FAMILY MEDICINE® COLUMN

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

A SUNBURN IS A REAL BURN -- TREATMENT DEPENDS ON SEVERITY

Question: I was working outside the other day and managed to get a sunburn. It has peeled and now I'm fine, but why does a burn hurt so much? Is it best to put medicine on a sunburn or to let it "air"?

Answer: The skin is the largest and some say the most important organ of the body. It protects us from injury and helps maintain the ideal environment for the body's cells. A 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 a sunburn.

The skin is rich with nerve endings that keep us informed about the environment around us -- feeling the size, shape and texture of everyday objects, sensing temperature and pain. When we get a sunburn, the skin inflammation stimulates these nerve cells and they say "OUCH!" That is why a sunburn hurts.

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 of skin involved, the depth of burn, the individual’s age and pre-existing health conditions -- such as diabetes -- that may be present. Whether the burn was produced by the sun, boiling water, chemical injury or other cause is much less important.

A mild sunburn is typically 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 burn produces deeper skin damage. Blisters occur as does pain. Even air blowing across this type of burn is painful. The healing usually takes two or three weeks and a permanent mild scar or change in skin color may result.

A third-degree burn damages all the layers of skin. Touching a new third-degree burn with slight pressure may give some discomfort, but it's nothing like the sheer agony that this would produce if it was a less severe second degree burn. Healing takes many weeks and always produces a scar.

Now to address your question about burn treatment. As a general guideline, if your burn doesn't seem any worse than a 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.

The best way to treat a burn is to prevent it. Here are two tips that will help you avoid having to deal with the pain of sunburn again: First, avoid being outdoors during the parts of the day when the sun’s rays are the most direct -- between about 10 a.m. and 2 p.m. Second, When you go outside during the day, put a number 15, or higher, sunscreen lotion on the exposed areas of your body.

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, or via e-mail to readerquestions@familymedicinenews.org. 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 diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.