Sunburn

Sunburn is an inflammatory reaction of the skin resulting from excessive exposure to ultraviolet (UV) radiation from the sun or artificial sources (e.g., tanning beds). The underlying mechanism of injury is the destructive effect of UV rays on the DNA of epidermal cells, which can lead to the activation of inflammatory cascades, the formation of free radicals, and ultimately to cell damage. Clinically, sunburn presents with erythema, swelling, pain, and, in severe cases, the formation of blisters that may become infected. Chronic exposure to UV radiation significantly increases the risk of developing various forms of skin cancer, including melanoma.

History of the disease and interesting historical facts

Sunburn has been known to mankind throughout history. In ancient Rome and Greece, where the sun played an important role in life and culture, sunburn was also quite common. The first medical descriptions of skin damage caused by solar radiation appeared in the works of Hippocrates, who pointed out the need to protect the skin from sun exposure. In the Middle Ages, although knowledge of sun protection was limited, some cultures already used oils and ointments to reduce skin inflammation. In the 20th century, with the increasing popularity of tanning, professions that involved full or partial nudity began to pay more attention to sunburn. Research conducted in the last third of the century established a relationship between regular sunburn and an increased risk of melanoma, which led to active campaigns to raise awareness and the introduction of sun protection products.

Epidemiology

According to statistics from the World Health Organization (WHO), sunburn affects a significant number of people worldwide, especially in the summer season. Approximately 30% of the adult population suffers from sunburn each year, with young people aged 15 to 29 years being at highest risk. Sunburn is also common in children and adolescents, highlighting the need for preventive measures. An increase in sunburn, as well as skin cancer, is observed in countries with high sun exposure, such as Australia and the United States. Research shows that more than 5 episodes of sunburn in a lifetime can increase the risk of developing melanoma by 80%.

Genetic predisposition to this disease

Genetic susceptibility to sunburn varies depending on phenotypic variations related to skin, hair and eye colour. It is known that people with lighter skin (Fitzpatrick phenotypes I and II) have a significantly higher risk of sunburn. In addition, susceptibility may be associated with mutations in genes responsible for protecting the skin from UV radiation, such as genes encoding proteins involved in DNA repair (e.g., Xeroderma pigmentosum genes). Research suggests that high variability in the antioxidant defence system due to polymorphisms in the relevant genes may also predispose to greater skin reactivity to sun exposure.

Risk factors for the development of this disease

The main risk factors for sunburn are:

• Prolonged exposure to the sun without adequate protection.
• High intensity of ultraviolet radiation in certain geographic areas.
• A light skin type characterized by low melanin content.
• Lack of adequate sun protection cosmetics, such as creams with SPF.
• Artificial tanning (solariums).
• Certain medications increase the skin's sensitivity to light.
• Genetic predisposition.

A comprehensive understanding of these factors allows for more targeted preventive measures.

Diagnosis of this disease

Diagnosis of sunburn is mainly based on clinical examination of the patient. Visual symptoms such as erythema, swelling, and the presence of blisters allow for rapid diagnosis. Symptoms can range from mild soreness and redness of the skin to more severe forms, including vesicular eczema and signs of intoxication (e.g., nausea, malaise).

Laboratory tests are not required but may be useful in cases of severe burns to rule out infectious complications. Radiological studies are not required but may be used if deeper tissue damage is suspected.

In the differential diagnosis, it is important to exclude other skin diseases that may present with similar symptoms, such as contact dermatitis, eczema or allergic reactions.

Treatment

Treatment for sunburn is primarily aimed at relieving symptoms and supporting the natural healing process. General recommendations include:

• Avoid contact with the sun until the skin is completely healed.
• Cooling compresses to reduce inflammation and pain.
• Use moisturizers to maintain skin hydration.

Pharmacological treatment may include nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve pain. In more severe cases, corticosteroids may be prescribed to reduce inflammation.

Surgical treatment may be necessary if blisters develop and infection develops, requiring drainage and treatment of the burn area.

Complementary treatments such as phototherapy become relevant in cases where conventional methods do not bring relief.

List of medications used to treat this disease

The main medications prepared for the treatment of sunburn include:

• Ibuprofen (NSAID) - to relieve pain and inflammation.
• Ketoprofen gel - for local use.
• Hydrocortisone ointment - to reduce inflammation locally.
• Aloe Vera - to soothe and moisturize the skin.
• Antibiotic ointment - in cases of increased risk of infections.

Disease monitoring

Monitoring after sunburn involves regularly assessing the skin and monitoring for complications such as infections. The prognosis is generally good, and most mild cases heal without sequelae. However, there are risks, especially if the patient has had repeated sunburns, which can lead to chronic changes and increase the likelihood of developing melanoma. Complications can include secondary infections and long-term pain.

Age-related features of the disease

Sunburn manifests itself differently in different age groups. Newborns and infants have very sensitive skin to UV radiation, so special care and protection are required. Sunburn is also common in children and adolescents, especially in the summer when they spend more time outdoors. In older people, progressive skin aging can increase the risk of burns and slow down the healing process. Therefore, preventive measures should be adapted to the age group.

Questions and Answers

• What is sunburn? Sunburn is an inflammatory reaction of the skin to excessive exposure to ultraviolet radiation, causing redness, swelling and pain.
• What are the main symptoms of sunburn? The main symptoms include erythema, swelling, tenderness and, in severe cases, blistering.
• Is it possible to avoid sunburn? Yes, using sunscreen with a high SPF, wearing protective clothing, and avoiding the sun during the middle of the day can help prevent sunburn.
• What medical care should be provided for sunburn? It is important to keep the affected area cool, use moisturizers and, if necessary, sedatives; in severe cases, medical attention may be required.
• What are the risks of recurrent sunburn? Repeated sunburn increases the risk of developing skin cancer, including melanoma, so it is important to monitor your skin and take preventative measures.