As summer begins, it is important to remember to protect our skin when we are in the sun, but sometimes even when we do our best to prevent it, we still get burned. Here are my top tips and tricks for how to take care of your skin after spending a little too much time in the sun.
What should you do immediately after you notice a sunburn?
If you get sunburned, take an anti-inflammatory like ibuprofen to help with the redness and pain, and drink plenty of water. If you are feeling hot or light-headed, take a cool shower, and coat the sunburned areas with a hydrating ointment to protect the skin. Studies show that damaged skin heals faster when occluded with an ointment, allowing keratinocytes to divide and migrate in a moist environment.
What should you do in the days after you have a sunburn?
Stay out of the sun, drink plenty of water and protect the damaged skin with a gentle moisturizer or healing ointment if blistered to prevent additional water loss.
What types of ingredients can help soothe sunburns and help the skin heal? Do you have any shopping tips for sunburn relief products?
The funny thing is that aloe has never been shown to protect the skin from sunburns or speed the healing of burns. It is 99% water, and the after-sun products are often in a gel which is also primarily water, so there is a cooling sensation as the gel evaporates, which feels good on hot skin. A sunburn is a significant assault on the skin. The sun's rays are radiation that damages the skin cells by causing mutation in our DNA. These mutations then must be corrected, or the cells die. The redness of sunburn comes from blood vessels in that area becoming dilated to bring oxygen and nutrients to damaged skin to help repair it. The blistering and peeling are dead skin cells that are too damaged to repair.
What can help?
If blistered, the RESTORE Healing Balm is a plant-based ointment made with castor seed oil shown to inhibit inflammation and glycerin, which pulls water to the damaged skin. It is also hypoallergenic and speeds healing without petroleum. It is a better, cleaner option than Vaseline but more expensive because of the selective, higher-quality ingredients. If your budget doesn't stretch, I recommend pure petroleum jelly over other ointments such as Neosporin, Polysporin, and Aquaphor, which are common causes of allergy now. Over-the-counter topical antibiotics contain Neomycin and Bacitracin, which are "Top-10 Sensitizers" per the North American Contact Dermatitis Group, with reported rates of reaction as high as 34%. Decades of use have led to widespread resistance, so they're also ineffective. Lanolin, a key ingredient in Aquaphor, has never been shown to aid in healing, and the incidence of allergy is rapidly increasing. A recent study of 1,012 children found 66% of kids with eczema and 29% without reacting to lanolin when patch tested. You don't want to use this stuff on raw skin because more ingredients are absorbed, and the risk of allergy is increased.
If the skin is intact, use a supportive moisturizer that will hydrate and heal the dried-out sunburnt skin without causing more irritation. Look for products containing squalene, shea butter, ceramides, centella asiatica, and glycerin. Be aware that many products on the market do not help and often further harm the skin. Once the skin is damaged, the barrier is not intact, and it will absorb more of whatever you put on it, making it more susceptible to irritation, so you have to be selective. Only use products that are safe for sensitive skin and/or certified by the National Eczema Association.
Can you name some of your favorite sunburn relief products and explain why you recommend them?
How often should you be applying these products?
When the skin is burned, it loses water very quickly, and water is required for it to heal. Therefore, if possible, apply a hydrating moisturizer as often as you can and drink plenty of water.
At what point should you see a doctor about your sunburn?
All burns are classified by degrees, including sunburns.
-1st-degree burns affect the epidermis only (first layer of skin, first degree) and typically heal in 4 to 5 days without scarring. These burn types are best treated with ointment to protect the skin while it heals.
-2nd-degree superficial burns affect the epidermis and superficial layer of the dermis (second layer, second degree), often blisters, and heal in 12 to 14 days, typically without scarring. They can be best treated with ointment and bandages over raw skin.
-2nd degree deep burns affect the epidermis and deep dermis, causing blistering and scarring. They take 3 to 4 weeks to heal and may need surgery and antibiotics in addition to ointments and bandages.
-3rd-degree burns affect the epidermis, dermis, and fat (three layers, third-degree) and can affect muscle and even bone. These burn types often need skin grafting and can take months to heal.
You should see a physician if you have a 2nd-degree burn with blistering that is not healing.
Lastly, as summer approaches, I must remind everyone that sunscreen is just one part of protecting your skin. We've come a long way with a UPF rating (the term used for sun-protective apparel). There are now easy-to-find, quality rash guards and sun shirts in various styles. Hats and sunglasses protect your face, eyes, ears, and head. Aside from the cosmetic concerns of wrinkles, age spots, and broken blood vessels from the sun's radiation, its damaging effects cause cancer. The number of women under 40 diagnosed with melanoma has more than doubled in the last 30 years, while the incidence of squamous cell carcinoma has increased almost seven times. We can and need to do a better job of protecting ourselves, and it starts with being smart about safeguarding our skin which protects us from skin cancer and aging.
Dr. Rogers is faculty at the University of Washington School of Medicine, a member of the AAD Media Team, the founder of Doctor Rogers Skin Care, and co-founder of Modern Dermatology in Seattle, WA.