How to treat sunburns? (Management of 1st degree burns)

Dear burn surgeon, last weekend we spent a long time on the beach and my daughter had sunburn on her face. Now the skin is peeling off and I am wondering if we did not treat her well and is she going to have a scar?

Mrs Mabel

California.

USA

Sunburns is usually a first degree burn and does not need special physician care as first degree burns does not cause fluid loss and is not included in the calculation of burn percentage for fluid resuscitation. The patient usually has been exposed to sunlight for a long time as on the beach. The skin shows redness and when you press your fingertip on this area, there is blanching (skin becomes pale and pink again). The outermost layer of skin (epidermis) is intact but red. If there is blistering of skin then this is a 2^nd degree superficial burn and the management will be different as we have seen before..

Management of 2nd degree superficial burns- (2nd degree burns)
http://asktheburnsurgeon.blogspot.com/2010/01/management-of-2nd-degree-superficial.html

However patients with sunburns may have severe dehydration and should take plenty of fluid orally like water, juices or oral rehydration preparations. For small areas of sunburn, one should cover the area with a piece of cloth soaked in cold water. This will ease the pain and one can combine it with regular analgesics like ibuprofen, paracetamol, aspirin, diclofenac sodium etc. For burns that are extremely painful, a local anaesthetic like xylocaine can help. Avoid aspirin in children. For larger areas one can take a cold shower or soak in a bath tub. In children, this should be avoided for fear of hypothermia (abnormal lowering of body temperature). This can be followed up with applications of mild lotions or Aloe Vera preparations, or moisturisers. One should wear light and loose cotton clothing to avoid irritation of the burn area.

To avoid sunburns one should use a sunscreen with a SPF (sun protection factor) more than 25. If you are a fair complexion person, use one with an SPF greater than 45 to prevent sunburns. This burn usually heals in a week’s time.

First degree burns do not cause a scar normally and as the healing takes place the damaged epidermis may peel of slowly revealing the new epidermis underneath. Protect this new skin from sunlight by using a sunscreen and avoid direct bright sunlight for a few weeks.

So don’t worry Mrs. Mabel, your daughter should be fine by God’s grace.

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