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Sunburn

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Sunburn, Sun Burn, Photodermatitis, Phototoxic Reaction, Photocontact Dermatitis, Phototoxic Dermatitis, Photoallergic Reaction, Photosensitivity Reaction, Berloque Dermatitis

  • See Also
  1. Burn Evaluation
  2. Drug-induced Photosensitivity
  • Risk factors
  • Photosensitivity
  1. Drug-induced Photosensitivity
    1. See Photosensitizers
  2. Primary Photodermatitis
    1. Polymorphic light eruption
    2. Solar Urticaria
    3. Hydroa vacciniforme (EBV infection)
  3. Photo-aggravated Conditions
    1. Dermatomyositis
    2. Malasma
    3. Rosacea
    4. Systemic Lupus Erythematosus or Cutaneous Lupus Erythematosus
  • Signs
  1. Sufficient exposure to Ultraviolet Light
  2. Immediate erythema
    1. Occurs within minutes of exposure
    2. Fades within 30 minutes
  3. Delayed erythema
    1. Reappears 3 to 6 hours after exposure
    2. Peaks at 12 to 24 hours
    3. Persists for days
  4. Associated findings
    1. Edema
    2. Vesicles
    3. Desquamation often within 1 week
  • Management
  1. See Burn Management
  2. See Drug-induced Photosensitivity
  3. Treat as minor Burn Injury
  4. Cool wet compresses applied for 10-30 minutes
    1. Avoid ice due to Vasoconstriction and increased tissue injury
  5. Oral Analgesics
    1. NSAIDs
    2. Acetaminophen
  6. Skin protectants
    1. Skin Lubricants (e.g. Eucerin)
    2. Aloe Vera gel may be used if soothing
      1. However, aloe has no evidence-based benefit over other topicals
  7. Consider Topical Anesthetic for localized burn (Lidocaine preparations such as Lidocaine 4% patch)
    1. Do not apply to non-intact skin
    2. Avoid Benzocaine preparations (sensitizer)
  8. Avoid ineffective and potentially harmful agents
    1. Avoid topical or Systemic Corticosteroids
    2. Avoid Topical Antibiotics (e.g. neomycin) due to Contact Dermatitis risk
  9. Avoid home remedies
    1. Avoid applying butter
      1. Occlusive and may trap heat, increasing Burn Injury
    2. Avoid apple cider vinegar, buttermilk, lavender oil
      1. No evidence for benefit
  • Prevention
  1. See Sunscreen
  2. See Sun Exposure
  • Complications
  1. Two Sunburns before age 18 predisposes to Melanoma
  • References
  1. (2018) Presc Lett 25(8)
  2. Goroll (2000) Primary Care Medicine, p. 1065-6
  3. Habif (1996) Clinical Dermatology, Mosby, p.602-3
  4. Oakley (2022) Photosensitivity, StatPearls, Treasure Island, FL
    1. https://www.ncbi.nlm.nih.gov/books/NBK431072/