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Pediatric - Sunburn

Sunburn

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First Aid - Heat Exhaustion
First Aid - Heat Exhaustion

Sunburn - Face
Sunburn - Face

Sunburn - Back
Sunburn - Back

Definition
  • Red or blistered skin from sun overexposure
  • The pain and swelling starts at 4 hours, peaks at 24 hours, and improves after 48 hours

Degrees of Sunburn

  • Most sunburn is a first-degree burn that turns the skin pink or red.
  • Prolonged sun exposure can cause blistering and a second-degree burn.
  • Sunburn never causes a third-degree burn or scarring.
When to Call Your Doctor

Call 911 Now (your child may need an ambulance) If
  • Passed out or too weak to stand
Call Your Doctor Now (night or day) If
  • Your child looks or acts very sick
  • Fever above 104° F (40° C)
  • Unable to look at lights because of eye pain
  • Extremely painful sunburn
  • Looks infected (e.g., draining pus, red streaks, increasing tenderness after day 2)
Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If
  • You think your child needs to be seen
  • Large blisters (over ½ inch or 1.25 cm)
  • Many small blisters
  • Swollen feet interfere with walking
  • Blisters on the face
Call Your Doctor During Weekday Office Hours If
  • You have other questions or concerns
Parent Care at Home If
  • Mild sunburn and you don't think your child needs to be seen
HOME CARE ADVICE FOR MILD SUNBURN

Treating Mild Sunburn
  1. Ibuprofen: Start ibuprofen (e.g., Advil or Motrin) for pain relief ASAP if age older than 6 months (Reason: If this anti-inflammatory agent is begun within 6 hours of sun exposure and continued for 2 days, it can reduce the swelling and discomfort experienced).
  2. Steroid Cream:
    • Apply 1% hydrocortisone cream ASAP 3 times/day.
    • If used early and continued for 2 days, it may reduce swelling and pain.
    • Use a moisturizing cream until you can get some.
  3. Cool Baths:
    • Apply cool compresses to the burned area several times a day to reduce pain and burning.
    • For larger sunburns, give cool baths for 10 minutes (caution: avoid any chill). Add 2 oz. baking soda per tub.
    • Avoid soap on the sunburn.
  4. Extra Fluids: Offer extra water on the first day to replace the fluids lost into the sunburn and to prevent dehydration and dizziness.
  5. Blisters:
    • Caution: leave closed blisters alone. (Reason: to prevent infection)
    • For broken blisters, trim off the dead skin with a fine scissors cleaned with rubbing alcohol.
  6. Antibiotic Ointment:
    • For any large open blisters, apply an over-the-counter antibiotic ointment. Remove it with warm water and reapply it twice a day for 3 days.
  7. Expected Course: Pain usually stops after 2 or 3 days. Peeling usually occurs day 5-7.
  8. Call Your Doctor If:
    • Pain becomes severe
    • Sunburn looks infected
    • Your child becomes worse
Preventing Sunburn
  1. Sunscreens: Use a sunscreen with an SPF of 15 or higher. Fair-skinned children (with red or blond hair) need a sunscreen with an SPF of 30.
    • Apply sunscreen 30 minutes before exposure to the sun to give it time to penetrate the skin. Give special attention to the areas most likely to become sunburned, such as the nose, ears, cheeks, and shoulders.
    • Reapply sunscreen every 3 to 4 hours, as well as after swimming or profuse sweating. A "waterproof" sunscreen stays on for about 30 minutes in water.
    • Most people apply too little sunscreen. The average adult requires 1 ounce of sunscreen per application.
    • The best way to prevent skin cancer is to prevent sunburns.
  2. Infants and Sunscreens:
    • The skin of infants is thinner than the skin of older children and more sensitive to the sun. Therefore, try to keep babies under 6 months of age in the shade and out of direct sunlight. If they have to be in the sun, use sunscreens, longer clothing, and a hat with a brim.
    • When a sunscreen is needed, infants can use adult sunscreens (AAP recommendation) even though the FDA hasn't approved their use under 6 months old. There are no reported harmful side effects from today's sunscreens.
  3. Protect lips, nose and eyes:
    • To prevent sunburned lips, apply a lip coating that contains sunscreen.
    • If the nose or some other area has been repeatedly burned during the summer, protect it completely from all the sun's rays with zinc oxide or titanium oxide ointment.
    • Protect your child's eyes from the sun's rays and cataracts with good sunglasses.
  4. High-risk Children:
    • If your child has red or blond hair, fair-skin and never tans, he or she is at increased risk for sunburn.
    • These children need to use a sunscreen even for brief exposures.
    • They should avoid sun exposure whenever possible.
  5. Time of Day: Avoid exposure to the sun during the hours of 10:00 AM to 3:00 PM, when the sun's rays are most intense. Caution: When overcast, over 70% of the sun's rays still get through the clouds.

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.


Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 1/19/2009

Last Revised: 8/5/2007

Content Set: Pediatric HouseCalls Online

Copyright 1994-2009 Barton D. Schmitt, M.D.

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