Sunburn: symptoms, treatment and prevention

Sunburn, also called solar erythema, is an inflammatory reaction after ultraviolet radiation injures skin cells. It can affect any exposed area, including the face, ears, neck, shoulders, back, arms and legs. The skin may feel hot, tight or sore before its appearance fully changes.

The injury can occur on bright days and during outdoor activities when the air feels cool. Reflection from water, sand or snow can increase exposure. Sunburn is different from a tan: a tan is also a response to ultraviolet injury, not a sign that skin has been protected.

Skin redness and tenderness are very common presentations of sunburn. The affected area may feel warm, dry, tight or itchy, and clothing or touch can be uncomfortable. More marked burns may swell or form fluid-filled skin blisters; peeling often begins as the injured surface sheds.

A large burned area, severe pain, fever, chills, nausea, dizziness, confusion or dehydration needs prompt medical advice. Blisters should not be deliberately broken because the covering helps protect the underlying skin.

Ultraviolet A and ultraviolet B radiation can damage the DNA and structure of skin cells. The immune system responds with inflammation, widening small blood vessels and sending fluid and immune signals into the area. That response produces heat, redness and swelling.

Exposure is increased by unprotected time outdoors, reflective surfaces, high elevations and lamps that emit ultraviolet radiation. Windows block some ultraviolet radiation but do not remove every source of exposure.

Redness and discomfort may become clearer after exposure rather than immediately. Mild burns generally improve over several days as the surface repairs. Peeling can follow, and the new skin may be temporarily more sensitive. Repeated burns contribute to sun-damaged skin and can increase long-term skin-health concerns.

Risk is higher for skin that burns easily, for people with little natural pigmentation, and for anyone outdoors without protective clothing or shade. Children, people working outside and those using ultraviolet-emitting tanning equipment need particular care. Some medicines and topical products can increase sensitivity; a pharmacist or clinician can check your specific treatment list.

A clinician usually diagnoses sunburn by examining the skin and asking about recent ultraviolet exposure, symptoms and medicines. The location, extent, tenderness and presence of blisters help show how deep the injury may be. Tests are not usually needed for a straightforward burn, but severe symptoms may require assessment for heat illness or dehydration.

Move out of the sun, cool the skin with a cool damp cloth or shower, and drink fluids. A bland moisturiser or [Emollient Therapy](/treatments/medical-dermatology/emollient-therapy/) can ease dryness after cooling. Follow label directions for pain relief if suitable for you, and avoid ice directly on the skin.

Do not pick peeling skin or break blisters. A clinician may consider [Topical Corticosteroids](/treatments/medical-dermatology/topical-corticosteroids/) in selected inflammatory situations; these are not appropriate for every burn and should be used as directed.

Wear loose, soft clothing and avoid further ultraviolet exposure until the skin settles. Keep blisters clean and covered with a non-stick dressing if they open. Fragrance, scrubs and very hot water can sting injured skin, so choose gentle washing and moisturising.

Seek urgent care for widespread blistering, severe swelling, faintness, confusion, repeated vomiting, trouble drinking or signs of infection such as worsening pain, pus or spreading redness. Sun exposure can also injure the eyes; marked eye pain or vision changes warrant prompt assessment.

Plan outdoor activities around shade, use a broad-spectrum sunscreen as directed, and reapply after swimming or sweating. A wide-brimmed hat, sunglasses and densely woven clothing add physical protection. Check areas people often miss, such as ears, lips, scalp partings and the backs of hands.

A dermatologist can assess recurrent burns, unusual reactions to sunlight, extensive blistering or persistent changes after healing. Bring a list of medicines and describe when the exposure occurred, which areas were affected and whether symptoms such as fever or dizziness developed.