By Martha A. Simpson, D.O., M.B.A.
Assistant Professor of Family Medicine
Ohio University College of Osteopathic Medicine

TO PREVENT SUNBURN AVOID NOONTIME SUN, WEAR PROTECTIVE CLOTHING

Question: Last Saturday, after lunch, I went outside to work in my garden wearing a short sleeve shirt, short pants and sandals. I was only out for about an hour and got a painful sunburn on the exposed areas of my feet, legs and arms. I did have a hat on so my head is OK. Why did I burn so quickly, when usually I tan rather than burn? What precautions should I take in the future?

Answer: I think the reason you burned with relatively short sun exposure has to do with the time of day that you did your gardening. But, before I get into more specifics about prevention and treatment of sunburn, let me first give you a brief course in “sunburnology.”

Sunburn is produced when sunlight damages the deeper growing layers of the skin. The resulting irritation to the skin, blood vessels, and associated tissue causes the inflammation we call sunburn. In addition to being painful, the burn can interfere with the skin’s functions of protecting us from injury and helping maintain the ideal environment for the body’s cells.

The skin is rich with nerve endings. These keep us informed about the environment around us by allowing us to feel the size, shape and texture of everyday objects as well as sense temperature and pain. The pain of sunburn develops when these nerve cells are stimulated as part of the inflammation of the sunburn. The label “sunburn” only tells that the damage came from being out in the sun, not the extent of the injury.

The health problems associated with burns are related to the amount -- the area -- of skin involved, the depth of burn, the individual’s age and pre-existing health conditions (e.g., diabetes) that may be present. The specific cause of the burn --the sun, boiling water, chemical injury or other cause -- is not important. The extent of skin damage is what counts and also what determines if you should see your doctor about it.
Typically, sunburn is painful with or without being touched. The “sunburned” look and discomfort improve after two or three days. The dead, damaged skin usually peels off in a week or two. This type of burn is referred to as a superficial, or first-degree, burn.

A second-degree or partial thickness burn produces damage deeper into the skin and can be very painful. Even air blowing across the burn can hurt. In addition to the pain, the skin will blister. Healing usually takes two or three weeks, and a permanent mild scar or change in skin color may sometimes result.

As a general guideline, if your burn doesn’t seem any worse than mild sunburn, you can probably take care of it yourself. Protect the skin -- stay out of the sun -- and take aspirin, acetaminophen or ibuprofen for the discomfort. Don’t put butter or other “gooey” substances on the burn. There are several non-prescription “sunburn” lotions and sprays that are soothing, but they will not hasten the healing of damaged skin.

If you feel sick because of the burn, or if it covers a large percentage of your body, you should see your doctor. More severe burns with immediate blistering or blackening of the skin should have a doctor’s attention today –- don’t wait until next week. Deep burns over a large amount of the body surface can be immediately life threatening and require prompt hospitalization.

Here are two tips that will help you and my other readers from having to deal with the pain of sunburn again:

• Avoid being outdoors during the hours of the day when the sun’s rays are the most direct -- between about 10 a.m. and 2 p.m.
• When you go outside during the day, protect your skin with clothing or by putting a number 15, or higher, sunscreen lotion on the exposed areas of your body. Remember, a thin shirt or a water soaked one doesn’t provide much protection. You may need sunscreen on your back even though you have a shirt on.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnosis and recommend treatment for any medical conditions. Past columns are available online at http://www.FamilyMedicineNews.org.