Sunburn is a sneaky thing. You notice the colour. You feel the heat. It’s only much later, once the damage is done, that you realise just how burned you are. The day is likely over, but it might even still be happening. There will be plenty of time to read up on how to prevent this from re-occurring, but right now you’re in crisis control mode. Most try to undo sunburn using a mix of methods based on habit, folklore and instructions on the back of a bottle. Let’s save some time and energy. You’ll need both when you’re in repair mode.
WHAT'S ACTUALLY HAPPENING
Sunburn is caused by radiation, not heat. The warmth of a summer day comes from infrared but UV is a different part of sunlight, and you can't see or feel it. The damage it does is to DNA inside your cells. What you feel is your body responding. Blood vessels in the skin widen, which is where the redness, heat and swelling come from. Pain usually peaks around a day later. Your body goes into triage mode and cells too wrecked to repair are shut down. Those are the ones you'll be peeling off after a few days.
Some damaged cells survive with DNA changes that can't be fixed. That's a long term threat: a history of sunburn is linked to a higher risk of melanoma. Around half of one kind of UV damage to DNA in pigment cells formed in the dark, hours after the exposure ended. The work was done on cells in a lab, not on someone home from the beach, but it suggests the wreckage probably doesn't stop when the UV exposure ends.
Nothing you put on your skin changes any of that.
TAKE IT OR LEAVE IT
These common responses aren’t going to undo what’s taken place. Some might make the situation worse.
- Vinegar. A kitchen cure with a long history and no evidence behind it. Undiluted, it can cause chemical burns of its own.
- Coconut oil. It feels like care, but oils can trap heat in the skin and make the burning worse.
- Ice on the skin. The right amount of cooling is beneficial, but ice is too much of a good thing. A cool, damp towel is better.
- Numbing spray. Might relieve discomfort but should be used knowing that end in "-caine" can irritate the skin or trigger an allergic reaction. Discretion is advised.
- After-sun. It can make you more comfortable, which is good. It isn’t going to repair the damage. Nothing is.
- “It'll turn into a tan.” A tan is skin trying to protect itself, and by some estimates it offers protection of around SPF 3.
- “It wasn't even that hot.” UV can't be seen or felt, and can be just as high on a cool day as a hot one. You won’t know you’re burning until it’s too late.
THE FIRST NIGHT
You’re home, you feel like you’re on fire, and you want to do everything you can to mitigate the fallout. The game plan is simple.
- Cool it, often. A cool shower, or a damp towel over the worst of it, as many times as it helps.
- Moisturise while the skin's still damp. Moisturiser is widely supported. Aloe is where the experts part ways: American dermatologists recommend it, while Healthdirect says it doesn't speed healing and can sometimes irritate. Your skin will tell you which way to go.
- Drink more than you think you need. A sunburn draws fluid to the skin's surface and away from the rest of the body.
- Pain relief. Ask a pharmacist what suits you.
- Check your eyes. If they feel gritty, are watering more than usual, or feel light-sensitive a few hours after a day out, that's photokeratitis; sunburn of the eye. Take contacts out, don't rub, and it usually settles in a day or two.
IS IT JUST SKIN?
Sunburn and heat illness often arrive on the same day. They're easy to confuse and they're not the same thing. Sunburn is hot, red, sore skin. Miserable, but not typically an emergency. The other two are more severe.
- Heat exhaustion: skin feels cool, pale and clammy but still sweating. Your body is sending a warning and you need to get out of the heat.
- Heatstroke: hot, red or dry skin, little or no sweating, confusion or slurred speech and the body can no longer hold its temperature, which has climbed above 40°C. This is a medical emergency. Call 000. Get somewhere cool, remove excess clothing, sponge with cool water, and put cold packs on the cheeks, palms and soles.
THE NEXT FEW DAYS
If you blister, leave them be. The fluid inside is sterile. Popping them is what opens the door to infection. If the skin is blistered or broken, stay out of the water. Salt and bacteria can irritate and infect it. If it's just red, water isn't the problem. Cover the burn as best you can and be extremely vigilant.
Around day three, you’re likely to peel. The cells your body shut down are on their way out. Don't pull or scrub. Let them depart at their own pace, and keep moisturising.
WHEN TO SEE A GP
If things look like they’re taking a turn for the worse and intervention is needed, sooner is better. These are the signs to look out for:
- Large areas of blistering
- Fever, or yellow crusts on the skin are signs of infection
- Severe pain.
- Dizziness, peeing less than usual, unusual tiredness are signs of dehydration.
If you’re on a multi-day walk or a trip well away from home, this is the list that helps decide it’s time to call it quits.
YOU'RE NOT READY YET
You might look and feel ok, but you’re probably not ready to go another round. More sun on healing skin means UV landing on unfinished repairs, with the guard down. Somewhere around the end of the week the redness fades, the peeling stops, and your skin looks more normal. It's tempting to head straight back out but the repair work is ongoing and you are setting yourself up for more pain.
When researchers exposed small patches of human skin to simulated sunlight, between 2 and 9 per cent of one kind of DNA damage was still unrepaired three weeks later, in 16 of the 17 people tested. It wasn't a sunburn study, and the numbers are small. But it suggests skin can look finished well before it is.
Your skin's security is down. UV knocks out immune cells in the skin whose job includes finding and clearing cells with damaged DNA. The exposure that caused the sunburn has also sent part of the clean-up crew home. Burned skin may over-react. Skin with a compromised outer barrier reacts more strongly to UV than healthy skin. Researchers compromised the barrier with tape, not sunburn, so the link to peeling skin is an inference rather than proven fact.
You won't hear "I told you so" from us. Sunburn is a constant risk with a life spent outdoors, but it shouldn’t be treated as inevitable. Every burn you avoid means less down time to allow your skin to repair. If the UV index is 3 or above, 15 minutes unprotected is enough to start doing damage. When you do get caught, remember that “looks healed” and “is healed” aren't the same. Give your skin the time and support it needs before getting back to doing what you love. You’ll thank yourself in the long run.
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While it heals
Skin that's still recovering is more sensitive to UV, and dermatologists suggest keeping it covered until it's done: sleeves, a proper brim, and something for your eyes.
