Reassurance and Education
Sunburns are caused by direct sun exposures (ultraviolet or UV light). Most sunburns are a first-degree burn that, like other burns, turn the skin pink or red, are warm to the touch and painful. Prolonged sun exposure can cause blistering and a second-degree burn. Severe sunburns can cause fever, chills, headache and general feeling of illness. Sunburns do not cause third-degree burns or scarring. Those with darker skin coloring tend to be less sensitive to the sun, but everyone is at risk for getting a sunburn. Damage to skin from the suns burning rays builds over time, since most sun damage occurs in childhood it is important to take the proper steps to protect your child.
Sunscreens → When used correctly sunscreen can protect this skin from sunburn and some skin cancers. Use a sunscreen with an SPF of 15 or higher. Fair-skinned children (with red or blond hair) need a sunscreen with an SPF of 30. Pick a sunscreen that says broad-spectrum on the bottle – this will protect your child from both UVA and UVB rays. More research is needed to conclude if sunscreens with more than SPF 50 offer any additional protection. Remember to use sunscreen any time your child is in the sun. 80% of the suns UV rays can penetrate through the clouds, causing a sunburn even on days with high cloud coverage or fog.
Application → Apply sunscreen 30 minutes before exposure to the sun to give it time to penetrate the skin. Give special attention to the areas most likely to become sunburned, such as the nose, ears, cheeks, and shoulders. Reapply sunscreen every 3 to 4 hours, as well as after swimming or profuse sweating. A waterproof sunscreen stays on for about 30 minutes in the water. Most people apply too little sunscreen, be sure to apply a generous amount with each application. The best way to prevent skin cancer is to prevent sunburns.
- Sunscreen for Babies → The skin of infants and toddlers is thinner and contains lower levels of protective melanin than the skin of older children, this causes them to be more sensitive to the sun’s rays.
- Babies less than 6 months old: Sun avoidance is recommended for babies less than 6 months of age. Try to keep babies under 6 months of age in the shade and out of direct sunlight. If they have to be in the sun, use sunscreens, longer clothing, and a hat with a brim. When sunscreen is needed, infants can use adult sunscreens (AAP recommendation) even though the FDA hasn`t approved their use under 6 months old. There are no reported harmful side effects from today`s sunscreens. Even licking off sunscreens is harmless.
- Babies more than 6 months old: Sun avoidance or protective clothing are recommended for children 6 months to 3 years. Apply sunscreen to all areas of the body, paying close attention to avoid contact with the eyes. If your baby rubs sunscreen into his/ her eyes, wipe their eyes with a damp cloth and clean your babies hands. If skin irritation from sunscreen occurs try switching to a different brand. If the irritation continues you should contact your pediatrician.
Mild sunburns can be treated at home without the need to see a doctor. The following care guidelines should help you care for your child at home.
- Ibuprofen for Pain → A sunburn is an inflammatory reaction of the skin; so anti-inflammatory drugs such as ibuprofen can reduce erythema and skin edema. Anti-inflammatory medication does need to be started early, if begun within 6 hours of sun exposure and continued for 2 days, they can greatly reduce the discomfort experienced. Use of Ibuprofen is not approved for children under 6 months of age. Redness from a sunburn usually doesn’t appear until 4 hours after sun exposure and will peak around 24-36 hours. For pain relief, start ibuprofen as soon as possible and administer every 6-8 hours. Follow the dosing chart based on your child’s current weight.
- Fluids – Offer More → Offer extra water on the first day to replace the fluids lost into the sunburn and to prevent dehydration and dizziness.
- Cool baths for pain → Apply cool compresses to the burned area several times a day to reduce pain and burning. For larger sunburns, give cool baths for 10 minutes (caution: avoid any chill). Add 2 ounces (60 ml) baking soda per tub and avoid using soap on the sunburn.
Additonal Sunburn Treatment
- Steroid Cream for Pain → Apply 1% hydrocortisone cream 3 times/day. If used early and continued for 2 days, it may reduce swelling and pain. Use a moisturizing cream until you are able to purchase the steroid cream. Avoid ointments because they can interfere with sweating and heat release.
- Protect Lips, Nose and Eyes → To prevent sunburned lips, apply a lip coating that contains sunscreen. If the nose or some other area has been repeatedly burned during the summer, protect it completely from all the sun`s rays with zinc oxide or titanium oxide ointment. Protect your child`s eyes from the sun`s rays with good sunglasses.
- High Risk Children → If your child has red or blond hair, fair-skin and never tans, he or she is at an increased risk for sunburn. These children need to use a sunscreen even for brief exposures and should avoid sun exposure whenever possible.
- High-Risk Time of Day → Avoid exposure to the sun during the hours of 10:00 AM to 4:00 PM, when the sun`s rays are most intense. Use caution on days of overcast, over 80% of the sun`s rays still get through the clouds. You can also get a sunburn while swimming and being under water only partially blocks the sun`s rays.
Pain from the sunburn usually resolves after 2 or 3 days. Peeling usually occurs day 5-7.
Call Your Doctor
If You should call your doctor if pain becomes severe, the sunburn looks infected or your child becomes worse.
(1) Barton D. Schmitt, MD, FAAP. David Thompson, MD. (2017) Volume 0
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