Sunburn is from over-exposure to the harmful ultraviolet rays of the sun. While the symptoms are usually temporary (such as red skin that is painful to the touch), the skin damage is often permanent and can have serious long-term health effects, including skin cancer.

Keep in mind:

• There is no such thing as a "healthy tan." Unprotected sun exposure causes premature aging of the skin.
• Sun exposure can cause first and second degree burns.
• Skin cancer usually appears in adulthood, but is caused by sun exposure and sunburns that began as early as childhood. You can help prevent skin cancer by protecting your skin and your children's skin from the harmful rays of the sun.

• Infants and children are especially sensitive to the burning effects of the sun.
• People with fair skin are more likely to get sunburn. But even dark and black skin can burn and should be protected.
• The sun's rays are strongest during the hours of 10:00 a.m. to 4:00 p.m. The sun's rays are also stronger at higher altitudes and lower latitudes (closer to the tropics). Reflection off water, sand, or snow can intensify the sun's burning rays.
• Sun lamps can cause severe sunburn.
• Some medications (such as the antibiotic doxycycline) can make you more susceptible to sunburn.

The first signs of a sunburn may not appear for a few hours. The full effect to your skin may not appear for 24 hours or longer. Possible symptoms include:

• Red, tender skin that is warm to touch.
• Blisters that develop hours to days later.
• Severe reactions (sometimes called "sun poisoning"), including fever, chills, nausea, or rash.
• Skin peeling on sunburned areas several days after the sunburn.

• Try taking a cool bath or shower. Or place wet, cold wash cloths on the burn for 10 to 15 minutes, several times a day. You can mix baking soda in the water to help relieve the pain. (Small children may become easily chilled, so keep the water tepid.)
• Apply a soothing lotion to the skin.
• Aloe gel is a common household remedy for sunburns. Aloe contains active compounds that help stop pain and inflammation of the skin.
• An over-the-counter pain medication, such as acetaminophen or ibuprofen may be helpful. DO NOT give aspirin to children.

• DO NOT apply petroleum jelly, benzocaine, lidocaine, or butter to the sunburn. They make the symptoms worse and can prevent healing.
• DO NOT wash burned skin with harsh soap.

Call immediately if there are signs of shock, heat exhaustion, dehydration, or other serious reaction. These signs include:

• Feeling faint or dizzy
• Rapid pulse or rapid breathing
• Extreme thirst, no urine output, or sunken eyes
• Pale, clammy, or cool skin
• Nausea, fever, chills, or rash
• Your eyes hurt and are sensitive to light
• Severe, painful blisters

• Avoid sun exposure during hours of peak sun ray intensity.
• Apply generous amounts of sunscreen with a sun protection factor (SPF) of at least 30. Pay special attention to your face, nose, ears, and shoulders. The higher the SPF, the greater the protection.
• Apply sunscreen 30 minutes prior to sun exposure to allow penetration. Re-apply after swimming and every 2 hours while you are outdoors.
• Wear sun hats. There is also SPF clothing and swimwear available.
• Wear sunglasses with UV protection.
• Use a lip balm with sunscreen.

Kaplan LA. Exposure to Radiation from the Sun. In: Auerbach PS. Wilderness Medicine. 5th ed. St. Louis, Mo: Mosby; 2007: chap. 14.

Han A, Maibach HI. Management of acute sunburn. Am J Clin Dermatol. 2004;5(1):39-47.