The issue
Short-term effects of sunburn include damage to the skin manifesting as immediate painful inflammation, peeling and possible blistering depending on the severity. Severe sunburn can lead to systemic symptoms causing fever, chills, dehydration, nausea, dizziness and headaches.
Long-term effects include permanent DNA damage, which could lead to skin cancer, and permanent damage to underlying structures in the skin that can lead to early skin aging, such as wrinkles, brown spots, blood vessel formation and red spots.
With more than a decade in the field, Dr. Kristen Whitney, a dermatologist with Allegheny Health Network, is here to aid in cooling your nerves about a number of seasonally topical concerns.
Q: At what point is a low SPF wholly ineffectual? For instance, women’s foundation carries an SPF of 15. Is that makeup really doing anything for you?
A: SPF measures the sunscreen’s level of protection from UVB rays (burning rays). It indicates the length of time your skin is protected from sunburn while wearing it, compared to the time it takes to burn without it.
For example, if you have very fair skin and would burn out in the sun in five minutes, using SPF 30 and applying would protect you for 150 minutes before you would start to burn.
In general, dermatologists and the American Academy of Dermatology recommend an SPF of 30, which blocks 97% of UVB rays, or above. SPF 50, which blocks 98% of UVB rays, is recommended when outside for extended periods of time, especially in the summertime when UVB rays are more intense.
SPF 15 blocks roughly 93% of UVB rays, providing adequate daily protection with minimal sun exposure. SPFs under 15 provide very minimal protection.
Both UVA and UVB rays are constant throughout the year and contribute to premature skin aging and skin cancer; however, UVB rays are more intense in the summer months. It’s important to make sure your sunscreen is broad spectrum, meaning it protects against both UVA and UVB rays.
Makeup with SPF in it is not a reliable source of sun protection. You would need to apply a lot of makeup to get the SPF listed on the product — roughly seven times the normal amount of foundation and 14 times the normal amount of powder. You can still wear makeup, but pair it with sunscreen. Alternatively, many people find tinted sunscreens are a good replacement for powder or foundation.
Q: On the other side of the SPF spectrum, is there a law of diminishing returns associated with super-high SPFs? If so, who actually needs them?
A: SPFs higher than 50 provide a little extra protection. Specifically, SPF 50 blocks 98% of UVB rays, while SPF 100 blocks 99%. Thus, higher SPF filters slightly more, but the difference is marginal. SPFs higher than 50 are recommended for high-risk people such as those with a previous history of skin cancer or autoimmune disease.
Q: How often should people reapply sunscreen? Does it differ from person to person or by age?
A: Sunscreen should be reapplied every two hours regardless of SPF number. If swimming or sweating, use water-resistant sunscreen. Water-resistant sunscreens are reported as 40 minutes or 80 minutes on the bottle, thus they would need to be reapplied accordingly every 40 or 80 minutes when swimming/sweating and after towel drying.
Sunscreen should be applied to children starting at 6 months of age.
In children, mineral-based sunscreens are recommended, with zinc and titanium as active ingredients.
Q: What are the pros and cons of using mineral-based sunscreen rather than typical varieties?
A: All patients can use mineral-based sunscreens. It is the preferred sunscreen in babies 6 months and older, children, patients with sensitive skin and pregnant patients.
It is a physical blocker, meaning the sunscreen sits on the top of the skin and blocks the sun’s rays, while nothing is absorbed systemically. However, these sunscreens may leave a white cast, depending on the formulation.
Chemical sunscreens are more easily absorbed into the skin, do not leave a white cast and are usually lightweight. But patients with sensitive skin may react to these products.
They also require 15 to 20 minutes after application before they are effective.
Q: For someone who has been burned a lot in the past, is there anything they can do beyond adequately protecting themselves moving forward to help prevent potential adverse long-term health effects like skin cancer?
A: For people with significant sun exposure, it is recommended to get an annual full body skin check by a dermatologist. Your doctor may recommend more frequent skin checks if atypical growths or other high-risk features are found. When skin cancer is caught early, it is highly treatable.
It is never too late to be consistent with sun protection. Studies have shown regular daily use of SPF 15 can reduce risk of developing squamous cell carcinoma of the skin by 40% and lower your risk of malignant melanoma by 50%.
In addition to sunscreen, wearing hats is an important part of protection. Broad-brimmed hats are better than baseball hats. Sun-protective clothes are also great, along with sunglasses that block UVA/UVB rays. Avoid midday sun exposure when the sun is strongest (10 a.m. and 4 p.m.), and seek shade whenever possible.
Q: Do clothes that claim to help protect you from the sun really work?
A: Sun-protective clothes are great. They are measured by UPF factor (ultraviolet protective factor), which indicates how much UV radiation a fabric allows to reach your skin. I recommend the clothes be UPF of 50 or higher.
Q: What are some lesser known or underrated methods of treating sunburn once you already have it?
A: Start by applying cool compresses to the affected areas, which can help to reduce heat and inflammation. Taking over-the-counter anti-inflammatory medications like ibuprofen or other NSAIDs (nonsteroidal anti-inflammatory drugs) can also significantly alleviate pain and swelling. Aloe vera gel is a classic remedy for a reason. Its soothing properties can provide much-needed relief. It’s also really important to stay well-hydrated by drinking plenty of water.
If your sunburn is moderate to severe, or if you develop blistering, fever or extreme pain, it’s crucial to be evaluated by a medical professional. They can assess whether additional prescription therapies might be necessary.
And I can’t emphasize this enough: Please learn from your mistakes! Underutilizing sunscreen, not applying it properly or not reapplying it frequently enough is almost always the culprit behind a sunburn.
Q: How do I know when my sunburn represents something more problematic than temporary peeling, itching and burning? What should I do?
A: In general, seek medical attention if large blisters, fever, significant pain, signs of infection, dizziness or if the sunburn is covering a significant portion of the body (20% or more). If in doubt, seek care from a medical professional.