Sunburn: What happens to our skin?

Sun vs Skin

Our body needs sunlight to synthesize vitamin D which is important for its various functions. However, our exposure to the sun should be done early in the morning or late in the afternoon, and not at 3 in the afternoon nor with the hours as the effects of excessive and long-term exposure to the sun's ultraviolet radiation have been linked not only to premature aging skin and allergic reactions but also with pre-malignant and malignant lesions.

The deterioration of the skin, from exposure to the sun, occurs gradually, regardless of whether a sunburn is caused

The tan

When the sun's ultraviolet radiation (UV) is intense and/or when the skin is exposed to it for more than a few minutes, certain cells in the skin (called melanocytes) that contain its natural pigment, melanin, are activated. Melanin is secreted to protect the deeper layers of the skin from UV and is responsible for its tanning.

Clinical manifestations of sunburn range from simple, mild erythema to edema (swelling), blistering, and severe pain.

How is the burn caused?

When the skin does not naturally produce much melanin or the sun exposure is sudden and intense, the consequence is sunburn, as UV causes damage (mutations) in the DNA of the surface layer of skin cells (called keratinocytes).

The keratinocytes with the "damaged" DNA begin to produce certain molecules that attract immune cells to begin treating the problem. These immune-reactive cells reach the site of damage through blood, which escapes from the small vessels into the spaces between the cells and the various structures of the skin, causing the area to swell and redden, causing heat and pain.

Invasion of immune cells to the area begins soon after the damage, while the sufferer may still be at the beach, but increases significantly about an hour after leaving the sun and peaks 24 to 48 hours later – and this is precisely why the red and the pain of sunburn may be felt the next morning or evening.

When immune cells reach the site of damage, some of them begin to repair skin cells that are capable of repair, and others secrete chemicals that drive the most damaged cells to self-destruct. This is necessary because irreparable DNA damage paves the way. in the development of cancer.

The action of the immune cells can cause a local reaction in the skin resulting in pruritus (itching). In addition, several hours later blisters (blisters) may begin to form where entire layers of keratinocytes are destroyed, as each dead layer begins to separate from the underlying ones and the space between them fills with fluid.

When the inflammation subsides, the deeper layer of skin cells begin to grow rapidly to replace the dead cells. Post-sunburn peeling is essentially the shedding of layers of dead cells that are shed from the epidermis to make room for new ones. skin.

Damage to keratinocyte DNA also signals melanocytes to start producing melanin, which is why the skin appears tanned after the redness of the sunburn subsides. Melanin is spread over the skin cells to protect them from the next exposure to the sun, but in reality the protection it provides is as much as a sunscreen with an SPF equal to 2, so a previous tan does not protect us from solar radiation.

Signs of damage

All these reactions and symptoms practically mean one thing: the skin has been seriously damaged by the sun. When this happens often and especially at a young age (under 18) the risk of skin cancer increases because the immune cells are not able to repair all the DNA damage and some are reproduced in the new skin cells. Over time, these damages add up and at some point the skin cells may begin to reproduce uncontrollably, triggering the appearance of cancer.

Studies have shown that a sunburn every two years triples the risk of developing malignant melanoma, the most aggressive form of skin cancer.

Immediate Treatment of Sunburn

Cool the skin
Place a cool compress (not ice) on the skin for 15 minutes or take a cool shower/bath. Do not rub the skin with the towel, wipe it gently to avoid further irritation.

Moisturize the skin
Get a burn cream from the pharmacy to soothe the skin and speed up its healing. No oil, butter, oils and perfumes, no toothpastes that contain menthol and are more irritating. Prefer creams containing aloe, panthenol, calendula, calamine for immediate relief. It would be good to apply the product immediately after showering/bathing, so that the moisture is "locked" in the skin. You will need to repeat this step daily for several weeks to deal with the peeling.

Take a pain reliever
Fight pain and inflammation with a pain reliever/anti-inflammatory medication. It will take approximately two 24-hour treatments to achieve a satisfactory result.

Do not injure the skin
If blisters have formed on the skin, do not try to pop them, as scarring or infection may occur. The blisters will go away on their own within a few days. Use sterile dressing if needed to prevent infections. Wear comfortable and light cotton clothing during recovery.

Drink plenty of fluids
Sunburn is often associated with faster fluid loss through the skin. Make sure to drink plenty of water to prevent dehydration. Avoid drinking alcohol as it promotes dehydration.

Caution: If the sunburn is severe, then immediate medical intervention is needed. Visit your doctor or nearest hospital if you experience: blisters covering up to 20% of the skin, have severe swelling of the hands and feet so that they become numb or of the face and neck so that you have difficulty breathing, fever or chills, nausea , severe pain or headache, tendency to faint or dizziness.

Finally, the best treatment is definitely prevention, so let's enjoy the sun without forgetting:

• the appropriate sunscreen for our skin type with an SPF index greater than 30.
• sunglasses, hat and t-shirt, on the beach.
• Drink lots of fluids.
• Do not increase, abruptly, the time of exposure to the sun, but gradually.
• Avoid exposure to the sun between 11.00 and 16.00.
• Be aware that the sunscreen is not designed to increase the time of exposure to the sun, but to protect, so we often renew its application.
• The sun's ultraviolet radiation penetrates the clouds, so we put on sunscreen even on cloudy days and in the city.
• To protect, above all, babies and young children from exposure to the sun,
• Prolonged exposure to the sun in addition to a burn can cause heatstroke.

Sources:

American Academy of Dermatology, FDA.gov, American Cancer Society. Cancer Facts & Figures 2016, Hellenic Cancer Society, Hellenic Society of Pediatric Dermatology, European Academy of Dermatology and Venereology, Hellenic Society of Dermatology and Venereology (EDAE)