Sunburn can be explained as an acute inflammatory reaction of the skin due to extreme exposure to UVR (ultraviolet radiation). Sources of UVR include tanning beds, arc lamps, phototherapy lamps and sun. Most sunburns are categorized into first-degree or superficial burns.

In addition to increased time and higher intensity of sun exposure, other risk factors that would predispose an individual to sunburn include, latitude, reduced ozone layer, use of certain drugs, phototype and clear sky.

Patients and public in general should be encouraged to find out the causes, ways to prevent skin cancer, and the available treatment methods so that the number of affected people and the extent of the disease are minimized while ethe quality of life of the patients is enhanced. It is crucial because reinjuries that is, multiple sunburns, cause skin cancer and also result in visible alterations in the skin and poor aesthetic outcome.

This is a very common health problem in the United States. One-third of US adults and two-thirds of children annually. The risk is higher near the equator and with increasing altitude. Skin reactions are more prevalent in lighter-skinned individuals. Fitzpatrick skin types are classified based on their tendency to tan or burn, or to do both. A bit more men than women suffer from sunburn.

Sunburn is more common in children as compared to adults, and easy sunburing at infancy may indicate serious underlying diseases.

This can lead to sunburn or DNA damage as a result of exposure to UVA and UVB. The UVA radiation induces the formation of reactive oxygen species, while the DNA is directly absorbed by the UVB radiation and the thymine-thymine cyclobutene dimers are formed. IN return, these dimers trigger a repair response in the body that involves apoptosis of the cells and release of multiple inflammatory markers such as prostaglandins, reactive oxygen species, and bradykinin. The final result is vasodilation, edema, and pain–in other words, the red, painful skin of sunburn. In addition, UVB can increase the chemokines such as C-X-C motif chemokine 5 CXCL5 and activate peripheral nociceptors, which sensitize the pain receptors of the skin.

Sunburn is the result of excessive exposure of skin to UVR, which could be further divided into A-I, 340-400nm, A-II, 320-340nm, UVB, 290-320nm, and UVC, 200-290nm. Although UVB rays are more potent than UVA rays in causing erythema, the latter still makes up a large proportion for the immediate and long-term cutaneous effects. The minimal erythema dose is the amount of erythema produced after 24 hours on an exposed site. Factors influencing erythema induced by UVR include environmental reflection, wavelength, hydration, pigmentation, skin type, coverage by ozone, time of day, season, latitude, cloud cover and altitude. The MED (minimal erythema dose) varies in amount according to the skin type, and is affected by a whole range of other factors including pigmentation/skin type, ozone coverage, season, wavelength, etc.

Sunburn, often uncomplicated, has the least possible interim morbidity and resolves spontaneously. In rare cases, it causes severe burns, secondary infection or dehydration. Prolonged exposure leads to cutaneous neoplasms like malignant melanoma, squamous cell carcinoma, and basal cell carcinoma.

Symptoms of this condition includes the following:

Erythema might develop in three to four hours and intensify at 12 to 24 hours.

Recent outdoor activity or exposure to sun.

Using tanning equipment indoors.

Pain.

Blistering.

Erythema which resolves over one week, generally with peeling and scaling.

Malaise, chills, possible fever, vomiting or nausea in severe conditions.

In general people who have blond hair, blue eyes, or fair skin are at the high risk of this condition typically.

Acute inflammatory response following exposure to sun occurs in 12 to 24 hours like:

Tenderness

Warmth

Edema

Erythema

Blistering

Second- degree burn

Severe cases may suffer from fever

Desquamation and delayed scaling might occur in 4 to 7 days post exposure.

Herpes simplex

Lupus erythematosus

Eczema

Chronic actinic dermatitis

Heat exhaustion

Heatstroke

Premature aging

Dermatoheliosis

Solar keratoses

Squamous cell carcinoma

Basal cell carcinoma

Melanoma

Dehydration

Prehospital care: In many cases, this involves administration of basic first aid to manage symptoms.

In severe cases, like second- degree burns, more intensive treatment might be required including high fluid resuscitation and specialized skin care.

Medical care: Most sunburns are symptomatic but not life-threatening. Management includes NSAIDS, cool soaks, fluid replacement, and emollients like aloe vera. Topical anesthetics must be avoided because of possible sensitization and associated dermatitis. Systemic steroids sometimes are used to shorten the course and decrease the pain, but there does not exist any evidence to support this. The more serious burns, secondary infection, or poor control of pain demands admission to the hospital, while mild burns are managed with cool baths or showers and anti-inflammatory/analgesic medications, which should be accompanied by avoidance of further sun exposure. Both the thermal and thermal burns need to be managed in the setting of an in-patient facility.

Emergency Medicine

Shade provision

Installation of shade structures such as awnings, pergolas, or umbrellas in outdoor areas should be done. Shade must be used particularly during peak sunlight hours.

Protective barriers

UV-blocking films or UV-filtering window shades should be installed to reduce indoor UV exposure. Additionally, UV-blocking curtains or blinds in areas that receive frequent sunlight can also be used.

Outdoor surfaces

Materials with UV-reflective properties for outdoor surfaces, such as light-colored or reflective pavement and decking must be employed to reduce UV exposure from reflections.

Vegetation

Encourage planting of trees, shrubs, or other vegetation to create natural shade which helps to reduce direct exposure to sunlight in outdoor spaces.

Sun protection products

Apply UV-blocking coatings or paintings on outdoor surfaces and structures to minimize UV radiation penetration.

Emergency Medicine

Naproxen: This is indicated to relieve mild to medium pain. It is known to inhibit pain and inflammatory reactions by reducing the activity of enzyme cyclooxygenase leading to reduced synthesis of prostaglandins.

Aspirin: This medication acts on the heat-regulating center present on hypothalamus and reduces fever. It is also used in mild to moderate pain.

Ibuprofen: It is an analgesic and used as the drug of choice in the absence of contraindications.

Emergency Medicine

Acetaminophen: It is indicated in patients who are reported to be hypersensitive to NSAIDS or Aspirin, and in people who suffer upper gastrointestinal disease, or administer oral anticoagulants.

Emergency Medicine

Prednisone: This might reduce inflammation via reversal of enhanced capillary permeability and blocking the activity of PMN.

Emergency Medicine

Assessment

Examine the extent and severity of sun damage by examining symptoms such as redness, blistering, peeling, and signs of chronic damage, including wrinkles or changes in pigmentation.

Immediate care

Apply cool compresses and moisturizers to calm and hydrate the skin. Over the counter medications should be taken if necessary. Protect the affected area from the sun to prevent additional damage.

Treatment

Use creams or gels with ingredients such as aloe vera or hydrocortisone to reduce inflammation and support healing. Apply specialized products designed to hydrate and repair sun-damaged skin.

Prevention

Slather on broad-spectrum sunscreen with an SPF of 30 or higher. Reapply every two hours or after swimming or sweating. Wear a hat, sunglasses, and clothing that have a UV protection factor when going outside. Stay in the shade, especially during the peak sun hours from 10AM to 4PM when the UV rays are the strongest.