Health Education

What your doctor can (and can’t) do for a bad sunburn

Dawn Weinberger headshot By | June 27, 2019

It is common knowledge that sunburns damage the skin and increase the risk of skin cancer, but did you know that according to the Skin Cancer Foundation your risk for melanoma doubles if you’ve had five or more sunburns in your lifetime?

While that information alone is enough to keep many people out of the sun’s harmful rays, plenty continue to leave their skin unprotected (or even just under protected). In fact, the CDC reports that in 2010 alone 37.5 percent of adults indicated that they had been sunburned within the past year. That means that most of us have experienced at least one really bad sunburn in our life. And if you have, you know how painful it can be.

“Sun can damage the skin so severely,” says Dr. Dathan Hamann, a board-certified dermatologist and medical director at the Contact Dermatitis Institute in Phoenix, Arizona. “In addition to having redness and blisters and pain, you can actually have the death of the top layer of skin and the significant inflammation (from this) can actually affect the whole body. You can get a fever, chills, almost flu-like symptoms from a severe sunburn.”

The obvious solution is prevention, says Dr. Hamann. This, he says, means staying away from the sun during peak danger hours (between 10 a.m. and 2 p.m.), staying in the shade, covering up with hats, sunglasses and protective clothing and using sunscreen, repeatedly.

But what if it is too late? What if you accidentally fall asleep on the beach and wake up with a second degree burn—in pain, blistery, and looking like a lobster? Will your doctor prescribe something, like a topical corticosteroid or some other cream, to relieve the discomfort and help your skin heal?

Unfortunately, probably not—a 2008 study found that treating sunburns with topical corticosteroids like hydrocortisone or betamethasone is not particularly useful. Instead, doctors tend to recommend a cold compress, ibuprofen, and a soothing cream (such as aloe or petroleum jelly), says Dr. Nik Eshragi, a burn surgeon with The Oregon Clinic and director of the Oregon Burn Center at Legacy Emmanuel Hospital in Portland, Oregon.

If a sunburn is so severe that prescription medication is recommended, the patient would probably be hospitalized, Dr. Eshragi says. And even then, a sunburn is usually treated in other ways first, like with proper wound care, pain medication (NSAIDS or prescription meds, depending on pain level), and the same types of soothing creams used for less severe burns.

“In the burn world, we don’t treat with (topical) steroids unless we have a very specific reason to,” he says, explaining that these reasons might include a situation where someone is experiencing an immune reaction to sun exposure (in the form of welts or hives) or has open wounds related to their burn.

The best way to find out if your sunburn requires something more than the standard protocol of a cold compress, ibuprofen, and a soothing cream? Talk to your doctor!

“Some [doctors] do recommend a mild- to moderate-potency topical steroid,” says Dr. Hamann. “But it is really the exception, not the rule.”

He also emphasizes the importance of seeking medical attention if a severe sunburn is accompanied by fever, chills, lethargy, and dehydration.

“If someone is having significant systemic symptoms … things like that need to be managed by more than one doctor in a hospital setting,” he says.

It goes without saying, but the best thing you can do is to take preventative steps anytime you’re in the sun so that it never reaches that critical stage.