Skin cancer is the most prevalent form of cancer in the United States. Each year more than 1 million individuals are diagnosed with skin cancer. Moreover, >90% of all skin cancers are the result of excessive sun exposure.1Despite the constant reminders about avoiding overexposure to the sun, many cases of sunburn still occur, especially during the summer. Sun protection is equally important in the winter, because snow reflects up to 80% of the sun's rays and can cause sunburn and damage to uncovered skin.2 In addition, repeated overexposure to ultraviolet rays can cause drying and premature wrinkling of the skin.Repeated cases of sunburn can increase risk for melanoma skin cancer, especially in the pediatric population.3,4 Excessive unprotected overexposure to ultraviolet rays may also increase risk for developing ocular damage such as cataracts, and macular degeneration.4,5Sunburn is characterized by signs of erythema and dermal edema, as a result of an increase in blood flow to the affected area; pain; and skin irritation.3 The initial symptoms of sunburn may not be apparent for up to 4 hours after exposure and may peak between 12 and 24 hours following exposure.3 In general, the symptoms of mild-to-moderate sunburn are red, erythematous skin, tenderness, pain, and peeling of the affected skin. Severe cases may produce blisters and systemic flu-like symptoms that can include fever, weakness, and chills.3 Pharmacists always should advise individuals with severe cases of sunburn to seek immediate medical care to prevent further complications.Causes of Sunburn
Besides overexposure to the sun, the severity of the sunburn can depend on the following factors4,5:Skin complexion (individuals with light complexions have the highest risk of sunburn)Time, duration, and altitude of exposure to the sunUse of certain medications or skin preparations that may increase photosensitivityTreatment
Prior to recommending any products for treating sunburn, pharmacists should ascertain whether self-treatment is appropriate. In alleviating the symptoms of mild self-treatable cases of sunburn, the general goals of treatment should entail the following3:Providing adequate pain relief with regard to the sunburn areaPromoting healing of the affected area
Minimizing the incidence of skin irritation and preventing further complications such as development of an infection
Treatment of sunburn depends on the severity of the symptoms and typically incorporates both pharmacologic and nonpharmacologic measures. Pharmacologic measures can include various OTC products (such as topical aloe vera products), as well as topical hydrocortisone, topical anesthetics, or other skin protectants.
It is important to remind patients never to apply topical hydrocortisone to skin that is broken, because it may enable infections to develop.3,5 In addition, when appropriate, individuals may use systemic analgesics for the treatment of pain.
Pharmacists should remind those patients taking pharmacologic agents that may increase photosensitivity to always take precautionary measures, such as using sunscreen and wearing protective gear when out in the sun.
- 2007 Skin Cancer Facts. Skin Cancer Foundation Web site. Available at: www.skincancer.org/skincancer-facts.php.
- The Sun and Your Skin. American Academy of Dermatology Web site. Available at: www.aad.org/public/Publications/pamphlets/SunandSkin.
- Berardi R, Kroon LA, McDermott JH, et al, eds. Handbook of Nonprescription Drugs. 15th ed. Washington, DC: American Pharmacists Association; 2006. Chapter 41: 855-868.
- Sunburn and Sun Desensitizing Drugs. The MedicineNet Web site. Available at: www.medicinenet.com/sunburn_and_sun-sensitizing_drugs/page2.htm.
- Sunburn. Emedicinehealth.com Web site. Available at: www.emedicinehealth.com/script/main/art.asp?articlekey=58772&pf=3&page=1.