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Sunburn - Part 3

Tests and diagnosis
Your doctor is likely to conduct a physical exam and to ask questions about your symptoms, UV exposure and sunburn history.
If you experience sunburns or skin reactions after relatively minor exposures to sunlight, your doctor may recommend phototesting. During phototesting, small areas of your skin are exposed to measured amounts of UVA and UVB light to try to reproduce the problem. If your skin reacts to the UV radiation, you're considered sensitive to sunlight (photosensitive).
Treatments and drugs
Sunburn treatment doesn't heal your skin or prevent damage to your skin, but it can reduce pain, swelling and discomfort. If at-home care doesn't help or your sunburn is very severe, your doctor can prescribe medication. These include:
  • Nonsteroidal anti-inflammatory drugs (NSAIDs). Both topical and oral NSAIDs relieve pain, swelling and inflammation and are especially beneficial when given during the first 24 hours of sun exposure. Prescription NSAIDs provide higher potencies than do over-the-counter drugs. In one study, people who were treated with the topical NSAID diclofenac (Voltaren, Solaraze) within hours of sun exposure showed a significant decrease in pain and swelling 48 hours after applying the medication. Keep in mind that oral NSAIDs may also irritate your stomach and intestine.
  • Corticosteroid medication. Topical corticosteroids may help relieve itching that occurs as your skin heals. Combining topical corticosteroids with either topical or oral NSAIDs may be more effective than using either one alone. Limited evidence supports the benefit of using oral steroids, such as prednisone, for sunburn. Using topical corticosteroids may cause thin skin, red lesions and acne.
Lifestyle and home remedies
Once sunburn occurs, you can't do much to limit damage to your skin. However, the following tips may reduce your pain and discomfort in the hours and days after sunburn:
  • Take anti-inflammatory medication, such as aspirin or ibuprofen (Advil, Motrin, others), on a regular basis according to the label instructions until redness and soreness subside. Use caution when giving aspirin to children or teenagers. Though aspirin is approved for use in children older than age 2, children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin. This is because aspirin intake has been linked to Reye's syndrome, a rare but potentially life-threatening condition, in such children. Talk to your doctor if you have concerns.
  • Apply cold compresses — such as a towel dampened with cool tap water — to the affected skin. Or take a cool bath or shower.
  • Apply a moisturizing cream, aloe vera lotion or hydrocortisone cream to affected skin. A low-dose (0.5 to 1 percent) hydrocortisone cream may decrease pain and swelling, and speed up healing.
  • If blisters form, don't break them. They contain your natural body fluid (serum) and are a protective layer. Also, breaking blisters slows the healing process and increases the risk of infection. If needed, lightly cover blisters with gauze. If blisters break on their own, apply an antibacterial cream.
  • Drink plenty of fluids. Sun exposure and heat can cause fluid loss through your skin. Be sure to replenish those fluids to prevent dehydration — when your body doesn't have enough water and other fluids to carry out its normal functions.
  • Treat peeling skin gently. Within a few days, the affected area may begin to peel. This is simply your body's way of getting rid of the top layer of damaged skin. While your skin is peeling, continue to use moisturizing cream.
Some products — such as topical "-caine" products, for example, benzocaine — claim to relieve sunburn pain. Some dermatologists warn against using these products because they can irritate the skin or cause an allergic reaction. Benzocaine has also been linked to a rare but serious, sometimes deadly, condition that decreases the amount of oxygen that the blood can carry. Don't use benzocaine in children younger than age 2 without supervision from a health care professional, as this age group has been the most affected. If you're an adult, never use more than the recommended dose of benzocaine and consider talking with your doctor.
Use these methods to prevent sunburn:
  • Avoid sun exposure between 10 a.m. and 4 p.m. Because the sun's rays are strongest during these hours, try to schedule outdoor activities for other times of the day. Seek shade whenever possible. If you're unable to avoid being in the sun, limit the amount of time you're outdoors during these peak hours.
  • Cover up. Wear tightly woven clothing that covers your arms and legs, and a broad-brimmed hat, which provides more protection than does a baseball cap or golf visor. Also consider wearing clothing or outdoor gear specially designed to provide sun protection.
  • Use sunscreen frequently and liberally. Use a broad-spectrum sunscreen with an SPF of 15 or greater. The American Academy of Dermatology currently recommends using a broad-spectrum sunscreen with an SPF of 30 or more. Apply sunscreen generously, and reapply every two hours — or more often if you're swimming or perspiring. Even the best sunscreen might be less effective than the SPF number on the bottle would lead you to believe if it isn't applied thoroughly or thickly enough, or if it's perspired away or washed off while swimming. Use it even on cloudy or hazy days. UV rays can penetrate cloud cover.
  • Wear sunglasses when outdoors. Look for a manufacturer's label that says the sunglasses block 99 or 100 percent of all UV light. To be even more effective, choose sunglasses that fit close to your face or have wraparound frames that block sunlight from all angles.
Some people try getting a "base" tan to prevent sunburn. The idea is that a few sessions of indoor tanning will protect them from burning in the sun. There's no scientific proof that this is true. A base tan is no substitute for sound sun protection. Plus, the risks of long-term tanning outweigh the unproven benefits of a base tan.

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