By Dr. Tariq Jagnarine
Family Medicine, Endocrinology/Diabetes

Sunburn can be painful, and can increase the risk of skin cancer. After-sun creams and cool compresses can soothe the pain of sunburn. Tips for preventing sunburn include applying sunscreen before going out, and wearing clothes that cover the body.
Sunburn is the term for damage caused by overexposure to UV rays from the sun or other sources, such as a sunlamp or tanning bed. Sunburn can vary from mild to severe. Sunburn can cause pain and burning, and according to this 2005 study, it can also increase the risk of skin cancer, wrinkles, brown spots, and freckles. The skin may appear swollen, possibly with blisters.
People with any skin tone can experience sunburn. Fair or lighter skin typically turns pink or red, but dark skin tones may become darker. The extent and severity of sunburn will depend on the person’s skin type and level of exposure to the sun.

A person is more likely to experience sunburn if they have:
* Vitiligo
* Alopecia
* Albinism
* Photosensitivity due to:
* Systemic lupus erythematosus
* Porphyria
* The use of some drugs, such as tetracycline
* Certain genetic conditions

A 2005 study explains that, in medical terms, sunburn involves inflammation leading to erythema (a rash) and edema (swelling) due to the buildup of fluids. It also involves changes to skin cells. It triggers the development of sunburn cells, which can become cancerous, and a reduction of mast cells, which play a role in the immune system. The symptoms of sunburn vary between people. Sunburn can affect anyone, but those with lighter skin are more susceptible. Following exposure, the skin may become:
* Hot
* Sensitive to the touch
* Painful
* Irritated
* Itchy
* Blistered
* Light skin may turn red, dark skin may change to a darker tone.
Symptoms of severe sunburn can affect the whole body. They include:
* fever
* chills
* headache
* nausea and vomiting
* a general feeling of being unwell.
A person with severe sunburn may need medical attention. Heat exhaustion can occur in extreme cases; or, more severely, heatstroke. If a person experiences the following, they should seek immediate medical advice:
* Low blood pressure
* Fainting and dizziness
* Rapid pulse
* General pain throughout the body
* Extreme weakness
* Shallow breathing
* Changes in behaviour, such as irritability, confusion, difficulty thinking, or hallucinations.
A doctor would diagnose heat exhaustion when the core body temperature is higher than usual after sun exposure, but no higher than 104°F (40°C). The core body temperature will be over 104°F (40°C) in a person with heatstroke. Heatstroke is a life-threatening condition that needs urgent attention.

A person can expect the following with sunburn:
* A rash usually appears 2–6 hours after exposure.
* Skin symptoms peak around 12–24 hours after exposure.
* The skin peels and flakes off around 4–7 days later.

If sunburn occurs, a person should do the following:
* Get out of the sun, and preferably go indoors.
* Avoid further sun exposure until the sunburn heals.
* Cool the skin with a damp cloth or towel, or take a cool bath.
* Apply moisturizer or after-sun cream, such as aloe vera.
* Take over-the-counter medications, such as ibuprofen or other nonsteroidal anti-inflammatory medications (NSAIDs) to relieve pain and reduce swelling.
* Apply hydrocortisone cream to reduce inflammation and itching.
* Drink extra water to help prevent dehydration.
* Avoid touching or breaking small blisters to reduce the risk of infection. Blisters protect the skin.
* Avoid scratching, picking at, or removing peeling skin.
* Wear loose-fitting clothing while the skin heals.
In cases of severe sunburn, a doctor may prescribe oral steroids to help reduce inflammation. For severe dehydration or heat stress, intravenous fluids may be recommended.

The best way for a person to avoid sunburn is to manage the way they expose their skin to sunlight. This includes:
* Sitting in locations with shade
* Wearing clothing that covers the body, and it preferably should be made of tightly woven fabric.
* Wearing a wide-brimmed hat
* Protecting the eyes with sunglasses
* Avoiding going out in the hottest part of the day
* Always wearing sunblock of SPF 30+, and reapplying it regularly.
* Considering extra protection for the face, neck, trunk, and parts not usually exposed to the sun.
Some sun exposure is essential for the body to produce vitamin D, but the American Cancer Society does not recommend sun exposure without protection, because of the risk of skin cancer. Instead, it recommends dietary sources, such as fatty fish and fortified foods.

Sunscreens and sunblock are commercial preparations that block UV light when people apply them to the skin. They have an SPF rating based on the sunscreen’s ability to prevent sunburn. The higher the SPF rating, the more protection from UVB rays a person can expect, and the less direct skin damage that should occur.
The sunscreen should also offer protection from UVA radiation. UVA radiation does not cause sunburn, but it does contribute to skin aging and an increased risk of skin cancer. Many sunscreens provide broad-spectrum protection, meaning that they protect against both UVA and UVB radiation.
The American Academy of Dermatology recommends that everyone uses a sunscreen with:
an SPF of 30+, UVA and UVB protection, water resistance
People should apply sunscreen as follows:
* Use plenty to cover the body — most people only use 25–50% of what they need.
* Pay attention to the tops of the ears, the feet, the neck, and other places that are easy to forget.
* Apply 15 minutes before exposure.
* Apply to dry skin.
* Reapply every 2 hours, or after swimming or sweating.
* Use lip balm with SPF 30+.
* Check any instructions on the packaging before use.
As concerns grow about damage to the environment, some countries are now banning sunscreens that are not reef-friendly. Sunscreens can be damaging in other ways, too, but some choices are less harmful.
When looking for sunscreen Save the Reef recommends:
* Opting for products that contain micro-sized or non-nanoparticles, as these are less toxic than nanoparticles.
* Using a lotion rather than a spray or misting sunscreen, as lotions are less likely to be harmful to human health.
* Choosing one with the smallest amount of plastic and packaging necessary
* Finding a sunscreen that does not contain the polluting ingredients listed on the HEL list.
Home treatments can usually relieve discomfort, but if a person develops a fever, faintness, or changes in consciousness, they need immediate medical attention.