August 14,  2008

Island Medicine:  Preventing and treating sunburn


Welcome!  For those of you that do not know me I am Alexis Hodges. Most folks on the island know me as Alex.  I am an owner of the recently opened Hatteras Island Family Medicine in Frisco and a family nurse practitioner.  I am also a mother of four busy children and the wife of Dr. Al Hodges.  I am looking forward to utilizing some of my journalism heritage (My mother was an editor and publisher.) and bringing interesting and informative medical information to islanders and visitors.

One of the most frequent calls we get in the summer is what to do for sunburn.  Unfortunately, sunburn can strike very quickly, and often you do not realize it is happening.  It can appear within just a few hours after exposure to the sun, but it can take several days or even weeks to fade. No one is immune to this, and I can tell you as a resident of the island and mother of four children, whose ages range from 5 to 13, I, too, have had sunburn strike in the Hodges household.  Knowing how to prevent it doesn’t always mean that it doesn’t happen. 

Sunburn is caused by too much exposure to UV or ultraviolet light.  UV light causes your skin to produce melanin at a faster rate.  Melanin is the dark pigment that gives your skin the darker color.  The extra melanin is produced to protect the skin’s deeper layers, which actually creates the “tan.”  A suntan is actually your body’s way of blocking the UV rays to prevent sunburn and other damage.  As much as 90 percent of UV rays can pass through the clouds, so you can get burned on a cloudy or hazy day. 

Sunburn symptoms may include pinkness or redness of the skin, skin that is hot or just warm to the touch, pain or tenderness, swelling, blistering, eyes that feel painful or even gritty, and if the sunburn covers a large area, headache, fever, and fatigue.  It is best to be seen by a health care provider if you have any of the following -- the blistering covers a large portion of the body, is accompanied by high fever, extreme pain, confusion, vomiting or diarrhea, or does not respond to at home treatment.  Also if you believe there is an infection, seek treatment. The symptoms of infection include increasing pain and tenderness, increasing swelling, yellow drainage from a blister (pus), or red streaks leading from a blister.

Treatment of sunburn will not heal the skin or prevent damage, but it can reduce pain, discomfort, and swelling. If you do not have any other medical conditions, you can try at home treatment. If your symptoms are severe or they do not improve with treatment, seek medical attention.  Take anti-inflammatory medications, such as ibuprofen or aspirin, on a regular basis, unless you have been told not take them, apply cool compresses (cool towel or cool bath), drink lots of fluids, and do not drink alcohol. Do not break blisters. If they break on their own, apply an antibacterial cream.  Use aloe vera gel without lidocaine or other additives. This is green in color. 

Usually sunburn will resolve on its own within days or weeks, depending on the severity of the burn. 

The best way to avoid sunburn is to prevent it.  You are not only preventing the pain of the burn but also the damage of the UV rays that can lead to premature aging of your skin and skin cancer.  Burning of the eyes can actually lead to progressive clouding of the lens or cataracts.

Prevention includes:

Avoid the sun between 10 a.m. and 4 p.m.  This is when the sun’s rays are the strongest.  Try to schedule outdoor activities during other times and seek shade whenever possible.  I realize this is extreme, but we often try, especially this time of year with heat indexes so high, to go out just a bit later so we can enjoy that much more time outside. 

Cover up. Wear lightly woven clothing and a broad-brimmed hat. Rash guards make an excellent choice and have saved the day many times to allow a child back into the sun.  Baseball caps or visors do not provide enough protection.  Sun protection clothing is an excellent choice.  A few of the island watermen are leading by example on this one with shirts, etc. 

Thankfully sunscreen has improved since I was a child, and it is much more user friendly!  The best rule of thumb is to apply sunscreen frequently and liberally. Apply it 30 minutes before going outside and re-apply every two hours or sooner if in the water or perspiring.  This is a must even on cloudy days.  A good SPF is 30.  Our kids will tell you that we have everyone apply sunscreen before we go out, using lotions and easy to use face sticks to make sure everything is covered.

A large percentage of sunburns occur because sunscreen was not re-applied. Once we are outside enjoying the day, we use the sprays that are easier to reapply and quicker to get six of us back into the action. We generally wait just a few minutes to allow the sunscreen to be absorbed before we return to the water. There are probably a few folks who have heard me lecture the kids at the pool about getting out of the water to get more sunscreen.  I know it is not always an easy task, especially with kids who tan and mom does not!

Wear sunglasses that block 99-100 percent of all UV light.  Kids especially love glasses, so make this fun.  We’ve had a pair of crab glasses for 10 years that are still going strong. You might see little Al wearing these on the beach! 

(Alex Hodges is a family nurse practitioner and an owner of Hatteras Island Family Medicine in Frisco. If you have suggestions for topics you would like to see covered, please visit and click the email link for her. She will do her best to see that your ideas are addressed.  She cannot address specific medical questions.)

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