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How to Treat a Sunburn
It's best to do everything we can to protect our children from the sun: keep them out of the sun at midday, encourage play in the shade, dress them in hats and clothes that cover as much skin as possible and apply and reapply broad-spectrum sun-block with at least SPF 15. But as much as we try, occasionally a fun day at the pool or beach turns into a painful night due to sunburn.

What is sunburn?
Sunburn is a burn of the skin from the sun's ultraviolet (UV) radiation. Within 30 minutes of exposure, the sun's UV rays can damage the skin tissues. The sun's rays are strongest nearer the equator, in the summer months and at higher altitude. There's also danger when the sun's rays reflect off water or snow. Light-skinned people are at greater risk for sunburn because they have less melanin protection in their skin, but dark-skinned people can also get sunburned.

What are the symptoms of sunburn?
Mild sunburn causes redness and pain within two to six hours after exposure. The symptoms are usually worse between 12 and 24 hours afterwards, and this can make for an uncomfortable night's sleep. Slightly more severe sunburn can cause swelling and blistering. Your child may also have mild fever, chills, headache, nausea and vomiting. The damaged skin usually peels off after about four to seven days, which causes itching and leaves new, pink, sensitive skin underneath.

Caring for sunburn

1. Get out of the sun: Take your child out of the sun to reduce further sun exposure and skin damage. Unfortunately, it's impossible to reverse any damage. You can only try to prevent further damage and help your child's body heal itself.

2. Give plenty of fluids: Being in the hot sun and having a sunburn can cause dehydration. Fluids help your child's skin heal itself.

3. Reduce your child's pain:

  • Cool baths: Be sure the water isn't too cold because this can cause shivering and added discomfort. Also, don't put bath salts, oils or perfumes in the water because this can cause an allergic reaction. Don't scrub your child's skin. Just gently pat dry.

  • Cool compresses: Soak a soft, clean cloth in a solution of equal parts milk and water, or Burows solution from the pharmacy. Apply the compress on the skin and leave on for 15 to 20 minutes.

  • Aloe lotion: Helps relieve the sting of sunburn. But don't apply lotions with perfume or anesthetics, such as benzocaine, because these can cause an allergic reaction.

  • Pain reliever medicines: You can give your child acetaminophen or ibuprofen. Be sure to use the right dose as described on the package.

4. Don't put ice on the burn: Even though if might seem that ice would counteract the burn's damage, it can cause further damage by causing an ice burn or frostbite.

5. Don't pop the blisters: Blisters are the body's way of protecting the delicate skin underneath. Breaking them can slow the healing and increase the chance of infection. Either leave the blisters open to the air or cover them lightly with a bandage or gauze. If a blister pops on its own, leave the skin flap on and clean it gently with soap and water.

6. Relief for itching: When the skin starts peeling, you can apply skin lotion to help reduce the itching. But avoid lotion with perfume since this can cause more irritation.

When to seek medical treatment
Rarely, very severe sunburn can cause dehydration, poor circulation, infection or even death from sunstroke or sun poisoning. Be sure to call your child's doctor for any of the following:

  • Severe sunburn covering a large portion of the body with blisters

  • Severe sunburn with high fever, extreme pain, confusion, persistent vomiting or fainting

  • Severe sunburn that doesn't get better within a few days or shows signs of infection (increased pain, swelling, redness, warmth, drainage of pus and fever)

Medical treatment may include intravenous fluids for dehydration, silver sulfadiazine cream and/or oral steroids for severe burns, antibiotics for skin infections and stronger pain-relieving medication.

Remember, it's better to prevent than lament!

Karen Sokal-Gutierrez M.D., M.P.H. Pediatrician