Dermatology Made Easy is based on the most popular topics from DermNet NZ's vast array of material. The book combines the essential focus of the ‘Made Easy’ book series with the authority and knowledge base of DermNet NZ's unparalleled resources.
Author: Vanessa Ngan, Staff Writer, 2005.
Sunburn is simply a burn or erythema (reddening) and oedema (swelling) on your skin from excessive exposure to the sun’s rays, more specifically the ultraviolet (UV) radiation that is emitted from the sun. Sunburn may also occur from exposure to other UV light sources such as solaria or tanning salons.
At a cellular level, sunburn is associated with microscopic changes in the skin. There is the formation of UV induced sunburn cells and a reduction in Langerhan cells and mast cells, which play an essential part of the body's immune defence system.
To better understand the causes of sunburn we need to take a look at some basic principles of the electromagnetic (light) spectrum. This spectrum is divided according to wavelength into ultraviolet (<400nm), visible (400-760nm), and infrared (>760nm). The ultraviolet (UV) spectrum is further divided into 3 broad areas:
UV-C radiation is filtered out or absorbed in the outer atmosphere so does not pose a problem to humans. It is UV-A and UV-B radiation that are the primary causes of sunburn. Although both wavelengths are implicated in sunburn, the skin reacts differently to each one.
|Less potent than UV-B but is the wavelength that reaches the surface of the earth most (about 90% at midday)
Also penetrates into the middle skin layer (dermis) and subcutaneous fat causing damage to the site where new skin cells are created
Long-term exposure causes injury to the dermis resulting in ageing skin
|Much more potent at causing erythema
About 90% is absorbed by the surface skin layer (epidermis)
Epidermis responds by releasing chemicals that cause the reddening and swelling characteristic of the early signs of sunburn
Repeated exposure causes injury to the epidermis resulting in ageing skin
Skin phototyping categorises people into one of six groups based on baseline skin colour and the tendency to tan and/or burn when exposed to UV radiation.
|Skin Phototype||Typical Features||Tanning ability||MED (mJ/cm2)|
|I||Pale white skin, blue/hazel eyes, blond/red hair||Always burns, does not tan||15-30|
|II||Fair skin, blue eyes||Burns easily, tans poorly||25-40|
|III||Darker white skin||Tans after initial burn||30-50|
|IV||Light brown skin||Burns minimally, tans easily||40-60|
|V||Brown skin||Rarely burns, tans darkly easily||60-90|
|VI||Dark brown or black skin||Never burns, always tans darkly||90-150|
People with type I skin phototyping are at much greater risk of sunburn than their type VI counterparts. The amount of UV radiation, measured in energy per unit area, to produce erythema at an exposed site is called the minimal erythema dose (MED) and this is significantly lower in people with a low skin phototype grading.
Other factors that increase the incidence of sunburn include:
The signs and symptoms of sunburn differ for each individual according to their skin phototype and length of exposure to UV radiation. Fifteen minutes of midday sun exposure may cause sunburn in a white skin person, while a darker skinned person may tolerate the exposure for hours.
Signs and symptoms usually occur after 2-6 hours of exposure and peak at 12-24 hours, they may include:
In severe cases of sunburn, severe skin burning may result in second-degree burns, dehydration, electrolyte imbalances, secondary infection, shock or even death.
Around 4-7 days after exposure skin may start to peel and flake off.
The treatment of sunburn is to provide relief of the discomfort it can cause. This can be achieved with the use of analgesics (pain-killers), cool baths, aloe vera lotions and moisturisers.
However, sunburn is better prevented than treated. Sun protection is your best defence against sunburn and other damaging effects of UV radiation.
An oral food supplement containing Polypodium leucotomas may provide additional oral photoprotection and reduce sunburn.
If you are inadvertently exposed and expect to be sunburned:, you may lessen the severity of the burn with the following measures:
It is now clearly apparent that the long-term consequences of overexposure to the sun or other sources of UV radiation are significant (click on links below for further information). One blistering sunburn is said to double the likelihood of developing skin cancer.
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DermNet NZ does not provide an online consultation service. If you have any concerns with your skin or its treatment, see a dermatologist for advice.