How to prevent and treat sunburn
Rudyard Kipling once said that only mad dogs and Englishmen go out in the midday sun, as one study found (and any beach on a sunny Bank Holiday will attest to).
According to a May 2023 YouGov survey to mark Sun Awareness Week, 40 per cent of people in the UK reported at least one case of sunburn in the previous year.
Meanwhile, 33 per cent admitted they try to get a tan either through sun bathing or spending time in the sun without protection. But just how safe is this?
The UK sun is strong enough to cause sunburn from mid-March through to mid-October, and experts say you can suffer sunburn even on cool or cloudy days. Here’s everything you need to know to protect yourself…
What exactly is sunburn and how does it affect the skin?
“Sunburn results from damage to the skin cells and DNA by UVB rays,” says Dr Emma Wedgeworth of the British Cosmetic Dermatology Group. “The body tries to repair this damage and produces an inflammatory response, which causes the redness, swelling and pain of sunburn.”
“It’s a form of skin damage and something to be avoided because it increases your risk of developing skin cancer,” says Dr Bav Shergill from the British Association of Dermatologists (BDA).
UVB stands for ultraviolet-B, which is a type of radiation emitted from the sun. While it can offer some health benefits, like vitamin D, it also carries health risks like sunburn. The chance of which depends on factors like the time of year, the time of day, and cloud cover. And certain skin types, like fair and freckled, are more prone to damage. But regardless of skin type, repeated sunburn can cause premature skin ageing, and increase skin cancer risk.
Identifying symptoms of sunburn
According to the NHS, you may have sunburn if you’ve spent time in the sun and your skin feels hot to the touch, and sore or painful. If you have white skin, your skin will usually go red or pink after too much or unprotected sun exposure, but if you have black or brown skin, you may not notice a change in the colour of your skin.
“When you have a sunburn, your skin will also feel inflamed and tight,” says Dr Shergill, “as well as hot or warm to the touch, and tenderness or soreness is not unusual. Even if you don’t burn there is no such thing as a safe tan.
Severe sunburn symptoms, for which you should call your GP, or NHS 111, include:
If your skin is blistered or swollen
Your temperature is very high
You feel hot and shivery
You feel very tired, dizzy and sick
Severe sunburn can lead to heatstroke or heat exhaustion. This is particularly true for babies, young children, or the elderly.
Sometimes the damage is even invisible: “Whilst by definition, sunburn is redness of the skin, there can be damage to the skin even without it becoming red, which is known as suberythemal damage,” says Dr Wedgeworth.
Prevention and protection
Stay out of the sun between 11am-3pm
Cover up and wear at least SPF 30
Put cream on at least 20 minutes before sun exposure
An ounce of prevention is worth a pound of cure, when it comes to sunburn.
“The best way to protect your skin from too much sun is to spend time in the shade, especially between 11am and 3pm in the UK,” says Beth Vincent, a health information manager at Cancer Research UK. “Cover up with a shirt that covers your shoulders, a hat and sunglasses. Wear sunscreen with at least SPF 30 and four or five stars on the parts of your body you can’t cover with clothes – make sure you put plenty on and reapply it regularly.”
“The good news is sunburn is entirely preventable,” says Dr Wedgeworth. And there are three pillars of sun protection, he says:
Behaviour – avoid exposing skin to direct sunlight for long periods of time or when the rays are strongest between
Clothing to cover you
High broad spectrum sun protection, which needs to be applied generously. As a guide, use two finger lengths for the face and two tablespoons for the whole body
“Put it on 20 minutes before going outside, and then repeat every two hours or after you’ve had an activity which may have rubbed it off, like swimming, running, or even towelling yourself dry,” adds Dr Shergill.
“It is also fairly easy to underestimate a sunburn, especially if there’s a cool breeze or you’re in and out of cool water, which can make you not notice you are getting burnt because you don’t immediately feel the effects.”
How to protect sensitive areas from sunburn
As well as the tips above, don’t forget to cover up and apply sunscreen to places like the tops of your ears, hair parting (or whole head if you’re bald), the back of your neck, and the tops of the feet, especially if you’re wearing sandals. These areas are often overlooked, but easily burnt. Lips can also get sunburnt, so use a sun-blocking lip balm that contains SPF.
Treating sunburn
Moisturise
Take painkillers
Have a cool shower and rehydrate
“The best way to treat a sunburn is to not get one in the first place, because once that damage is done to your skin there is no reversing it or the risks it carries,” says Dr Shergill. “However, if you do experience sunburn the first thing to do is get out of the sun, preferably somewhere cool and shaded.
“Some ways to deal with it include soothing moisturisers to help ease the pain of sunburnt skin, and anti-inflammatory medications like ibuprofen to help with pain management.”
A cool shower will help, along with drinking plenty of water to prevent dehydration, and apply after-sun cream liberally. There is no evidence from clinical studies that aloe vera helps heal sunburn.
Sunburn risks and long-term effects – who is at most risk?
Those with fair skin, freckles or moles
People with a family history of skin cancer
Infants, children and the under-20s
Anybody can get sunburn, including those with black and brown skin. While darker skins have more melanin than fairer ones, meaning they’re better protected from sun damage, there is still some risk and they’re less likely to detect it.
Melanin is a substance in your body that determines hair, skin and eye colour, and the more you produce the darker these things will be and the more natural protection they’ll have from the sun.
Therefore those with fair skin, freckles, several moles, a family history of skin cancer, or who are only exposed to intense sun occasionally, should take extra care. Those who are in a very hot country should also be extra vigilant, along with people who spend a lot of time in the sun, for example those who work for long periods of the day outside.
Children playing sports outdoors in the summer months should also take extra care. “A sunburn is skin damage for everyone, regardless of their age,” says Dr Shergill. “But for children and babies it is especially important to protect them from the sun.
Studies show that approximately one-quarter of the lifetime UV damage suffered by our skin occurs before the age of 20, which increases the risk of getting skin cancer later in life. Teaching your child healthy sun safety habits is going to be helpful in both the short and long term.
“Sunscreen is actually not always recommended for infants under six months,” he adds. “This is because they have a higher surface-area to body-weight ratio compared with older children and adults, which means that a baby’s exposure to the chemicals in sunscreens is greater, possibly increasing the risk of an unwanted reaction. Therefore the best approach is to keep infants under six months out of direct sun and in the shade as much as possible, not only to reduce their UV exposure but also to reduce the heat load on the baby.”
Can sunburn lead to skin cancer?
Yes, unequivocally. “Getting sunburnt just once every two years can triple the risk of developing melanoma skin cancer, compared to never being burnt,” says Vincent.
Dr Shergill agrees: “Repeated exposure, and repeated sunburn increases your risk of developing skin cancer later in life. Skin cancer is currently the most common type of cancer in the UK, with an estimate of over one quarter of a million cases being diagnosed annually.”
There are two types of skin cancer – melanoma and non-melanoma. With non-melanoma you have basal cell carcinoma and squamous cell carcinoma. Basal cell is the most common (accounting for about 75 per cent of skin cancers) and it won’t spread and won’t kill you, but if left untreated it will continue to get bigger and form an ulcer.
Squamous cells rarely spread but they can and will also need to be removed. Melanoma is the most serious form of skin cancer, and if it’s caught early the survival rate is almost 100 per cent. However, if it’s left it can spread to other organs in the body and survival rates then rapidly drop.
How long does it take for sunburn to heal?
The pain is usually at its worst a few hours post-exposure and up to 48 hours afterwards, and how long your sunburn takes to heal will depend on its severity. “After a few days, your skin may begin to peel or flake, which should then heal,” says Dr Shergill. It’s important to avoid sun exposure until your skin is fully healed.
However, Dr Wedgeworth says whilst the sunburn will fade in a few days, “the damage to skin’s DNA and genes may be permanent, which is why sunburn is a significant risk factor for skin cancers”.
Is sunscreen necessary on cloudy days?
Yes. “Sunburn doesn’t just happen on the hottest days, you can still get burnt even when it’s cloudy,” says Vincent. While it’s true that clouds do offer a small amount of protection, over 90 per cent of UV rays still pass through them and potentially cause sunburn.
