hours after being in the sun. The pain and redness keep getting worse. They don't peak for 24 to 36 hours. 
• Lesson: if you think your child got too much sun, start ibuprofen then. Give it 3 times per day for 2 days. Don't wait for redness.

Call 911 Now

• Passed out (fainted) or too weak to stand
• You think your child has a life-threatening emergency

Call Doctor or Seek Care Now

• Fever higher than 104° F (40° C)
• Can't look at lights because of eye pain
• Fever and looks infected (spreading redness more than 48 hours after the sunburn)
• Your child looks or acts very sick
• You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

• Sunburn pain is severe and not better after using care advice
• Large blisters (more than ½ inch or 12 mm)
• Many small blisters at the burn site
• Blisters on the face
• Swollen feet make it hard to walk
• Looks infected (draining pus, red streaks, worse pain after day 2) and no fever
• You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

• Itchy rashes in sun-exposed skin occur many times
• You have other questions or concerns

Self Care at Home

• Mild sunburn

Care Advice

Treating Mild Sunburn

What You Should Know About Sunburns:

• Most sunburns do not blister.
• Most blisters can be treated without needing to see a doctor.
• Here is some care advice that should help.

Ibuprofen for Pain:

• For pain relief, give an ibuprofen product (such as Advil). Start this as soon as you can.
• Give every 6-8 hours.
• Reason: if started within 6 hours, it can greatly limit the pain and swelling. Must give for 2 days.
• Caution: not approved for age under 6 months.

Steroid Cream for Pain:

• Use 1% hydrocortisone cream (such as Cortaid) as soon as possible. No prescription is needed.
• Put it on 3 times per day.
• If used early and continued for 2 days, it may reduce swelling and pain.
• Use a moisturizing cream or aloe vera cream until you can get some.
• Use creams only. Avoid putting ointments on red skin. Reason: they can block the sweat glands.
• Burned skin can be very painful. Covering it with a cream can give great relief.

Cool Baths for Pain:

• Use cool wet washcloths to the burned area. Do this several times a day to reduce pain and burning.
• For larger sunburns, give cool baths for 10 minutes. Caution: avoid any chill. Can add 2 ounces (60 mL) baking soda per tub.
• Do not use soap on the sunburn.

Fluids - Offer More:

• Offer extra water on the first day.
• This helps to replace the fluids lost into the sunburn.
• This will also help to prevent dehydration and dizziness.

Blisters - Don't Open:

• Caution: leave closed blisters alone. Reason: to prevent infection.
• For broken blisters, trim off the dead skin. Use a fine scissors cleaned with rubbing alcohol.

Antibiotic Ointment for Open Blisters:

• For any large open blisters, use an antibiotic ointment (such as Polysporin). No prescription is needed.
• Remove it with warm water. Then, reapply it 2 times a day for 3 days.

What to Expect:

• Pain stops after 2 or 3 days.
• Peeling occurs day 5-7.

Call Your Doctor If:

• Pain becomes severe
• Sunburn looks infected
• You think your child needs to be seen
• Your child becomes worse

Preventing Sunburn

Sunscreens:

• Use a sunscreen with an SPF of 15 or higher. Fair-skinned children need a sunscreen with an SPF of 30. This is especially true if your child has red or blond hair.
• Put sunscreen on 30 minutes before exposure to the sun. This gives it time to get down into the skin. Give special attention to the areas most likely to become sunburned. Examples are the nose, ears, cheeks, and shoulders.
• Put sunscreen back on every 3 to 4 hours. Apply often while swimming or if sweating a lot. A "waterproof" sunscreen stays on for about 30 minutes in water.
• Most people use too little sunscreen. The average adult requires 1 ounce (30 mL) of sunscreen at a time.
• The best way to prevent skin cancer is to prevent sunburns.

Infants and Sunscreens:

• The skin of infants is thinner than the skin of older children. It is more sensitive to the sun. Sunburns can occur quickly.
• Sun avoidance is best for children under 6 months. Stay in the shade.
• Sun avoidance or sun proof clothing are best for children 6 months to 3 years. If they have to be in the sun, use clothes that fully cover the arms and legs. Also, have your child wear a hat with a brim. Apply sunscreen to exposed skin. Use a stroller with a canopy.
• When a sunscreen is needed, infants can use adult sunscreens. The FDA hasn't approved their use under 6 months old. However, the AAP supports their use at this age. There are no reported harmful side effects from today's sunscreens.

Protect Lips, Nose and Eyes:

• To prevent sunburned lips, apply a lip coating that contains sunscreen.
• If the nose or some other area has been burned often, protect it completely. Use zinc oxide or titanium oxide ointment.
• Protect your child's eyes from the sun's rays and cataracts with good sunglasses.

High-Risk Children:

• Some children are at higher risk for sunburn. If your child has red or blond hair, he is at higher risk. Fair-skinned children and children who never tan are also at higher risk.
• These children need to use a sunscreen even for brief exposures.
• They should avoid sun exposure whenever possible.

High-Risk Time of Day:

• Avoid exposure to the sun during the hours of 11:00 AM to 3:00 PM. This is when the sun's rays are most intense.
• Caution: when overcast, over 70% of the sun's rays still get through the clouds.

Care Advice

This shows a second degree burn on the face. The area is red, raised and blistered.

This shows a first-degree sunburn on the chest. It is red without blistering.