When should I see a doctor for sunburn?

Globe and Mail

5 hours ago

Ask a Doctor is a series of physician-authored columns offering insights and advice on common health topics. It is not a substitute for seeking medical care.
As an emergency doctor, I've seen plenty of people come to the hospital with painful sunburns – sometimes severe enough to need medical care. Many of these patients were surprised by how quickly their skin turned red after an afternoon gardening or a walk in the park.
While most sunburns can be treated at home, some symptoms warrant a closer look. Here's what to do if you've already experienced sunburn – and how to protect your skin from sun exposure.
Sunburn is a type of radiation burn from excessive exposure to ultraviolet (UV) rays. Your skin reacts with inflammation that ranges from varying degrees of redness and pain to blisters and peeling. Here's what you can do to help:
If you notice any of the following, seek medical care right away:
There are two main types of UV rays: UVA and UVB. Both cause damage to skin components and DNA, leading to tanning, burns, accelerated aging and an increased risk of skin cancer over time.
You don't have to experience sunburn to sustain damage and even a single sunburn increases your lifetime risk of skin cancer. A tan also means injury, since your skin darkens in response to UV exposure to protect itself. That increased melanin production is actually a sign that DNA damage has already occurred.
Sunburns and bug bites are summer rites, but you can minimize the feeling of irritation
In Canada, UV levels peak between late spring and early fall, and are usually highest between 11 a.m. and 3 p.m., but UV rays don't stop outside these hours or seasons. Cloud cover does not block all UV; up to 80 per cent of rays can still reach you on overcast days. And harmful sunlight can also reach through windows or in your vehicle.
If you will be spending time outside, it's important to use a sunscreen with broad-spectrum protection that shields against both UVA and UBV rays. Pay attention to the sun-protection factor or SPF number. The Canadian Dermatology Association recommends sunscreen with a SPF 30 or higher.
Make sure to apply sunscreen generously 15 to 20 minutes before exposure. Be sure to reapply every two hours, and more often if sweating or swimming, and don't forget ears, neck, feet and scalp lines. For your lips, choose an SPF 30 or more lip balm, and reapply every hour.
Most people don't use enough sunscreen for it to be effective. Health Canada recommends adults use about a teaspoon of sunscreen to cover each area of exposed skin (e.g. a teaspoon for each arm). For just the face and neck, aim for about 1/2 a teaspoon.
Spray sunscreens are popular because of their ease of application, but it's difficult to know whether enough has been applied. If using a spray sunscreen, apply liberally until the skin is glistening, then rub the sunscreen in to get even coverage. For the head and neck, do not spray directly onto it to avoid inhaling the spray. Instead, spray a large amount onto your hands, then rub onto your face, ears and neck.
Looking for sunscreen advice? Listen to the experts, not social media
But remember that sunscreen alone won't protect you. Here's what I tell my patients:
Dr. Shazma Mithani is an emergency physician working with adult and pediatric patients in Edmonton. Dr. Mithani is actively involved with the Canadian Medical Association, Alberta Medical Association and Sexual Assault Centre of Edmonton. She is also co-host of The Doc Talk Podcast.