SUNBURN

By Gary M. White, MD

Sunburn on the shoulder


A sunburn is the reddening, inflammation, and, in severe cases, blistering and peeling of the skin caused by overexposure to the ultraviolet rays of the sun.

Clinical

The skin becomes erythematous and tender in the areas of photo-exposure. Blisters may form. Later, desquamation occurs.

Treatment

In one intriguing DBPC study [Scott JF et al, JID Abstract 2017 (890) Cleveland Ohio], 200,000 International Units of Vitamin D3 given 1 hour after UV exposure (up to 3 MED) significantly reduced skin inflammation in humans. No toxicity of vitamin D or calcium was seen. None of the subjects were taking Vitamin D before the study.

If the patient is seen within 24 to 48 hours after the sun exposure, a short course of oral corticosteroids may be helpful. Otherwise, cool wet compresses may be soothing. The topical anesthetics are usually not effective and may rarely cause an allergic contact dermatitis. The patient should be educated about the long term risks of repeated sun exposure (e.g. wrinkling, photodamage, basal cell carcinoma, squamous cell carcinoma and melanoma).

Prevention

240 mg BID of Polypodium Leucotomos extract [PLE] reduced the likelihood of sunburn in healthy adults in a RDBPCT [J Clin Aesth Dermatol 2015;19]. It also increased the minimal erythema dose. Similar findings were shown in a study that had subjects take 240 mg of PLE 2 hours and 1 hour before UV exposure [JAAD 2017;77;33]. Of note, Heliocare is currently the preferred product available OTC in the US that contains PLE.

Additional Pictures

Sunburn on the thigh

Desquamation after a sunburn
Desquamation is very common after a sunburn.

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