Sunburn • What helps against pain & itching?

From a medical point of view, what we know as sunburn is an inflammation of the skin, which in Latin is called dermatitis solaris. This arises as soon as the skin has been exposed to intense sun radiation.

Under natural conditions, sunburn is mainly caused by the effect of the ultraviolet parts of sunlight, UV radiation. Likewise, artificial UV radiation from a tanning salon or solarium can cause sunburn. The symptoms are comparable to those of a burn and should be treated as such.

Every sunburn increases the risk of skin cancer

Sunburn is uncomfortable, but heals after a few days. But the skin does not forget any of these damages. Frequent sunburn is a major risk factor for skin cancer, especially if it occurs in childhood.

Sunburn: symptoms and stages

The typical symptoms of sunburn are redness and swelling and overheating of the skin. All of this is combined with burning pain and sometimes an excruciating itching sensation. In the case of severe sunburn, skin blisters can also appear, which can later be peeled off as skin scraps.

The symptoms appear after three to six hours, depending on the skin type and intensity of the sun's rays, and the redness then blooms within 24 hours. Attention: Even those who have applied sunscreen can suffer from sunburn if they are exposed to the sun for too long.

Sun terraces are particularly at risk

The changes in the skin are usually sharply limited and affect the areas of the skin that have been exposed to UV radiation. Typical places for a sunburn are the so-called "sun terraces": shoulders, décolleté, forehead, bridge of the nose, ears and back of the feet. In principle, however, sunburn can occur anywhere on the body if the skin is exposed to the sun for too long.

It can take a week for the symptoms to subside. When a sunburn heals, the affected skin itches and usually even peels off. In the case of mild sunburn, the reddening usually turns into a tan of the skin.

Severity of sunburn

As with burns, sunburn is classified into three severities:

• The skin is red in grade 1 sunburn. If you press the skin with your finger, the area will first turn white and then return to the red color of the remaining sunburnt skin. There is also swelling and overheating of the skin and the entire body. The burning pain, which can be combined with an itching sensation, is particularly excruciating.

• The same symptoms appear in grade 2 sunburn, but the skin also forms blisters. After bursting, the blisters leave superficial defects (erosions) that can also wet. The drying of the wound secretion leads to the formation of yellowish crusts. The blisters can later be peeled off as scraps of skin.

• In the case of grade 3 sunburn, the epidermis and uppermost parts of the dermis were largely destroyed. Finally, the top layer of skin peels off.

Additional symptoms can be added to the sunburn. If skin rashes and itchy pustules occur, it can also be a sun allergy or "Mallorca acne". On the other hand, nausea, vomiting, headache, drowsiness or chills are signs of heat stroke or sunstroke, which must be treated accordingly.

Sunburn: causes and triggers

The cause of the sunburn is a local inflammatory reaction of the skin, which is mainly caused by the short-wave UV components of the sun's radiation. A distinction is made between UV-A, UV-B and UV-C radiation. While UV-C is filtered by the ozone layer, parts of UV-B and UV-A radiation reach the earth. Both of the latter increase the risk of skin cancer.

UV-A ensures quick tanning of the skin through melanin.

UV-B rays, on the other hand, cause longer-term pigmentation, which protects the skin from future solar radiation. However, UV-B penetrates into deeper skin layers. There the rays cause sunburn and damage the genetic make-up, but at the same time ensure the production of the vital vitamin D.

The artificial UV radiation from a sunbed can also cause sunburn. Anyone who tans often in the solarium exposes their skin to excessive exposure to UV-A radiation.

The intensity of UV radiation depends on various factors. These include:

• season
• Time of day
• Latitude
• Height above sea level
• Reflection of the radiation by water, sand or snow

Whether and how quickly someone gets a sunburn depends on the genetically determined skin type. Everyone has an individual protection period with regard to solar radiation. Light-skinned types, such as red or blond haired people, are more at risk of getting sunburned. On the other hand, very dark skin types can remain in the sun for up to 40 minutes without protection. After the skin reaction to the first 30-minute sun exposure in summer, six different skin types are distinguished.

When the time in the sun triggers a sunburn also depends on the tanning and the intensity of the UV radiation. The stronger the UV radiation, the shorter the radiation duration that triggers a sunburn.

Risk of sunburn even in the shade

What many forget: Sunburn can also occur in cloudy weather and in the shade. Clouds, smog or parasols keep some of the UV radiation out. Most of it is broken by dust particles and other air components, runs parallel to the surface of the earth and hits us from the side. In the shade, we still get about 30 to 40 percent of the UV radiation. So even in the shade, caution is advised, otherwise the skin reacts with an alarm level of red.

Sunburn: diagnosis and doctor's visit

Sunburn is easy to identify even for medical laypeople. It is sufficient to examine the skin in combination with the information that someone has been exposed to the blazing sun a few hours before the symptoms appear.

Whether the person concerned takes medication is also relevant. Because some drugs, such as antibiotics such as tetracycline, doxycycline and minocycline or cortisone, can increase sensitivity to light.

Sunburn or more: when to see a doctor?

In the case of normal, mild sunburn, no doctor is usually consulted. However, a visit to the doctor is recommended if the sunburn is severe and blisters form on the skin.

Medical help is also appropriate if you experience nausea, vomiting, drowsiness, fever and other more serious symptoms. Because then it can be a heat stroke, which necessitates fast medical care.

What helps against sunburn? Therapy and home remedies

In the event of mild sunburn, cooling, damp envelopes relieve the burning pain and the feeling of heat. These should remain on the skin for at least 20 to 30 minutes or be renewed several times until the pain is no longer felt. Extreme cold, for example in the form of ice cubes, is counterproductive. This only stresses the skin even more, it can even cause cold damage.

Cooling home remedies can even be found in the kitchen. For example, curd wrap and envelopes with buttermilk and yoghurt are helpful, even apple cider vinegar diluted with water cools. A boiled and cooled bag of black tea, which is used to dab the skin, inhibits the inflammation.

Aprés-Sun lotions or gels that are free of active ingredients also help. Aloe vera gel or lotions with chamomile extract soothe stressed skin, provide it with moisture and accelerate healing.

Ointments and fat creams are not suitable for the treatment of sunburn because hardly any heat can be dissipated from the skin under the fat film.

The best home remedies for sunburn

Loose, light clothing helps the skin to recover and makes the next few days somewhat tolerable for the sunburn-stricken.

Always important, but even more so with sunburn: Drink enough, because the swelling of the skin or the formation of blisters draws fluid from the blood. In this case, experts recommend around two to three liters.

The sunburn usually healed in a few days. After that, however, the skin is often still dry and flaky. Therefore, the affected skin should be treated with a moisturizing lotion twice a day.

Until the sunburn has completely healed, the sun and intensive sweating should be avoided if possible so that the skin can recover.

With blistering: go to the doctor!

Sunburn with blistering should be treated by the doctor. If the blisters cause a pronounced feeling of tension, the dermatologist may puncture the blister contents with a sterile syringe. A sterile dressing can then be applied. In general, the lifted skin layer should not be removed. This protects the underlying healthy skin layers from infections.

Otherwise, with a second degree sunburn similar to a first degree sunburn, cooling moist envelopes and active ingredient-free lotions or gels can relieve pain and itching. You may also need hydrocortisone preparations that are applied as a gel or lotion. For severe pain, an over-the-counter pain reliever (such as acetylsalicylic acid (ASA) or acetaminophen) can be taken.

If second degree sunburn occupies more than 50 percent of the body surface, inpatient treatment in the hospital should be considered.

The replacement of lost fluids and mineral salts by infusion may be useful. The inflammatory reaction can be effectively dampened by the internal administration of cortisone preparations for a few days.

Third degree sunburn: a case for skin specialists

In the case of third-degree sunburn, inpatient treatment in a skin clinic is necessary. Because the affected person can lose a lot of liquid including mineral salts through the destroyed skin, this is replaced by infusions. A cortisone preparation can be given as a tablet or as an infusion to dampen the inflammatory reaction. To prevent bacterial infection of the wounds, an antibiotic may be administered.

Sunburn: course, healing and risks

The symptoms of mild sunburn usually improve significantly within a few days. However, it can take around two weeks to heal completely. During this time, the skin areas affected by the sunburn are very sensitive, react irritably to pressure or if something brushes over them. The sunburn spots should not be exposed to the sun for the time being.

Sunburn with blistering can result in thickening of the skin or lighter (depigmented) scars. Children and the elderly are particularly at risk of shock.

Biggest risk: skin cancer

The fatal thing about sunburns is that they favor tumors, even decades later. Frequent severe sunburns in childhood are now considered a major risk factor for the development of skin tumors (malignant melanoma, basalioma).

Permanent skin damage occurs long before sunburn

What few people know: permanent skin damage caused by the sun arises long before the visible signs of sunburn. Even those who can bring their skin to safety in time from sunburn must expect permanent skin damage.

Our skin does have repair mechanisms to repair sun-related damage immediately. But if the sun dose is too large, the skin can no longer keep up with the repair work. Natural sun protection is then no longer provided.

Many sun worshipers have chronic light damage. This shows up as premature skin aging in sun-exposed areas. Typically, the facial skin appears leathery, thickened with coarse folds, sometimes covered with fine blue-red veins. Arms and hands are often over-pigmented, which means that the skin is covered with small brown spots. With frequent and careless sunbathing without adequate sun protection, such phenomena sometimes even appear before the age of 30.

Preventing sunburn: How to protect your skin

In order not to get sunburn in the first place, but also to prevent tumors of the skin such as basalioma and malignant melanoma, consistent protection against UV radiation is recommended. Parents have a high responsibility for their children, especially since children's skin is particularly sensitive to UV radiation.

In general, extensive sunbathing is not recommended. In summer, no one should be exposed to the blazing sun at lunchtime between 11 a.m. and 3 p.m., but should stay in the shade. But even in the shade, the intensity of UV radiation is still around 50 percent. This should be borne in mind especially in southern holiday countries, for example on the Mediterranean or in the tropics, and generally by the sea or in the high mountains.

Long clothes and cream

During a beach holiday as well as at home in summer, it is better to wear light clothing instead of swimming trunks or bikini, which with long sleeves and trouser legs or with a long skirt keeps out the UV radiation. You should also protect your face and head with a sun hat.

And cream yourself: face and all other body regions not covered by clothing with a sunscreen with a high sun protection factor (SPF). The value indicates the factor by which the sunscreen increases the sunburn threshold compared to unprotected skin.

The following table shows the times in summer in Central Europe for the different skin types:

Source: DKG

These values ​​apply to Central Europe. As a precaution, use one in the Mediterranean Sun protection factor of around 25 and in the tropics, high mountains and especially on glaciers a factor of at least 30.

An extension of the light protection cannot be achieved by repeated application. However, it is important to apply a new cream after bathing, since the so-called protection is also important waterproof sunscreen reduced by about half when bathing. Since light stabilizers only develop their full effectiveness about half an hour after application, the full sun should be avoided during this time.

When the sunburn-free time is exhausted, only sun protection by clothing helps. After sunbathing, the skin needs about twenty hours to regenerate, to be ready for another sunbath.

Read detailed tips on optimal sun protection, skin types, sun protection factor and sun cream here.

Not recommended: visits to the solarium

A preventive visit to the solarium to get the skin used to increased UV radiation before a holiday cannot be recommended. This is because UV-A lamps are used for skin tanning in solariums, the radiation of which only produces tanning through pigment incorporation and does not build up a thickened horny layer. However, this in particular improves the skin's own protection; it only develops when irradiated with UV-B radiation components, such as those that occur when sunbathing in nature. Visits to solariums not only increase the number of sunbaths at all, but also encourage them Skin aging and increase that Skin cancer risk.

Do conventional sunscreens protect against an increased risk of skin cancer?

Conventional sunscreens filter the UV-B, but mostly not the UV-A portion of the ultraviolet radiation. Therefore, they protect against sunburn, but not against UV-A exposure with accelerated skin aging and the development of Skin cancer as possible late effects.

How do you protect babies from UV radiation?

Newborns and infants, i.e. all children in the first year of life, must be completely protected from direct sunlight, i.e. from blazing sun, because their skin is extremely thin and cannot yet form a protective layer of light.

Children in the first year of life should stay in the shade. Areas of skin not covered by clothing should be lotioned with sunscreen with a sun protection factor of at least 20.