If you've unfortunately stumbled upon this post because you have a sunburn, we're going to be talking about what you should be doing and what you shouldn't be doing right now and all things sunburn about sun burn.
If you have a sunburn right now, you can scroll to the section of treatment of sunburn because you have no interest in learning about the mechanism of sunburn right now. You just want to know the treatment.
What causes sunburn?
Obviously the sun, but what exactly is happening on the molecular level? Let us know that, then we can talk about some of the treatments that will make more sense.
The sun gives off multiple wavelengths of light. One of the ones that's most problematic is UVB. This UVB's maximum absorption occurs in the chromophore of our DNA.
In our skin cells, they absorb most of the UVB. Now what happens is this results in a triggering of cell death called apoptosis. The skin cells die, the little nucleus is all shriveled up.
Then additionally, you also have cell signaling from nitric oxide, which causes the blood vessels to dilate, which is where you get the redness, warmth, that goes along with the pain of your dying skin.
So basically what's happening when you get hit with the sun and you end up with a sunburn is absolute mayhem underneath the microscope. Your skin cells are dying. Your blood vessels are getting dilated. Prostaglandin is going crazy.
Nitric oxide is going crazy. You have free radical damage just beating up your entire skin cells. It's absolute mayhem and death, DNA damage, horrible scene underneath the microscope.
It's not good. This is why we tell you to wear sunscreen. Now as a result of this, what happens? You get immediate redness.
After that immediate redness, then you can get pain. You can get swelling. You can get really profound edema like what you saw in the above image.
Your skin cells are dead, so they actually slough off. So you'll actually get a peeling effect afterwards, an exfoliating effect to some extent. Not a good exfoliating effect, but a bad exfoliating effect.
Then over time, healthy skin cells will come in, but there's still damage of DNA at that point and sunburns certainly increase your risk of cancer.
How to prevent sunburn
Now let's talk about what you're going to do to prevent these, right? And prevention is actually key. We'll talk more about that in treatment, but prevention is the name of the game with this.
So the first thing we are going to talk about is sun avoidance. I'm more of like the sun protection kind of person. If you don't know me, I'm a surfer. I love being outside. I think being active is good for you as a whole person, but sun protection is paramount.
Sunscreen is foundational, right? Sunscreen works in multiple different ways. It can not only reflect some of the light out, but also absorb some of the energy from the light. The whole goal, the whole purpose is to prevent that light and energy from getting to your skin. Additionally, you can elevate that with some topical antioxidants.
You can actually supplement with oral antioxidants as well. Both of those help complement sunscreen to decrease the damage to your skin. But to keep it a million times more simple than that, what you're going to do is you're going to just wear sunscreen.
You're going to wear sunscreen at least SPF 30, which is going to give that UVB protection against sunburns and also broad spectrum, which is going to give you protection against UVA. You're going to reapply it every two hours when you're out in the sun. And if you're in the water, it might be water resistant up to 80 minutes.
You have to look at the front of your sunscreen bottle to know how water resistant it is. But if it is water resistant up to 80 minutes, then you're going to reapply every 80 minutes if you're out in the water. And that's essentially how you're going to prevent sunburn in addition to some of the sun protective clothing, antioxidants and the other things. But that's the minimum thing you need to do. Just wear sunscreen. That's how you prevent it.
How to treat sunburn?
Now, let's talk about treatment. So you have a sunburn. So how do you treat it? Well, first off, the cells are actually already dead.
This is a big problem when it comes to treating the sunburn. But you can go through multiple topical anti-inflammatories or better yet, ingredients that help with wound healing. We're not necromancers.
We cannot bring your cells back to life. But what we can do is try to calm down that inflammatory reaction. Now, researchers have done a ton of studies on this, probably not enough studies to be honest.
But the main things that the scientists looked at and the dermatologists looked at in the past, these are like many years going back, like 80 years they've been studying how to treat sunburns.
The main things that you would think of is be like corticosteroids, like hydrocortisone or NSAIDs because there's this inflammatory cascade happening. What they found was there wasn't actually really much of a benefit to any of these things because again, the cells are already dead.
So we have somewhat bad news for you. There's nothing to reverse this inflammatory process once that cascade is happening. It's like a car wreck.
And like once the cars hit, you cannot stop them from the damage happening at that point. What you can do is really just control symptoms, unfortunately. So what are we doing to control symptoms as follows:
You can do some cold compresses. That's just going to help with some of the redness, some of the pain. The next thing that you can do is put on some calming and soothing ingredients. One of the top players here would be aloe vera.
Yeah. And I'm a huge proponent of aloe and I love it in this space because I think aloe vera is like the marriage of those two products. So it has some anti-inflammatory properties.
It's actually pretty well studied. It has been shown to help with wound healing. Plus, unlike some other ingredients, it can really feel cool and soothing.
So you get the nice subjective experience backed up with some objective data. And so I'm a big fan of aloe vera.
A problem with aloe vera though, if you use the raw plant, it has anthraquinones in it, which are problematic and cause irritation, cause allergenicity.
So you may be probably better off finding this ingredient in a product. So aloe is an option.
You can use other just bland emollients, fragrance-free moisturizers, something from CeraVe, from Cetaphil, from Neutrogena, something that's going to calm and soothe the skin.
If you look at Aveeno, they have a lot of oat, which is calming and soothing to the skin. So just really bland emollients that are going to protect the skin barrier.
You could certainly use Vaseline on the skin here. It's protective. It's very helpful with burns. So it wouldn't be contraindicated. In fact, I'm a big fan of Vaseline.
Another thing that people do is they'll take Vaseline. They'll actually wrap the areas with saran wrap to really just calm the skin down. And things under occlusion tend to be more helpful and more effective.
But again, this inflammatory cascade is already occurring, it's very difficult to stop it with vaseline or petrolatum and sunburns or burns in general.
So immediately after a burn, yes, you want to cool it in cool water, cool compresses. That's fine. When you're dealing with the aftermath of it and the healing process, Vaseline becomes your best friend.
In fact, it's commonly used in a lot of blistering disorders, burns. It's been studied in burns, shown to be helpful with healing. It's an absolutely appropriate ingredient to help with the healing process of a sunburn. Immediately after it might feel uncomfortable, but it's a great option.
Then the next major player in topicals would be something like a corticosteroid or hydrocortisone or triamcinolone or some other prescription option. Now, they've looked at this extensively because it makes the most sense of all the topicals because it calms down all the inflammation that's occurring.
It appears in all the studies that they've looked at that topical corticosteroids don't seem to have benefit in sunburn. But believe it or not, now, I can see them helping with the symptoms, but it doesn't seem to be effective for some reason. It's just not very effective.
So then if you go on to the oral medications that you can take for this, again, you can take oral corticosteroids. If you're somebody who's in that severe inflammatory stage where you have tremendous swelling, then that could definitely help with some of the symptom relief.
But again, the data showing that it actually helps slow the progression of sunburn or make sunburn any better as far as like the timeline of it. The data just doesn't exist.
Then you look at oral NSAIDs like your ibuprofen, its that going to be beneficial because prostaglandins are involved? And it appears that they have better data than your corticosteroids or your prednisolone or your topical corticosteroids.
But at the same time, it can also have untoward effects because what's happening when you have a bad sunburn is you get third spacing of fluid in your body. So you get a lot of leaking of water, the water in your body into your tissues, which can actually cause you, even though you don't seem dehydrated, you actually look swollen, your body is dehydrated, your intravascular pressure is dehydrated.
So you can actually get a lot of poor perfusion to your kidneys. And so then if you take an NSAID while you're dehydrated, that could really damage the kidneys.
So if you're going to take ibuprofen, which is recommended for some people that have bad sunburns, both for pain control and for to decrease those prostaglandins, if you're going to do that, you have to drink a ton of water because otherwise you could really damage your kidneys in this process.
There's also some thing called sun poisoning or hyperthermia that you get. This is when your body totally loses regulation of your temperature. You lose your ability to control your body temperature, but that's completely beyond the scope of this here. We're just talking about sunburns, but it really can become a serious thing.
Facts about treatment of sunburn
This is what you're going to do. In the first two hours afterwards, just get out of the sun and start applying cool compresses, not ice, but just cool compresses to cool down that inflammation.
After that, you can apply aloe vera. Aloe vera probably has the best data, even though it's controversial. Aloe vera will help calm and soothe in that process. And you can also apply just bland emollients.
So if you're allergic to aloe vera, just a bland fragrance-free moisturizer in the immediate aftermath.
After 24 hours, start using Vaseline to heal that burn tissue essentially at that point. Now, if you're having a lot of pain, ibuprofen or acetaminophen could be appropriate like your Tylenol, but just know that it could damage the kidneys and have other bad side effects.
So just make sure you're drinking a ton of water and only take those if you absolutely have to. And again, if it gets worse and worse, make sure you go see your dermatologist. That pretty much sums it up.
I mean, the most important thing is preventing this from occurring, but guess what, you're here, we're here, it's done, and we'll help you through it. Sorry that this happened to you. We'll see you all in the next post.
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