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SUNBURN

DESCRIPTION

Sunburn is inflammation of the skin that follows overexposure to the sun, sun lamps, or occupational light sources. Exposed skin on any part of the body is involved.
Appropriate health care includes:
  • Self-care for minor sunburn.
  • Doctor's treatment, but usually only necessary for severe sunburn.

    SIGNS & SYMPTOMS

  • Red, swollen, painful, and sometimes blistered skin.
  • Chills and fever.
  • Nausea and vomiting (severe burns).
  • Delirium (severe, extensive burns).
  • Tanning or peeling of the child's skin after recovery, depending on severity of the burn.

    CAUSES
    Excess exposure to ultraviolet (UV) light. This is not screened out by thin clouds on overcast days, but it is partially screened by smoke and smog. A great deal of ultraviolet light reflects from snow, water, sand, and sidewalks.

    RISK FACTORS

  • Genetic factors, especially fair skin, blue eyes, and red or blonde hair.
  • Exposure to industrial light sources, such as welding arcs.
  • Use of drugs, including sulfa, tetracyclines, amoxicillon, or oral contraceptives.

    PREVENTING COMPLICATIONS OR RECURRENCE

    Instructions for your child to avoid sunburn:
  • Avoid the sun from noon to 3 p.m.
  • Use a sun-block preparation for outdoor activity. Products with a sun-protective value of 20 or more protect almost totally. Those with lower values offer partial protection and allow minimal tanning. Some of these resist water and perspiration, but reapply them after swimming or after prolonged exposure. Baby oil, mineral oil, or cocoa butter offer no protection from the sun.
  • For maximum protection, use a physical-barrier agent such as zinc-oxide ointment. Reapply after swimming and at frequent intervals during exposure. Barrier agents are especially helpful on skin areas that are most susceptible to burns, such as the nose, ears, backs of the legs, and back of the neck.
  • If you rarely burn, use a sun-screen product that permits tanning and provides minimal protection.
  • Wear muted colors such as tan. Avoid brilliant colors and whites, which reflect the sun into your face.
  • If you insist on tanning, limit your sun exposure on the first day to 5 to 10 minutes on each side. Add 5 minutes per side each day.

    BASIC INFORMATION

    MEDICAL TESTS

  • Your own observation of symptoms.
  • Medical history and physical exam by a doctor.

    POSSIBLE COMPLICATIONS

  • Skin changes leading to skin cancer, including life-threatening malignant melanoma.
  • Keratoses, pre-malignant skin lesions.
  • Premature wrinkling and loss of skin elasticity.
  • Temporary delirium in worst cases.

    PROBABLE OUTCOME
    Spontaneous recovery in 3 days to 3 weeks, depending on the severity of the child's sunburn.

    TREATMENT

    HOME CARE

  • To reduce heat and pain, dip gauze or towels in cool water and lay these on the child's burned areas.
  • After skin swelling subsides, apply cold cream or baby lotion.
  • For badly blistered skin, apply a light coating of petroleum jelly. This prevents anything from sticking to the child's blisters.

    MEDICATION

  • Use non-prescription drugs, such as aspirin or acetaminophen, to relieve pain and reduce fever. Non-prescription burn remedies that contain local anesthetics, such as benzocaine or lidocaine, may be useful, but they produce allergic reactions in some children.
  • Your doctor may prescribe pain relievers or cortisone drugs for your child to use briefly.

    ACTIVITY
    Your child should rest in any comfortable position until fever and discomfort diminish. Covering the child with an upside-down "cradle" or tent of cardboard or other material helps to keep bed linens off the burned skin.

    DIET & FLUIDS
    No special diet. Your child should increase fluid intake.

    OK TO GO TO SCHOOL?

    When appetite has returned and alertness, strength, and feeling of well-being will allow.

    CALL YOUR DOCTOR IF

    The following occurs after sunburn:

  • Oral temperature spikes (rises suddenly) to 101F (38.C).
  • Vomiting or diarrhea.
  • Delirium.
  • Pain and fever that persist longer than 48 hours. ‡
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