Skincare Case 115

This case involves a 31-year-old woman with Fitzpatrick skin type III and combination skin who has developed a sunburn on her shoulders, back, and thighs after swimming and sunbathing. The affected areas are red and inflamed, with a few small, intact blisters. The skin is sensitive and painful to touch. She applied sunscreen on her face but did not use any on her body. Following the sun exposure, she applied ice cubes directly to her shoulders and took cool showers and Tylenol for pain relief.

Causes

Sunburn occurs when the skin is exposed to ultraviolet (UV) radiation, either from the sun or artificial sources like tanning beds, for too long without adequate protection. The UV radiation damages the skin cells’ DNA and triggers inflammatory responses, leading to symptoms like redness, swelling, pain, and in severe cases, blistering.

What is Done Wrong

1. Lack of sun protection: The primary mistake was not applying sunscreen to her body, which directly led to the sunburn. Sunscreen should be used on all exposed skin, not just the face.
2. Applying ice directly to the skin: While cooling the skin can help relieve sunburn symptoms, applying ice directly can cause frostbite and further damage the skin. It’s better to apply a cool (not cold) compress or take a cool shower.
3. Ignoring the severity: Sunburns can be severe and potentially lead to long-term skin damage and increase the risk of skin cancer. It is important to seek medical attention if severe sunburn symptoms, such as blistering or severe pain, occur.

Office and Home Treatment Options

Office treatments:

1. In severe cases, a healthcare provider might recommend prescription-strength pain relievers, corticosteroid creams, or burn ointments.

Home treatments:

1. Over-the-counter pain relievers: Non-prescription pain relievers like ibuprofen can help reduce pain and inflammation.
2. Topical soothing creams: Aloe vera or hydrocortisone cream can help soothe the skin and reduce inflammation.
3. Cool compresses: Applying a cloth dampened with cool water to the sunburn can help soothe the skin.
4. Stay hydrated: Sunburn can cause fluid loss through the skin, so it’s important to drink plenty of water.
5. Avoid further sun exposure: This is critical to prevent further damage while the skin is healing.

Preventions

1. Use sunscreen: Apply a broad-spectrum sunscreen with an SPF of at least 30 on all exposed skin, and reapply every two hours and after swimming or sweating.
2. Wear protective clothing: Wide-brimmed hats, long sleeves, and pants can provide physical protection from the sun.
3. Seek shade: Especially during the peak sun intensity hours between 10 am and 4 pm.
4. Avoid tanning beds: They emit harmful UV rays that can cause skin damage and increase the risk of skin cancer.

Home Care Daily Routine

Morning:

1. Gently cleanse the skin with a mild cleanser.
2. Apply a soothing cream like aloe vera.
3. If going outside, apply broad-spectrum sunscreen with an SPF of at least 30.

Throughout the day:

1. Drink plenty of water to stay hydrated.
2. Reapply sunscreen every two hours and after sweating or swimming if outside.

Evening:

1. Gently cleanse the skin with a mild cleanser.
2. Apply a soothing cream or hydrocortisone cream to help reduce inflammation.
3. Take an over-the-counter pain reliever if needed.

Following a sunburn, the skin will be more sensitive to sun exposure. It’s important to take extra precautions to protect the skin and allow it to heal properly. Sunburned skin begins to heal by itself, but if the sunburn is severe, it’s important to seek medical attention.