Sunburn can occur with any unprotected exposure to natural or artificial ultraviolet (UV) light sources, such as the sun or tanning booths. The main injury responsible for sunburn is direct damage to DNA by UV light, resulting in the actual death of skin cells. The symptoms associated with sunburn are a result of this extreme damage to the outermost layer of skin called the epidermis.
The inflammation associated with the process of UV light damaging the DNA and killing off skin cells, causes the blood vessels in the skin to dilate, giving the characteristic lobster-red color we all associate with sunburn. The increased blood flow to the affected area may leave the skin itchy, warm or hot to the touch. This can happen within minutes of exposure or may occur as a delayed response hours or even days later. Usually the redness begins roughly three hours after sun exposure and peaks at 24 hours.
Depending on how severe the damage is, sunburn may or may not be accompanied by blisters on the skin. Just one blistering sunburn or five nonblistering sunburns in adolescence doubles your lifetime risk of developing the deadliest form of skin cancer (melanoma).
Headache and Fever
When we are exposed to disease or injury, our bodies mount what is called an inflammatory response. Because sunburn is a toxic insult to the skin, an inflammatory response inevitably occurs at varying degrees. This means that when UV light damages the cells, blood vessels in the surrounding tissues dilate and release chemicals such as histamine, bradykinin, cytokines and prostaglandins, which can result in a variety of symptoms, such as swelling of the skin, headache, fever, chills or malaise.
Nausea and Vomiting
Just like a virus or bacteria can cause nausea and/or vomiting as a result of the body’s inflammatory reaction, so can the damage caused by unprotected exposure to UV light. It is very important to remain hydrated should you experience nausea and/or vomiting.
When to Seek Medical Attention
In most cases, sunburns occur without severe symptoms and fade naturally within a week after exposure. These are the circumstances, however, for which one should seek the attention of a health care provider:
- If blisters are covering at least 20 percent of the skin’s surface. This condition poses a serious risk of infection, and one should seek medical attention immediately. Note: For reference, if a child has blistering on their entire chest and back, this is equal to about 26 percent of their body’s surface area. For an adult, blistering on the chest or back alone as well as the face equates to 22 percent body surface area.
- If the burn is accompanied by a high fever (102˚ F or higher), extreme pain, headache, confusion, nausea or chills, call the doctor — these symptoms may require additional supportive care, such as medication or IV fluids, until symptoms resolve.
- If there is yellow drainage from a blister or red streaking, this may mean that the burned area is infected. For these cases, see a doctor immediately because prescription medication or IV antibiotics may be warranted.
- If the sunburn does not resolve within a week or so, it may be a good idea to inform your doctor. The unprotected exposure to UV rays may have brought on another skin condition.