Some Basics...

• Sunburn is skin damage from exposure to the sun or ultraviolet (UV) light.
• Sun or UV light exposure can also cause eye damage. This is called photokeratitis.
• Sunburn may cause a first-degree (redness and pain) or a second-degree (blistering) burn to the sun-exposed areas of the body.
• Long-term sun exposure increases the risk for skin cancer and causes aging of the skin.

Symptoms

• First Degree Sunburn: Most sunburn is a first-degree burn which turns the skin pink or red. The pain and swelling starts at 4 hours, peaks at 24 hours, and improves after 48 hours.
• Second Degree: Prolonged sun exposure can cause blistering and a second-degree burn.
• Third Degree: Sunburn never causes a third-degree burn or scarring.

Causes

• The Sun
• Tanning lamps
• Broken mercury-vapor lamps (overhead lighting): Damaged mercury-vapor (metal halide) lamps are known to cause UV-radiation "sunburns" and photokeratitis (corneal irritation).

What is Photokeratitis?

Photokeratitis can be thought of as a sunburn of the cornea. Exposure to intense light can cause corneal irritation (keratitis), especially if a person uses inadequate eye protection.

• Pain: Usually bilateral eye pain, tearing, and light bothers eyes.
• Vision Loss: Usually minimal vision change (haziness) to none. More severe photokeratitis can cause blurred vision. All people with blurred vision require medical evaluation. In skiers, photokeratitis is referred to as "snow blindness."
• Causes: This is most commonly seen in individuals with inadequate eye protection while outside on a bright sunny day (water sports, snow skiing). It can also occur in people who do not use eye protection while using a tanning booth. This can also occur in welders.

1. What You Should Know:
   • Sunburn is skin damage from exposure to the sun or ultraviolet (UV) light. Sun or UV light exposure can also cause eye damage.
   • You can treat mild sunburn and mild photokeratitis at home.
   • Here is some care advice that should help.
2. Pain Medicine: You can take ibuprofen (Advil or Motrin) if you have pain. Take them within 6 hours of sun exposure and keep taking them for 2 days. If you can't take ibuprofen, use acetaminophen (Tylenol) instead.
   • You can take one of the drugs listed below if you are in pain.
   • They are over-the-counter (OTC) pain drugs. You can buy them at the drugstore.
   Acetaminophen (Tylenol):
   • Regular Strength Tylenol: Take 2 pills (650 mg) every 4-6 hours. Each pill has 325 mg of acetaminophen.
   • Extra Strength Tylenol: Take 2 pills (1,000 mg) every 8 hours. Each pill has 500 mg of acetaminophen.
   • Do not take more than 3,000 mg of this drug per day.
   Ibuprofen (Motrin, Advil):
   • Motrin and Advil: Take 2 pills (400 mg) every 6 hours. Each pill has 200 mg of ibuprofen.
   • A second choice is to take 3 pills (600 mg) every 8 hours.
   Extra Notes:
   • Use the lowest amount of a drug that makes your pain feel better.
   • Your doctor might tell you to take more than what is shown above. That is because your doctor knows you and your health problems.
   • Acetaminophen is safer than ibuprofen in people over 65 years old. Acetaminophen is in many OTC and prescription drugs. It might be in more than one drug you are taking. Be careful how you take. Too much of this drug can hurt the liver.
   • Caution - Acetaminophen: Do not take it if you have liver disease.
   • Caution - Ibuprofen:
     • Do not take ibuprofen if you are pregnant.
     • Do not take this drug if you have stomach problems or kidney disease.
     • Do not take this drug for more than 7 days without checking with your doctor.
   • Read all package instructions.
3. Hydrocortisone Cream: Put on 1% hydrocortisone cream as soon as you can. Do this 3 times a day for 2 days. If you use it right away, it may help with the swelling and pain. If you don't have any, use a moisturizing cream until you can get some.
   • Keep the cream in the fridge. It feels better if put on cold.
   • Sold OTC in the United States as 0.5% and 1% cream.
   • Sold OTC in Canada as 0.5% cream.
4. Cool Baths:
   • Put a cool wet towel on the burned area a few times a day. This will help with the pain and burning.
   • For larger sunburns, take cool a shower or bath for 5-10 minutes. Be careful to avoid getting a chill. Add 2 oz. baking soda per bath. Avoid putting soap on the sunburn.
5. Extra Fluids: Drink extra water on the first day. This will replace lost fluids and prevent dehydration and dizziness.
6. Broken Blisters:
   • For broken blisters, trim off the dead skin with small sharp scissors. Clean the scissors with rubbing alcohol before and after use. Trimming the skin helps to prevent infection.
   • Put antibiotic ointment (like Bacitracin) on the raw skin under broken blisters. Put it on 2 times a day for 3 days.
   • Caution: Leave unbroken blisters alone. Unbroken blisters protect the skin and help it to heal.
7. What to Expect: Pain most often stops after 2 or 3 days. Skin flaking and peeling most often happen 5-7 days after the sunburn.
8. Call Your Doctor If:
   • Pain becomes severe and is not better after taking pain medication
   • Pain is not better after 3 days
   • Sunburn looks infected
   • You get worse

1. Photokeratitis:
   • Definition: Photokeratitis can be thought of as a sunburn of the cornea. Being exposed to intense light can cause corneal irritation. This often happens if a person does not use good eye protection.
   • Causes: This often happens to people who use poor eye protection in the sun. It can happen while snow skiing or playing water sports. It also happens to people who use tanning booths without eye protection. This can also happen to welders.
2. Eye Treatment:
   • Put cool wet compresses onto your eyes.
   • Try to rest with your eyes closed.
   • Do not wear contacts until your eyes get better.
   • Avoid rubbing your eyes.
3. What to Expect:
   • Symptoms should fully go away over the next 24 hours. There should be no permanent damage to the cornea.
   • You can prevent future eye problems from the sun by wearing sunglasses.
4. Call Your Doctor If:
   • Severe pain is not better after pain medicine
   • Pain lasts more than 3 days
   • Pus or yellow/green discharge occurs
   • Blurry eyesight occurs
   • You get worse

1. Reduce Sun Exposure:
   • Try to avoid being in the sun between 10 AM and 3 PM.
   • You can get a sunburn while swimming. Water only blocks some of the UV radiation.
2. Clothing:
   • Wear a wide-brim hat; it protects your face and neck from the sun.
   • When outdoors, wear long-sleeved shirts and long pants.
3. Use Sunscreen:
   • Put sunscreen on areas that cannot be covered by clothing. An adult needs about 1 oz. of sunscreen lotion to cover the whole body.
   • You should put on sunscreen again every 2-4 hours. You should also put it on again after swimming or sweating.
   • A sunscreen with a rating of SPF 15-30 should be used. Sunscreens over SPF 30 only give you a little extra sun protection.
   • Sunscreens help prevent sunburn, but do not prevent all skin damage. Sun exposure can still increase your risk of skin aging and skin cancer.
4. Vitamins C and E: These are anti-oxidants. This means that they help prevent sun damage to cells in your skin. Taking these vitamins may help reduce the sunburn reaction.
   • The adult dose of Vitamin C (ascorbic acid) is 2 grams. Take this 1 time a day.
   • Adult dose of Vitamin E (d-alpha-tocopherol) is 1000 IU. Take this 1 time a day.
   • Caution: Prevention is the key. Try to reduce your time in the sun and use sunscreens.
   • Read all package instructions.