Learn From Your Burn: Understanding & Preventing Sunburn
Why Am I Getting Sunburned?
Sunburn may seem like no big deal, but it's an actual radiation burn of your skin from the sun's UVB rays that penetrate the skin's surface. The sun's UVB light damages the DNA of your skin cells, causing them to mutate and literally to self-destruct. This triggers the release of inflammatory substances in skin, called cytokines, resulting in the redness, swelling, tightness, and pain we all know as sunburn.
We often hear from people who've gotten sunburned despite the fact that they applied sunscreen. This happens because lots of people don't know how to apply sunscreen and because wearing sunscreen isn't enough; you can't just put on sunscreen and then bask in the sun or walk around without shade all day long.
Many factors contribute to the risk of sunburn, including geographic location (it's much easier to get a sunburn in Australia or Arizona than in northern Canada or Russia), skin color, the kind of sunscreen you use, how much you apply, how often you apply and reapply, the time of day, and even certain medications you may be taking.
The more you know about the risk factors that contribute to sunburn and how to treat sunburned skin, the better you'll be able avoid the burn and keep your family sun-safe, too.
Skin Color and Sunburn
Sunburn can happen to anyone, regardless of ethnicity or skin color. No matter how much pigmentation your skin has, you must apply sunscreen with an SPF of 15 or greater (and greater is better) liberally on a daily basis to avoid sun damage, even when the sun isn't shining. (UV rays can cause sunburn even on cloudy days—sun damage is about daylight, not just when the sun is visible).
According to the Fitzpatrick Skin Phototypes chart that follows, those with lighter skin tones are more susceptible to what we commonly describe as sunburn, but those with darker skin tones aren't off the hook: In some cases, darker skin tones can burn, or at least feel the effects of too much time in the sun, even without seeing redness or peeling. And persons of any skin color can suffer the aging effects of sun damage, including skin cancer. Knowing your Fitzpatrick type is a good way to determine your risk of sunburn and to plan smart sun behavior.
Fitzpatrick Skin Phototypes:
Based on the chart above, those with Fitzpatrick Types I–III are the most susceptible to sunburn and should take the most precautions. Those with Fitzpatrick Type IV skin should be careful, too, while Types V and VI have enough melanin (skin pigment) to make their skin less susceptible to a painful, red burn—but even darker skin still needs (and will benefit from) sun protection! Regardless of your skin color, premature aging of the skin from sun damage will happen if you don't provide the proper protection.
How to Avoid Future Sunburns
To avoid sunburn, you should ask yourself several questions:
- Have you checked the expiration date on your sunscreen?
- Do you know how much sunscreen to apply before going outside, and how often to reapply?
- Are you avoiding the sun during peak hours (typically 10:00 a.m.–2:00 p.m.)?
- Are you relying only on sunscreen, and not wearing protective clothing, hats, and sunglasses?
- Are you seeking shade whenever possible?
- Is your skin becoming darker, but you're not doing anything to get it out of direct sunlight?
Knowing the answers to these questions, and implementing them, is the secret to enjoying the sun without harming your skin. Here are the answers to those questions.
Expired Sunscreen: Sunscreens don't last forever! Most reputable brands have an expiration date on the label, but a good rule of thumb is to toss any sunscreen that is over a year old. This is especially important if the sunscreen has been opened and exposed to heat or light, which reduces its effectiveness. Yes, that means that keeping sunscreen in a hot car all summer is a bad idea.
Tips for Applying Sunscreen: Many people wonder how much sunscreen to apply. "Liberal application" is stressed, but how much sunscreen equates to liberal? If we're just talking face and neck, liberal application is a nickel- to quarter-size amount for each area. This amounts to approximately ¼ teaspoon for the face and the same amount for the neck, which is the general recommendation of physicians.
It's important to apply sunscreen liberally on any areas not protected by clothing. For those days when you're exposing a lot of skin to the sun (think bathing suit and no cover-up), you should apply at least 1 ounce (a shot glass full) of sunscreen from head to toe. Common areas people miss when applying sunscreen are the tops of the ears, back of the hands, and tops of the feet. Tip: Avoid burying your feet in the sand because the abrasive nature of the sand literally scrubs the sunscreen off your feet.
Reapplying sunscreen every 2 hours is a good guideline for long days outdoors, because sunscreen that has rubbed or washed off cannot protect you! Using a water-resistant sunscreen can help keep you protected for longer if you're sweating or swimming, but you still must reapply, especially if you use a towel to dry off.
If you sweat profusely, wash your hands, swim, or get wet, you need to reapply your water-resistant sunscreen within 40 minutes, regardless of the SPF number on the product. If it's labeled "very water resistant," you get about 80 minutes of protection while perspiring or swimming.
Sun-Sensitizing Drugs and Skin-Care Ingredients: Sun sensitivity (known as photosensitivity) means that the skin is sensitive to sun exposure, and this can be caused by medications and some skin-care products. Photosensitivity means you are more likely to get a burn, so it's extra important to be vigilant with sunscreen. To protect yourself, it's important to check your medications and skin-care products for warnings.
Here are some of the skin-care ingredients that can increase the skin's sensitivity to sunlight:
- St. John's wort.
- AHAs like glycolic or lactic acids.
- Benzoyl peroxide.
- Some fragrance ingredients.
- Citrus oils, such as lemon, lime, grapefruit, and bergamot.
- Lavender oil.
- Rosemary oil.
- Sandalwood oil.
- Plants belonging to the Umbelliferae family, which includes parsley, carrot, dill, angelica, anise, fennel, and Centella asiatica.
You can reduce the risk of a sensitized reaction dramatically by protecting your skin with clothing, sunglasses, a hat, and, of course, a broad-spectrum sunscreen rated SPF 15 or greater (and greater is better).
The list of over-the-counter and prescription medications that can increase the skin's sensitivity to sunlight is extensive. It's always best to check your medication's prescribing information and/or to consult with your physician or pharmacist if you're unsure. Common medications that can make the skin more sun-sensitive include:
- Ibuprofen (Advil, etc.).
- Naproxen (Aleve, etc.).
- Tretinoin (Retin-A, Renova, etc.).
- Tetracycline, minocycline (antibiotics).
- Most antihistamines, including over-the-counter options.
- Birth control pills.
- Lovastatin (cholesterol-lowering medication).
- Most topical and oral anti-fungal medications.
- Sulfa drugs.
- Estrogen and progesterone (hormone replacement therapy).
Depending on how sensitive a medication makes your skin to the sun, it may be necessary to avoid exposure entirely. This is something to discuss with your prescribing physician.
Staying in the shade is always helpful, but when out and about, wear sun-protective clothing as an extra measure of defense. We like the Coolibar and Sun Precautions brands; they are Paula's favorites and tend to provide more attractive options that don't look like Hazmat suits!
Sometimes, despite your best efforts, sunburn happens! After the skin turns pink, the burn will continue to develop for 12 to 24 hours. Here are the critical dos and don'ts:
- Remove yourself from direct sunlight. Ideally, go inside or seek complete shade.
- Cool the burn as soon as possible. Cooling dissipates the heat that is simmering in the lower layers of the skin, and reduces inflammation.
- Use cold, damp compresses or bags of ice covered with a towel. Do NOT use ice directly on the skin.
- Keep applying cold compresses on and off for several hours.
- Apply a lightweight moisturizer that contains healing ingredients.
- Consider taking ibuprofen to reduce inflammation.
- Call your doctor if you develop a fever, experience chills, or feel significant pain from the burn.
- Don't immerse yourself in a tub of water or shower for a long period of time. Too much water inhibits the skin's healing response.
- Don't put ice directly on the skin—it's too cold and can cause a different kind of burn (think frostbite).
- Don't cover the burn with thick balms or ointments (butter is the worst!) because they trap the heat, which then continues to cause more damage.
- Don't apply any occlusive or overly fragrant moisturizers, which can impede healing.
If your burn is serious or extremely painful, don't hesitate to find the nearest hospital emergency room. Heat trauma from sunburn can be a serious threat to your health.
Learn From Your Burn
One sunburn a year might not seem very serious, but the research is clear: Repeated unprotected sun exposure, getting sunburned, or repeatedly getting tan not only causes premature signs of aging, but also causes DNA damage that triggers skin cells to mutate. Over time, and in the absence of sun protection and sun-smart behavior, these mutations can turn into skin cancers.
Repeated sun exposure and sunburn have long-term aesthetic effects, too, ranging from brown spots, rough skin and/or uneven skin tone, thin, crepe-like skin, white spots, and sagging. None of that is a fair tradeoff for going without sunscreen and enduring sunburn.
With the right sunscreen, sun-protective clothing, and following our other tips, you can avoid the misery of sunburn—and significantly reduce your lifetime risk of getting one of sunburn's most unwelcome side effects, skin cancer. Most important, with a bit of planning and preparation, you can have fun in the sun and keep your skin looking healthy for years to come!
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