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Sun Damaged Skin

Overview

Everyone benefits from the warmth and light of the sun. It is essential for the body to produce vitamin D and can affect your mood. Too much sun exposure, however, can cause skin damage. Ultraviolet rays (UV) can cause burning and long-term changes. The most common types of damage to the skin are:

Dry skin: Sun-exposed skin can gradually lose moisture and oils, causing it to appear dry, flaky, and prematurely wrinkled, even in young people.
Sunburn: Sunburn is the common name for the damage that occurs immediately after the skin is exposed to excessive UV radiation. Mild sunburn causes only reddening of the skin, but more severe cases may have tiny fluid-filled bumps or larger blisters.
Actinic keratosis: These are small patches of sun-damaged skin that vary in color - pink, red, yellow or brownish. They are a warning sign of increased risk of skin cancer. About 10 to 15 percent of actinic keratoses eventually change into squamous cell skin cancers.
Photoaging (premature aging): The skin develops wrinkles and fine lines due to changes in the collagen in the deep layer of the skin called the dermis.
Actinic purpura: This comes from UV radiation damaging the structural collagen that supports the walls of the skin's blood vessels. The vessels become more fragile and easily rupture with just slight impact.

Repeated episodes of sunburn and unprotected sun exposure increase the risk for malignant melanoma and other forms of skin cancer. People with fair skin are at the greatest risk for sun damage. Their skin contains less of the pigment called melanin, which helps protect the skin from UV radiation. According to a paper published by the National Institutes of Health, just five sunburns in a lifetime are sufficient to raise the risk of sun damage and skin cancer significantly.

Any exposed part of your body can burn, including ear lobes, the scalp, and lips. Even covered areas can burn, if the clothing is a loose weave that allows UV light through.

Signs And Symptoms

Signs and symptoms of sunburn usually appear within a few hours after sun exposure. It can take a day or two for the full extent of the damage to appear.

Signs and symptoms include:

Reddening
Feels warm or hot to touch
Pain, tenderness or itching
Swelling
Small fluid-filled blisters which may break
Headache, fever, chills, and fatigue if the sunburn is severe

Causes And Risk Factors

Sunburns are caused by exposure to too much UV light. UV light is not visible to the human eye but can be very harmful to the skin. Ultraviolet A (UVA) and ultraviolet B (UVB) are the two types of radiation most responsible for sunburn. Sun lamps and tanning beds also produce UV light and can cause the skin to burn.

Because ultraviolet rays are the cause sunburn, you can still develop a sunburn on cool or cloudy day. As much as 80 percent of UV rays pass through clouds. Snow, ice, sand, water and other surfaces can reflect UV rays, burning skin as badly as direct sunlight.

Risk factors include:

Fair skin
Working outdoors
Outdoor recreation with alcohol consumption
A history of sunburn, especially between the ages of 15 and 20 years
Regularly exposing skin to UV light from artificial sources such as tanning beds
Medications that cause photosensitivity of the skin

Immediate complications of sunburn include ruptured blisters that may become infected. Sun exposure and repeated burns cause premature aging of the skin. Photoaging causes weakening of connective tissue decreasing its strength and elasticity. The sun causes the skin to become rough and dry. Prolonged sun exposure will also form deep wrinkles, fine lines, and red veins on the cheeks, nose and ears to appear on the skin. It causes freckling and areas of dark or discolored spots on the face, arms, chest and upper back, called solar lentigines.

Excessive sun exposure, even without sunburn, increases the risk for skin cancer. Sunburns in childhood and adolescence increase the risk of melanoma. Skin cancer develops mainly on areas of the body most exposed to sunlight, including the scalp, face, lips, ears, neck, chest, arms, hands and legs.

Some types of skin cancer appear as a small growth or a sore that bleeds easily and doesn’t heal. A skin cancer can also appear in the form of a changing mole. See your doctor if you notice a new or changing skin growth.

Treatment

Sunburn treatment doesn’t heal the skin or prevent damage, but it can reduce pain and swelling. These tips may reduce your pain and discomfort:
Take a pain reliever, such as ibuprofen and naproxen, to help control pain, until redness subsides.
Cool the skin with a damp compress, such as a towel wrung out in cold water. Don’t apply ice directly on the skin – it can cause or increase skin damage.
Apply moisturizer, aloe vera lotion or gel, or cortisone cream. It may decrease pain and swelling, and speed healing. A low dose (0.5 – 1 percent) hydrocortisone cream can reduce swelling and speed healing. If the blisters break open, wash with gentle soap and water, apply an antibiotic cream or ointment and cover with a damp dressing.
Choose a clean, simple moisturizer for best results.
If blisters form, don’t break them. It slows healing and increases risk of infection.
Drink plenty of fluids, especially water. Sun exposure, burn and heat increase fluid loss through the skin.
Treat peeling skin gently. Continue to use moisturizer.
Protect the burned skin from further sun exposure.
Avoid applying “caine” products, such as benzocaine, used topically to reduce pain by numbing the skin. It has been linked to a condition called methemoglobinemia. It decreases the amount of oxygen which can be carried by blood and should not be used on children. Adults should not use more than the recommended dose, at the recommended frequency.

Prevention

Use these methods to prevent sunburn:

Avoid sun exposure between 10 a.m. and 4 p.m., when the sun’s rays are strongest. Schedule outdoor activity at other times. Limit the length of time you’re in the sun. Seek shade when possible.
Cover up. Wear tightly woven clothing. Dark clothes are more protective. Wear a broad-brimmed hat.
Nourish your skin daily with a 100% pure botanical moisturizer.
Use natural sunscreen frequently and generously – choose sunscreens that do not include parabens or petroleum-based chemicals (for more information read our free report, “The Poisons You Put On Your Face Everyday”). No matter what the natural skin color or type, use a broad-spectrum sunscreen, which blocks both UVA and UVB rays. The American Academy of Dermatology recommends using a product with a minimum sun protection factor (SPF) of 30. Apply it generously, every 2 hours. The Centers for Disease Control and Prevention does not recommend products that also contain insect repellents.

Your Questions Answered

I already have a tan. It protects me from burning, right? Research shows that a few sessions of indoor tanning before outside exposure to direct sunlight do not protect a person from repeat sunburn. Also, the long-term consequences of repeated tanning and burning are greater than any benefit from a base tan.
Is sunscreen safe for my children? Under age 6 months, sunscreen should not be applied. The American Academy of Pediatrics recommends using other sun protection, such as covering with clothing and using shade.
My eyes feel “gritty” when I get sunburned. Can my eyes burn, too? Yes. Wear sunglasses with the highest protection-rated lenses. It’s best to wear sunglasses that fit close to the face, in a wrap-around style.
Should I see a doctor if my eyes hurt? If pain relievers don’t help and the discomfort doesn’t improve, you should see your doctor.
I got sunburned all the time when I was a teenager. Isn’t it too late to do anything now? You should still take appropriate measures to protect yourself from sun, to prevent additional damage.
Isn’t getting a tan good for me? There are no benefits to health from tanning. Less sunlight than a tan is sufficient for the body to synthesize vitamin D.
Is it safe to tan before 10 a.m. and after 4 p.m.? Sun exposure can damage skin and cause burning even during the hours when the sun in less intense.
I have red streaks radiating out from broken blisters. What’s that? Infection may have entered the broken blisters and allowed infection. See your doctor.
When should I see a doctor for sunburn? You should see a doctor if the skin is blistered and covers a lot of the body, if you have fever, headache, confusion, nausea, or chills, or if it doesn’t improve after two days.
How will I know if it’s infected? If pain, swelling and tenderness are increasing, or if there is pus coming from a broken blister, or red streaks leading away from the wound it may be infected. See your doctor.

Article Written By Sheila M. Krishna M.D., FAAD

Dr. Krishna is a board certified dermatologist. She received her undergraduate degree at the Massachusetts Institute of Technology where she double majored in biology and foreign languages and graduated with Phi Beta Kappa honors. She is fluent in both English and Spanish. Dr. Krishna received her medical degree at the David Geffen School of Medicine at the University of California, Los Angeles, where she was a member of the Alpha Omega Alpha Medical Honor Society. She completed her dermatology residency at the Virginia Commonwealth University in Richmond, Virginia, and she served as Chief Resident in the Department of Dermatology. She completed an additional research year at UCLA with Dr. Lloyd Miller, where she gained expertise in research methods and protocol design and execution. Dr. Krishna is a Fellow of both the American Academy of Dermatology (AAD) and the American Society for Mohs Surgery (ASMS). Dr. Krishna practices in San Diego, California where she treats adults and children for skin conditions. Dr. Krishna was selected as a Top Doctor by her peers in San Diego in 2017. Website - https://www.sheilakrishnamd.com/